Learning to spot first signs of mind trouble

New course helps professionals to recognise mental illness

Betty Kitchener is urging people to be alert to the early signs of mental illness. Photo: Jason Borg

Betty Kitchener is urging people to be alert to the early signs of mental illness. Photo: Jason Borg

Paul is not his usual self: though he’s usually good at his work, he does not seem to be communicating as much, he looks tired and worried, is skipping lunch, complains of headaches and is not as sharp as he used to be.

They could, of course, be flu symptoms but, more importantly, they may well be the first signs of clinical depression, mental health educator Betty Kitchener warns.

Like any other physical illness, early intervention is key. Completing a course in mental health first aid helps equip people with the ability to spot the first warning signs in a friend, relative, colleague, neighbour or even in themselves and intervene before it develops into a full-blown crisis.

Ms Kitchener, CEO of Mental Health First Aid Australia, is in Malta to train Richmond Foundation mental health professionals.

The foundation plans to target professionals, such as police officers, people working with asylum seekers, paramedics and those offering support to victims of crime. The course will later be opened to the public.

Many depressed people focus on the frozen past or imagined future

The 12-hour course, split over four sessions, helps unravel the many myths and misunderstandings clouding people’s idea of mental health problems.

“Members of the public have no knowledge of picking up the early warning signs,” Ms Kitchener says.

“People often get help when they are quite severe or in a crisis, such as when they are suicidal, acutely psychotic (out of touch with reality) or have panic attacks. They would have had the symptoms for months.”

World Health Organisation studies have shown that certain mental health illnesses are more disabling than some physical ailments.

“Severe post-traumatic stress disorder is as disabling as a person in a wheelchair. It affects the person’s ability to find enjoyment and to keep a job.

“The good news is that there is a lot of know-how now about treatment, including non-medical options. Talking therapy, exercise and other complementary therapies help people with mild to moderate mental health illness,” Ms Kitchener notes.

Symptoms of mental health problems appear as an entire cluster that are all consistently present for at least four weeks. Once the symptoms are detected, one should approach the person in as a non-judgemental way as possible.

“So, for instance, if it’s a work colleague, you can invite him for lunch. He might first decline but, by showing empathy and care, he will eventually open up.

“You must listen non-judgementally. The worst thing you can ask is ‘why?’ Go for open-ended questions. Be very conscious of your non-verbal cues: do not fidget with your watch or phone and do not interrupt the person,” she advises.

The appropriate professional help should then be encouraged.

But what if the person refuses help?

Unfortunately, Ms Kitchener says, some people refuse help due to common misconceptions that being diagnosed with depression means they will be sacked, that their relationship will break down or that they would have to go on medication.

If people don’t want to go to the doctor, other support should be encouraged such as individuals who can help or self-help books based on cognitive behavioural therapy.

“Many depressed people focus on the frozen past or imagined future. Cognitive behavioural therapy helps them focus on the present. Exercise helps improve one’s mood, so you might invite your colleague. And offer help and support – we make allowances when a person is physically sick. Mental illness is no different,” Ms Kitchener says.

Action plan

Approach, assess and assist with any crisis
Listen non-judgmentally
Give support and information
Encourage appropriate professional help
Encourage other supports


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