Advocates Worry Mental Health First Aid Skirts Serious Mental Illness

Here is an article from U.S. News that describes the conflict between actual mental health care and mental health first aid.  Although I firmly believe that more cities, towns, groups, etc. should be involved in getting mental health care to their population, I also am afraid that this action will be seen as dealing with the mental health crisis when in fact it is not.

People with severe mental illness are living their lives out in our communities without benefit of any treatment due to stigma, lack of available care, lack of funding, and in some cases due to the issues of the actual mental illness.  The truth is that many people with mental illness never receive any care at all.

Please read this article and see what you think about this issue.


Advocates Worry Mental Health First Aid Skirts Serious Mental Illness

Advocates for people with severe mental illness say the mental health training doesn’t address the most dire needs.

By Kimberly Leonard | Staff Writer Sept. 12, 2016, at 6:50 p.m.

Advocates of mental health first aid hope to make the program as common as CPR training.(ISTOCKPHOTO)

A bill that would expand a program aimed at training ordinary people to recognize and intercede when they see signs of mental health issues in others is raising concerns among critics who say it takes the focus away from millions of Americans with serious mental illnesses who are unable to get medical care.

The eight-hour first-aid course, which sponsors hope to make as common as CPR training, provides trainees with information about how to listen to a loved one or to a stranger and to assess their risks for suicide or whether they are struggling with an addiction. Trainees also receive information to share about resources in the community, including doctors and social workers, that they can make people aware of.

Run by the National Council for Behavioral Health, a nonprofit comprised of mental health and addiction treatment groups, and the Missouri Department of Mental Health, the first-aid trainings in recent years have received $15 million in federal funding. More than 600,000 Americans, including first lady Michelle Obama, have taken the course.

Federal funding at this time is specifically allocated to train people who interact with youths because it was rolled out as part of President Barack Obama’s response to gun violence following the elementary school shootings in Newtown, Connecticut.

Members of Congress and the National Council for Behavioral Health are hoping the program can reach even more people and are backing the Mental Health First Aid Act, introduced by Rep. Lynn Jenkins, R-Kan. and Rep. Doris Matsui, D-Calif., which would allow for its expansion. Introductory statements on the bill began in subcommittee Monday.

 But advocates for people with serious mental illness are concerned that this type of legislation draws limited resources away from the 3.4 million people with untreated mental illness who need higher levels of care – and who also have the hardest time getting it. They point to cases of schizophrenia and bipolar disorder, in which people often become homeless or incarcerated and do not know that they are having delusions. Even when referred for services, they are unable to get them because not enough psychiatrists or hospitals are available. The training program, they say, is geared mostly toward people who want to assist less-severe mental health cases in which people are more likely to acknowledge they need help.

“Parents of the seriously mentally ill beg for treatment and cannot get it,” says DJ Jaffe, executive director of, who called mental health first aid a “sideshow” not aimed at serious mental illness.

Evidence shows mental health providers are lacking. According to Mental Health America, a mental health nonprofit, the availability of mental health professionals ranges across the country from 250 patients per provider in some states to 1,100 patients per provider in others. In addition, data from the Department of Health and Human Services show that 55 percent of U.S. counties, all of which are rural, do not have practicing psychiatrists, psychologists or social workers.

“You have to put serious mental illness in such a different category of all other medical issues because the system is so starved and so struggling,” says John Snook, executive director of the Treatment Advocacy Center, which advocates on behalf of people with serious mental illness. “[Mental Health first aid] is really helpful to start the conversation but it’s not going to stop the shortage of psychiatrists and the decriminalization of people with mental illness.”

Snook is concerned that Congress will see a bill like this as addressing the holes in mental health treatment, while ignoring other issues.

“We have concerns when they are being pitched as an alternative to other programs that are more expensive and more complicated,” he says, pointing to the example of crisis-intervention programs, often given to first responders like police and emergency departments.

Mental health reform has been a leading topic of medical discussion at the Capitol recent years. Obama’s health care law was supposed to expand coverage to behavioral health providers, but some loopholes remain. Members of Congress have sought to close some of the gaps, including looking at ways to make more hospital beds available. The legislation in the House and Senate have been tied up with gun-related amendments that could doom their passage.

Rep. Tim Murphy, R-Pa., a psychologist who introduced the House legislation, the Helping Families in Mental Health Crisis Act, says the awareness first-aid programs bring to mental health is helpful, but he agrees providers are lacking.

“It’s like saying we’ll invest people in training on how to identify a hear attack, but then we don’t have cardiologists and hospitals to send them to,” he says. “Our emphasis has to be on increasing investments where they are needed.”

Responding to questions about the benefits of these programs, Rebecca Farley, senior director of policy and advocacy at the National Council for Behavioral Health, pointed out that people gradually develop signs of mental illness.

“Symptoms might develop over time,” she says. “The sooner you are able to intervene in a person’s life, the better your long-term prognosis is.”

Still, she acknowledged better investments were needed to help people at different stages of their illnesses. Supporters of mental health first aid also say the training includes strategies for helping people with serious mental illnesses.

Despite some concerns, the program is gaining traction. A Senate companion was introduced by Sen. Kelly Ayotte, R-N.H. and Sen. Richard Blumenthal, D-Conn., and partners in the first-aid program include Aetna, Mental Health America and Sandy Hook Promise. New York City is aiming to train a quarter-million residents, and corrections officers in Pennsylvania and Rhode Island have received training.

“Training community leaders to recognize warning signs and provide appropriate aid can help all people dealing with a mental health issue, no matter the severity,” the House bill’s co-sponsor, Jenkins, said in an emailed statement. “This legislation would be a strong step in the right direction towards a more comprehensive safety net for mental health in America.”

Both Jenkins and her co-sponsor Matsui, as well as the National Council for Behavioral Health, supported Murphy’s legislation.

In an emailed statement, Matsui said the House had made progress with the passage of Murphy’s bill, which included policies she fought for.

“The Mental Health First Aid Act is one more step forward in our efforts to bring mental health out of the shadows,” she said, adding that more work was need, including addressing the workforce shortage and making sure mental health care is reimbursed in a similar way as physical care.

“I will keep working to ensure we are making needed investments in the entire spectrum of mental health care, from prevention to crisis, so that families receive the comprehensive support they need,” she said.

Those in favor of the training point to statistics that show 1 in 5 people in the U.S. has some kind of mental health disorder, often anxiety or depression. In vouching for the program’s effectiveness, the National Council on Behavioral Health points to studies from Australia, where the program was first developed, among others, which suggest training makes people more confident and reduces stigma.

Jaffe, however, says the program’s effectiveness should be measured based on whether more people go on to seek and receive services successfully.

“Treating the seriously mentally ill is the elephant in the room and first aid is another way to ignore it,” he says.

Updated on Sept. 13, 2016: This story has been updated to include information about support for the Helping Families in Mental Health Crisis Act and treatment for serious mental illness, as well as quotes from Rep. Doris Matsui. (read the article here)

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