Mental Health First Aid for Everyone - Practical Do's and Don'ts for Real Life

Okay, we're going to get started. I'm going to introduce myself first and thank you all for joining us in this important training. This is a training that is meant really for anyone who's not necessarily in the mental health professional field, but people who encounter, which really applies to everyone, but people who encounter mental health issues around them, people who encounter things where they want to be able to appropriately respond and react to mental challenges around them, uh, situations where it can be tricky to know what to do and also just as importantly, what not to do. So, we're going to talk about some of those things that apply to us uh in our experiences with other people. My name is Avi Landanda. I have a background in mental health. I got my degree and training in clinical counseling. I'm a licensed mental health professional. I have a private practice. I also work in Tamudal Academy of Baltimore as a Mashki counselor for the middle school for the high school. I also work at Ammudim which is the sponsoring organization of this training as the director of education prevention and awareness. And this is certainly an area that we feel is important to be able to help people have even just an initial awareness and initial education on the topic of mental health and how to uh handle people and how to guide people in their in their interactions with people who are struggling with mental health issues. And really, it's often the case that these strategies and these techniques work in almost every interpersonal relationship in our lives. Many of us, all of us at one time time or another are overwhelmed by emotion. That's just what it means to be to be a human being. And so when we are ourselves overwhelmed, when our family members and the people that we're living our lives with and people that we interact with on a regular basis are overwhelmed with emotion, you know, maybe we wouldn't call it something that's diagnosible as a mental health challenge, but it's certainly something that needs to be dealt with in a mental healthy informed way. And so these techniques are important for people in general. Okay, so let's get started. There are a number of points that I want to make in the few minutes that we have. We have about 40 minutes that I want to try to accomplish this in and obviously we can have follow-ups. We can we can request to go more in depth in certain details. But I want to make sure that we cover some basic points. The structure of the outline of what I want to discuss today is that I want to go over the most basic and common psychological issues that might be around us. And then I want to get into in each one of those like what are the dos and don'ts. And then we want to talk about empathy as a general tactic that can help de-stress, deescalate, and handle almost any mental health challenge that one might be presented with. So, let's start with some of the most common basic mental health issues that people struggle with in the world. The four that I want to make sure to touch on are ADHD, that's attention deficit hyperactivity disorder, uh the Asperger spectrum, anxiety, and depression. Let's start with ADHD. ADHD really is something which is a deficiency in a person's ability ultimately to control impulsivity. That's why there's actually been a movement amongst therapists and psychologists recently to dissolve with the term ADD and rather call everything ADHD. There's ADHD, attention deficit hyperactivity disorder that is attent that is predominantly hyperactivity, hyperactive type. And then there's the one that's predominantly inattentive type. But everything is called ADHD. And the question would be sometimes you have the kids or the people that are very wild due to ADHD. But you could also have those people who seem to be just totally spaced out due to ADHD. Why would you call it hyperactive? And that really cuts to the core of what ADHD is all about. What it's all about is a slowed down filtering part of the brain. Which is why when we have a person suffering with ADHD, it is actually a stimulant. It's a little strange when you think about it, a stimulant medication that is prescribed to help the person with ADHD because it's not, you would think you want to slow them down. It stimulates actually the filtering part of the brain, that preffrontal cortex that in split-second speed helps to filter some of our impulses. So, everyone notices the fly flying by their face at any moment. But people with a healthy filtering part of their brain instantly recognize, well, no, I got to pay attention to the teacher, the training, the the rules of the place that I'm in right now. That's more important than that flying by. Whereas somebody suffering with ADHD would have much less of a chance catching that in time and they would get distracted more easily. For some people that means that they get a bump and they immediately and we all may immediately think, "Hey, that person's being mean to me or that person's being aggressive with me. I'm going to turn around and punch them." But just as soon as that thought comes, it may not even make it into our conscious brain. The filtering part of the brain comes and says, "Hold on one second. There might be another explanation. Let's not jump to impulsive conclusions. For the ADHD person, wildly and out of control, it looks like they're not in control of their impulses. So therefore, when it comes to a person struggling with ADHD, so if there's a Hatsala member responding to a call and part of the call includes, which sometimes the dispatchers can be good with in terms of describing the whole situation that this is a child, teenager or adult that struggles with ADHD, we would expect that there's going to be a layer and a level of impulsivity. And just that knowledge itself is very important. It's not that we are looking at it as necessarily intentionally violent or aggressive, carefully thought out behavior or dangerous behavior, but rather lack of thought, lack of filtering, lack of control that therefore brings about. And if you think about it that way, just a little bit of time can change the whole dynamic of the emergency scene that you're at. If you're a teacher in a room, if you're a parent with children, same idea. Just a little bit of time and separation can change that whole dynamic because it allows that filtering part of the brain to catch up. Obviously, many times the height and heat of the emotional intensity does not allow even some time to catch everything back up, but that's certainly a first go-to thing when you think about the fact that it's a lack of impulse control, whether it's the spaced out type or whether it's the more hyper type of ADHD. So, it's really important to think about lack of impulse control when we think about ADHD, giving it some time and sometimes also just palming the whole like the more uh the more sensory inputs there are for the person, the more that there's a lot of people in the room, the much more difficult it's going to be to restore some of that basic impulse control. So, taking the person into a quiet room, one-on-one, twoon-one, where there's just few people in the room, and allowing that to be done in a calm, cool, and collected conversation, even if they're getting all flustered, you're staying calm, everything's going to be okay. That can really help the person regain a basic sense of control in terms of the impulsivity that's at the heart of the struggle with ADHD. That's ADHD. That's something to think about when it comes to ADHD in general. Asperger spectrum is something that can often look, believe it or not, in behavior similar to ADHD. I mean, if you get to know the people over time, you're going to be able to see pretty stark differences, but when you're encountering something all of a sudden, so this is the first interaction, you may see behavior. So, let's go back to that case where they get bumped and they turn around and punch the person. For the ADHD person, it's because that first impulsive thought that for the regular person is immediately counteracted by, well, maybe there's another explanation. Maybe it was an accident. It just triggers that punch. For the asberers person, it's the same punch. They'll turn around and punch the guy in this example in this muscle. Same same idea, but it's coming from a very different place. The way that I like to describe it is that Asperger spectrum disorder is more a deficiency in the ability to have the knowledge. In other words, the knowledge that there may be another explanation for what took place is really at the heart of what's going on with Asperers. Whereas the ability to access that knowledge is really at the heart of what's at going on by ADHD. Let me try to make this a little sharper with with an idea. There is an intervention that therapists like to try to offer their clients, their patients. Sometimes school counselors do this called social skills training groups. So they'll devise a group. You could do it with adults as well. And you'll come together and you'll bring up a bunch of scenarios where where you'll roleplay and you're act you'll act out what are some of the different uh things that can happen that can trigger some intensity and some difficulty and some challenges for the people in your group. what are the right ways to deal with it and let's try to get used to that and habituate to that and let's try to avoid the wrong ways of dealing with those types of social interactions. That type of group generally is extremely poor and not a great intervention for someone with ADHD and it's a fabulous intervention for someone with Asperers. And the reason for that is if you would take a written test of a 100 social scenarios and in a calm room where there's no distraction and there's incentive to focus, the ADHD person would get a 100 on that test if that's all they're struggling with. And by the way, many times you have comorbid situations where people are struggling with more than one diagnosis. So you could have ADHD plus asberers and they each play on each other's weaknesses and it becomes very challenging for therapists to treat. But let's just understand each each struggle, each challenge in and of itself in its pure form. The ADHD person who just has ADHD, he will get a 100 on that test. The knowledge is there like any other person his age has that knowledge. It's not a deficiency in knowledge and therefore they understand exactly what to do in all these social circumstances. It's that in the heat of the moment they get bumped. There's the distraction. There's something that happens right in front of them. at that moment, the ability to access the knowledge in usually the split-second time frame that they need to access it before they react impulsively. That's where they struggle. And again, that's why stimulant medication can help because it stimulates the filtering part of the brain that immediately responds to that first impulse and says, "Wait, there might be another thing going on here." before the reaction happens. So therefore, the social skills training group where you're trying to teach them in many different ways and many different approaches and different angles is really not what the ADHD person maybe if you take the same people that often trigger the ADHD person and you put them in the room with the and you repeat and repeat maybe you can get them to have a little bit more of an ability to keep on the forefront of their mind impulse control and maybe therefore they'll have more of a chance of accessing the knowledge they have. But with Asperers, it's not like that as well as what at all. With Asperers, it's that they are deficient in the knowledge and they can gain tremendously from the social skills training groups and from being creative and using all sorts of ways to teach and educate the deficiency of knowledge that they have. Hopefully that makes it a little bit more crisp and clear in terms of how you could have that same behavior coming from two different places. So now what happens as lay people if we come across a situation again as a hot solemn member responding as a parent helping a child as a teacher in a classroom we have somebody who instead of ADHD where we talked about giving them some time with the Asperers person giving them time is really not something that's going to be all too helpful I mean time can always be something which helps people calm down a little bit separating them from the situation but with the ADHD person it's actually striking to the root of the problem just the fact that you're giving them some time to think through in a calm environment. With Aspberers, that's not really getting to the root. You actually, if you're going to give them some time, you want to take the time to sit and actually talk them through. Hey, let's talk about what just happened. What could we have done differently? Do you want to try and go through some of those things in a non-threatening positive type of way? No blaming or anything else like that. And you can get the person to turn around, be more focused on positive solution focused thinking, and you can get them to uh respond more appropriately. So really in in that giving of time to the ADHD kid, he could feel that he's being insulted and not understood if you're like going through like what could we have done differently like to them to them like I knew what to do but I felt so strongly not so therefore it's really just the time itself a little bit of a difference a subtle difference there but a big difference in terms of the person feeling understood and the person feeling like okay let me try this I got this and that can be very helpful. So getting that information and noticing it also again it can be hard to see it in action but when you know and you understand with a clarity the difference between these two. So yeah in the hot solo response or in any other type of response and interaction with these people with these challenges you can start to look for some signs. You can look for like I tried to explain it a little bit. they seem to really having a hard time understanding and then it leans you more towards Asperers and the intervention like we discussed with Asperers. Whereas if they got it and they're just reacting, reacting, reacting, then it's more the impulsivity that's at the heart of ADHD. So good ideas to keep in mind. Let's talk about anxiety and depression, which actually are extremely common in our populations. So anxiety in general is a disorder that anxiety itself is a character a part of our character that we have with very purposeful intent. It is a very helpful it is a very purposeful uh useful trait that we have as human beings. If I'm walking and taking a hike in the woods and I see something big, brown and furry in the distance lift its head up towards me and start to approach me, all of a sudden a bunch of physiological, physical things are going to happen in my body. And this is purposefully. I will have more energy, adrenaline rush. I will have crisper vision. I will have increased heart rate and breathing, bringing more oxygen to my organs, to my muscles. All sorts of things are happening that make me very on edge, but also give me a much better chance of survival. Whether that's going to be fighting or fleeing, fight or flight, or even freezing, hiding, trying to remove myself from the situation as best as possible. All of those are to help my survival when there is a threat of danger. The question becomes, what happens if I'm not in a dangerous situation at all? So there's nothing big, brown, and furry out in the distance that I see. Or perhaps I'm inside a building with four walls around me, and I still feel that same feeling like there's some danger bearing down on me. That is where anxiety starts to become what we call an anxiety disorder. So anxiety itself is a perfectly normal human response. And this is a very important thing for emergency response people to keep in mind. If we come upon a emergency situation and we see somebody breathing very very laboredly and and they're they're in this very onedge state of mind and they just went through or witnessed something traumatic, something that represented true and apparent danger, then it's not our job to figure out how to make sure that that person calms down as quickly as possible. if they're a danger to themselves or anything like that, obviously, but really, we just want to be there for them and with them through the anxiety response. It's more that they feel like they're not alone as they go through it than that you're going to be the way that they're going to get out of their anxiety as quickly as possible. We do not have to assume anxiety disorder just because someone's having an anxiety response, especially if it was just an emergency situation. And therefore, it's really just being there for them, holding their hand, putting your arm around their shoulder, just just sitting next to them. You know, we have in the laws of of mourning in in Judaism that you go and you just sit with the person and don't start asking them questions and talking to them. You just sit with them. If they want to talk, if they open up, you allow them to open up and then you respond in kind, of course, and you be there for them and talk with them to the extent that, but you allow it to be even just sitting with them in silence, just clearly being a positive, reassuring force that's near them at that time. And over time, their anxiety response should get lighter and lighter. Every five or 10 minutes, every 15 minutes, you should see it going down. And that's that's the positive sign, and that's a healthy thing. However, sometimes we'll say, "No, this is what's going on. There's an anxiety disorder here." That means that there's no danger around and yet the anxiety response system is triggered in the person. When that happens, it starts to disorder their lives. It starts to make them not be able to school, go to school, or work. It starts to make them not be able to have normal relationships with people. they check out, they get too nervous, they need to disappear, they need to run away, they need to stay home, they need to stay in bed, etc. So now all of a sudden their lives are being into are being put into a state of dysfunction or disorder and that's how it becomes an anxiety disorder. So when a person has an anxiety disorder, we have to understand that the first approaches can still be basic reassurance and relaxation to just help the person calm down. So some basic relaxation techniques involve slow and focused breathing. It really the research shows it really doesn't matter so much exactly what breathing technique you use. There are uh those who use like kind of focusing on your belly moving in and out as you take deep breaths instead of your chest solely. It's actually a much more relaxing deeper way of breathing. And the person can put their own hand on their belly just feeling it going up and down as they take their breaths. But again, a big part of that is the focus. The fact that they're focusing on a part of their body moving as they breathe. If they can get their breathing in control and they're taking deep breaths, the oxygen itself is a great thing to help, which as emergency response technicians, you'll know obviously that oxygen is a very helpful uh intervention. But the fact that they're getting increased oxygen with the with the deep breathing is very helpful. You don't want hyperventilating. You want it to be controlled and focused. Another really great technique is getting someone to artificially create a sense of tension release. You can do that simply. You can all do it with me right now. You can do it with your whole body and all sorts of muscles in your body. But for the purposes of a more chaotic or more quick intervention response scene, you can just do it with your hands. You can take your hands and you can make a fist. Level one is just a very light fist. Level two is a little stronger. Level three is a little stronger. You tell the person level four is level five is as hard as you can make that fist. And hold it for five, four, three, two, one, and release. And just imagine the tension coming off your fingertips. do that three times in a row with a person, they actually start to feel some tension going down. If you do it with your hands and like your elbows squished against each other, your toes could be involved, that can be a very powerful quick trick to calm a person down from the tension that they're experiencing. Something that therapists use all the time in office and teach their clients to be able to use for themselves to calm themselves down. Obviously with ADHD asperers, if it's a heightened intense situation, you can use the same thing just as a basic way of calming the person down. Another another idea which is a little trickier to use, but if you want to tell the person to close your eyes, what's a really safe comfortable place that you would go to? Is it out on a lake on a boat that you remember? Is it on a certain hiking trail? Is it in your bedroom? And just close your eyes and picture it. But you don't want to just have them picture it. You want to have them start to describe it, which helps them really feel like they're there. So, what color are what color is the are the what colors are you seeing if it's out in nature? What color are the walls in your room right now? Is the window on the left or the right behind you? Tell me where is there a furniture? Is there a closet where And you have them describe a few things. It gets them to focus again on a much more calm, enjoyable, controllable uh environment for them. They start to feel like they're there a little bit, closing their eyes, breathing maybe after they did this a few times, and they start to become very calm and relaxed compared to where they were before. It's just some little tips in terms of relaxation techniques that can be very helpful if we're dealing with an anxiety disorder where that's the whole issue for the parent, for the emergency response technician, that this is the whole issue. it's it's anxiety, it's OCD, maybe the therapist is being called and and and that's really what the issue is. We want to be careful with too much reassurance. We can initially always say reassure everything's going to be okay. You're not in danger. But if we're seeing almost paradoxically that it's going in the opposite direction, it's like, "No, no, it's getting worse." Then really what we're dealing with is the paradox of anxiety where the reassurance is not going to work. It's actually feeding the anxiety monster that just wants you to keep reassuring but just gets worse and worse as the reassurance comes. It's not logical. It's not rational but it's very real emotionally. And therefore all the reassurance in the world is not going to be something which helps that person. In that type of case, you can sometimes see it come out in an extreme form of OCD, obsessivecompulsive disorder, where they have those obsessive thoughts that things are not okay, things are not safe, and then they even have a compulsion that they need to do to help calm themselves down. So, if they check their lock seven times, now they're like, "Okay, the door is locked." But guess what? Those people will then also often need to come back a little while later and check it again seven times because those false senses of security and reassurances which are not dealing with anything logical or rational are only very temporarily going to give them relief if that and it will actually make the anxiety just become worse and worse and worse over time. So, what we want to do in those cases is we want to just kind of repeat, "No, no, no. You're really not in danger." And now, if they keep saying, "No, but how do I know? Maybe I am." Like, like I said already before, just remember what I said before. Just remember what I said before. Just remember what I said before. You don't want to keep repeating, no, you're not in danger because and I'll prove it to you and I'll bring you another proof and if you were in danger and all these different types of ways of showing and proving and it just feeds the monster and makes things worse. So, we want to be very careful to not start feeding that reassurance black hole. And if that's how it starts to feel, that's probably what it is. It's an anxiety disorder or it's OCD. And we want to be careful with it. Sometimes the OCD can express itself specifically in religious form. Uh repeating words incessantly and prayers and and uh having issues with other uh laws uh in the religion and that can also lead to extremely unhealthy situations in those cases as well. Just just to make this point clear, the rabbi for example, any rabbi that is mental health informed is not going to just continue to uh puscin to explain the answer to every but maybe this but maybe what happens if you change this detail then maybe and all these different nuances and details. He's not going to go through every single one of those. He's going to say, "Like I said already before, I answered your question the first time. That answer applies." No, no, no. Just remember what I said before. Well, just remember what I said before. And you stay calm. Don't get frustrated. This is the struggle that that this person has. And ultimately, that can help them calm down. Again, you do the re relaxation techniques to try to just help them calm down. And that's that's what can help that person. Let's talk about depression for a couple minutes. So depression is something where you come across a person and you find that they seem to have and exhibit a lack of desire and happiness in life in general to do anything to want to be a part of anything. So first of all we have to differentiate between whether someone just has more of an introverted personality versus if they're suffering from depression. You know I'll deal with teenagers all the time. Sometimes there'll be these kids who just want to play chess against themselves in their room. That's their introverted personality. They really enjoy spending time with themselves reading and playing. And you want to have some social interaction, but it doesn't mean that the person has clinical depression, right? They're still going to school. The adults are still going to work. What happens if we get beyond that introverted personality? And you have this person who just they're not functioning again. there's the dysfunction, the disorder of their life due to the fact that they're feeling this sadness, this depression. So in those types of cases, you want to first of all look for well, is there anything that can get this person excited? Anything. So you talk to this person, you come upon them, they're just in bed, they're very low, they're they're low mood, low energy. You say, "Whoa, am I dealing with a depressed person?" Or they tell you, "This is a depressed person. This is what's going on over here." So, you want to start saying to them things like, "Is there anything that excites you?" Like certain food, a certain activity, anything. And if you could find something that excites them, and you could talk to them about it, maybe talk to them about maybe somehow depending on what position you're in with this person, but maybe facilitating that that can be helped to to to get for them, to give to them, to allow them to experience. That's wonderful. That's amazing. But even just talking about that experience often can get the person to be lifted out of that more depressive mood. And it often is a sign actually that it's not real clinical depression if that can work. So that's something to keep in mind. But sometimes you'll have a person who's clinically depressed. They are just not able to come up with anything. Now let's just avoid a trap first. You might have a person who says, "Oh yeah, well marijuana is the thing that I get super excited about. It makes me feel great. You know, drinking alcohol is a thing that I get super excited about or any other substance. Sometimes this can even be other things at unhealthy addictive heights and levels. So, gaming or video gaming can sometimes also be where really the person is suffering from clinical depression, but their distraction from life is the thing that's getting them excited. But that's really still what we would call a mental health disorder because the only thing that gets them out of bed is being distracted, right? Imagine the person says, "I love sleeping. Sleeping is the most amazing thing in the world." That is definitely still a sign of depression. You don't say, "Well, wow, they're so excited about sleeping." They're checking out of life by going to sleep. And so too, anything that is really the way for them to check out of life is going to be included in this in terms of them still suffering with clinical depression. So, it's important to just be aware of that when you're trying to encourage some of the excited talk about different things. If they start talking to you about drugs and other unhealthy things, ways to check out, that is not the direction in the conversation you want to go to get them out of their depression. That's not going to work well at all. You want to look for things like they're even going to have a lack of ability to eat, appetite, energy, all these things. If you're dealing with depression, obviously it can get to danger levels where you have a safety issue, where you start to have a safety issue that can look like a person harming themselves, uh cutting themselves or or uh pulling out hairs where there's an element of pain involved because that can have different types of manifestations. And then obviously and that that often by the way where they're where they're looking to experience pain is not necessarily a predeterminant factor of suicidality that they are that they are at risk of suicide. Um because they're actually looking to do something to get themselves out of their depressive state. Feeling the pain is something that is working for them in an interesting psychological way. But therefore that's what they're doing. which means that they're not thinking I want to end my life. They're thinking I want to live in a more comfortable state and paradoxically the pain is allowing me to do so. But still, the self harm itself can be dangerous. So therefore, if you're noticing those things, you want to document them. You want to make sure that your superiors know about it. You want to make sure as a parent that you're documenting these things. You want to make sure that there are professionals involved and and very much monitoring this situation because it can be very dangerous. Obviously it can lead to suicidality because it is an indication of a very severe low uh energy depressed person and therefore you want to look out for that. The general golden rule that mental health professionals have adopted in terms of addressing whether or not a person is what we call an imminent danger of suicide is whether or not they have a plan and whether or not that plan includes a means and a time for doing it. So if the person says, "I would just swallow all these pills." You say, you ask and you should ask. And you should never be thinking, "Oh, I'm planting thoughts in their mind." Whenever they're at this point already, you never have to worry. Oh, you're the one planting these thoughts. The thoughts have occurred that they could sit and dwell on them to them no matter what. You're not planting thoughts in their minds. So, you want to be safe and you want to keep them safe and you want to ask, "Have you thought about actually doing that at a certain time?" Well, no. Well, I'm just thinking I could do that and the whole thing would be over. Like, you know, when you'd want to No, no, no. Okay, so they don't have a time that they're planning on doing it. What if they say, you know, in in in two weeks I could just end it all? Really? How would you do that? Again, you're not planting thoughts by doing that, even though that's a understandable worry. That person, if he's at that point, has considered, has pondered, and either his brain really went down that path or it didn't. And your question's not going to make it. he's gonna answer no. Or he's gonna say, well, yeah, there's this, there's that, I have this. And then again, if they have a plan, is that plan reasonable? If he says, I'm going to uh jump jump off the Great Wall of China and and the guy's nowhere near there, like, are you planning on going to China anytime soon? No, but I could go there in the next few years. Now, obviously, it's just reasonable. Is this something which has some level and obviously airing on the side of caution even if it's a low level some level of realistic uh access a time and a plan and a means. So those are the things that you want to look for. That's a basic overview when it comes to these four psychological issues that people struggle with commonly. ADHD, asperers, anxiety, and depression where those things can get to the point of danger. Now I want to share with you um there's something called mental health first aid. Mental health first aid is a actually nationally recognized uh credential that a person can get. You can Google it mental health first aid. You'll see there are two different types of the trainings. They're like a whole day training. There's like two hours of pre-work like six hours of uh online instruction or could be in person. 45 minutes of postwork and you can get I went through this class. I learned some nice stuff. I think it's a great course if you have the time for it. But I want to present to you the central nugget of information right here because the name of this course is in 45 minutes I'm giving you as much as I can on this topic. So I want to just present to you what nationally is being recognized. The central nugget of information. Again I recommend you take the course to really get the full comprehensive nature of it. There's wonderful vignettes to demonstrate and ways to practice and all that. But the core is an acronym called algae. A L G algae. Algae is an acronym that stands for the following and it's at the heart of mental health first aid. A is for approach, assess, and assist with any crisis. That means you see something and it's mental health first aid again is responding not to like someone's call to a mental health emergency to respond. Obviously, you're going to do that. We're talking about lay people all around the world. When you are when you notice something off that seems to have a mental health component to it, algae, approach, assess, and assist with any crisis. Listen nonjudgmentally. And we're going to elaborate on that with the last five minutes of this course with empathy. But listen nonjudgmentally. Just listening can have huge effects on the person. Many people are simply not listened to on a regular basis. And all of a sudden, you come again as emergency responder, as a lay person, as a friend, as a stranger, as a parent, and you decide, you know what? This time I'm just going to sit and listen. Got to have the time for it. Got to have the patience for it. But it can be very helpful. And non-judgmentally means you're not challenging what they say. You're just listening, asking for more information. Again, we'll elaborate on that in a minute. G is give support and information. If there's any resources, hotlines, support services. Again, in the course they teach you about those, go ahead and offer those to them, make sure that you can write them down for them, that they can really have a chance of getting the help that they need. E is encourage appropriate professional help. Encourage that they get the professional help that they need. Uh obviously in a kind and gentle way. Offer to help them out if you can with a referral agency, with uh mental health professionals you may know that you could put them in touch with. And then the second E is encourage other supports. Try to make sure that you encourage as many supports as you can for them, whether it's extracurricular activities, other types of community uh groups and and intervention sites to be able to help these people have the supports that they need in their life moving forward. That's algae, alge. really at the heart of mental health first aid and it's at the heart of what is being taught nationally uh for the past couple of years to help people not mental health professionals to help people uh assist approach and and and intervene in mental health challenging situations. Okay, so that is really the core of the information I want to share with you. But we're going to end with something that I like to call tactical empathy. It's basically just recognizing that empathy is an extremely strong tool to use with people. It revolves a lot around that L of listen non-judgmentally. So let's first talk about what empathy is and isn't. There's a word in the English language empathy and there's a word sympathy. The way that we like to differentiate between the two is sympathy is you notice that somebody is feeling bad. They're feeling depressed or anxious. They're struggling with impulsivity or they're on the Asperger spectrum. They're struggling. Struggling. You notice it. You go over and you offer to help. That's feeling and being sympathetic to that person. It can be a wonderful thing. It can be a pretty selfish thing. Selfish sympathy looks like this. And uh there's a great uh psychologist who there's a great video online about this, Bnee Brown. Uh there's there's a you know it often the way she describes it is it often starts with the words at least. You know somebody trips and falls and you say well at least you didn't break your leg. Cheer up. You know everything's at least at least at least. So are you really trying to help that person or are you just uncomfortable being around a person who's not in a happy mood which is uncomfortable for people and you just want to cheer them up as quickly and as easily as possible so that you can be around happy people. And it's great for me and me myself and I. Okay. But sympathy doesn't have to be selfish, but it is much more shallow than empathy. Empathy is defined as trying to put yourself into their shoes and showing that, communicating that. Communication does not necessarily have to be verbal. It can be nonverbal. It can be in your eyes. Like I said before, it could be just sitting with that person. Just sitting with that person in a non-judgmental way is something that can be very helpful for a person to be able to start to feel better. And here's the key to feel understood. People in general want to feel understood. The more understood a person feels, the more their defenses go down, the more the intensity of their emotions go down. Just it's a tactical weapon. Now, I hate to say it as aggressively as that because it's the opposite of being aggressive, but that's the way that I look at it, especially in an emergency response situation. In lowering the temperature of what's going on in in hostage negotiations and terrorist situations, this is like the key go-to overriding principle that drives most of the interventions that are being attempted. It's listening non-judgmentally. It's being able to just be there for them, showing them, I want to make eye contact with you. I want to be there for you. I wanna I I'm I'm whatever. Now, here's the key that is the challenge with offering empathy unconditionally. Sometimes it feels like we are agreeing with or strengthening their irrational thinking. And the key thing to remember is validation does not necessarily equal agreement. I could validate the most ridiculous out of touch with reality, even psychotic people with psychosis where they're out of touch with reality. I could say, "So what you're saying is," and then say it over in my own words. I could do that with anything, no matter how crazy it sounds to me and out of touch with reality. So what you're saying is, and again, don't just repeat their words. Try to say it over in your own words. Show them how clearly you understand. Maybe ask a question, not a threatening question, like are you saying it like, "Do you mean this or that?" Like this. Yeah. Yeah. And they Yeah. Yeah. You get You're validating. You're just showing them they exist. Their opinion exists. They exist as a human being. They feel understood. It's It feels validating. You're not saying, "And you know what? You're right. I agree with you." You're stopping short of that. If they ask, "Do you agree? Do you think that's true?" You could just say, "Let me first still try to understand exactly what you're saying. I just want to be here with you and understand you." That type of empathy can almost always lower the temperature of a situation. It is the number one go-to thing that therapists in general approach their clients with on day session number one. It's all about validation and empathy, opening up channels for all sorts of exploration that normally would be closed and now have been open to the therapist and so too can then be opened to the people handling these people who are suffering unfortunately from these mental health issues and diagnosis. We have two minutes left so I'll open it up if there's any questions. Otherwise, those are the main points that I wanted to make to you guys today. Thank you so much for joining.