Mental Health First Aid: Your Friendly Neighborhood Mental Illness Maker


I did it. I finally did it. I went and took a Mental Health First Aid (MHFA) class.

Why did I do it? (Why does everyone around these parts keep asking me that?!) Well, honestly, I just wanted to be able to critique it better.

I mean, I had already conjured it up in my mind to be big, bad and terrible based on what I understood to be its basic premise, the affiliated website, and all I’ve ever heard about it from anyone else. However, the truth is that many of those anyones also hadn’t taken it, and so… what if it was better than we all thought? What if we were full of assumptions and were just plain wrong?

First, what is this thing called Mental Health First Aid? MHFA markets itself as:

“an 8-hour course that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders. The training gives you the skills you need to reach out and provide initial help and support to someone who may be developing a mental health or substance use problem or experiencing a crisis.”

The training’s target group is the ‘average Joe,’ and not so much someone who specializes in the ‘mental health’ field and is already assumed to have ‘deeper knowledge’ of these issues. Attendees may range from teachers to first responders to family members to your concerned neighbor Sally. In fact, before taking the course myself, I’d always kind of thought of it with the sub-title of, “The average citizen’s guide on how to diagnose and send off your friends and neighbors.” (And, in fairness, I still kinda think of it that way now, too.)

MHFA is also heavily backed by one of the nation’s most powerful mental health-oriented organizations, the National Council on Behavioral Health which has professed the dream of reaching ‘one million Mental Health First Aiders in the U.S.’ (It’s worth noting here that the Council is pro-Murphy Bill and heavily backed by the pharmaceutical industry.) MHFA also has its share of celebrity endorsements. For example, Dr. Oz’s sweet mug even greets you on the front of the MHFA website saying, “Dr. Oz is trained in Mental Health First Aid. What about you?” Now, if that doesn’t convince you, I don’t know what will.

But, what does an actual day in the life of Mental Health First Aid look like?

First, I want to take a moment before truly diving in to say that this blog is NOT a criticism of the two trainers who led the class that I took, and I don’t plan to identify them or the organization for which they work. They actually seemed to be putting in genuine effort to create space for me and the friend who accompanied me to challenge the material. Sometimes they even expressed their own contrary beliefs. (Why they then would feel compelled to continue to teach this curriculum as it’s written is a topic I’ll leave for another time… or, at least, later in this blog.) Yes, the class could have been much worse had we found ourselves at the hand of more rigidly minded facilitators. Thank goodness for small favors and all that.

So, moving on to the material itself: I have to admit that there was one (and only one) area where it seemed a bit better than the average tripe, and that was ‘self-injury.’ While it still had some problematic things to say on this topic, it also is probably the first training (coming from the traditional mental health set, anyway) that has ever stated so clearly that self-injury does indeed have a tangible benefit.

Otherwise, however, it hit all the most stereotypical marks including a nod to the ‘chemical imbalance’ myth (absent the mentioning of the myth part, of course), ignored most environmental factors (homelessness, racism, poverty, and so on), and offered plentiful references to the value of psychiatric drugs (including some solid re-assurances that at least the ‘anti-chem imbalance slideanxiety’ variety has supposedly “minimal side-effects”). And, had I been playing a drinking game based on how many times the words ‘mental illness’ or ‘disorder’ showed up (verbally or in writing), I would have left very drunk.

We were also asked to repetitively review (and sometimes chant) the meaning behind MHFA’s foundational tool, ALGEE. (One exercise even required us to put together a sort of word ‘puzzle’ to further help drill it into our heads.) It goes like this:

A is for ‘algee stands forAssess for risk of suicide or harm’

L is for ‘Listen nonjudgmentally’

G is for ‘Give reassurance and information’

E is for ‘Encourage appropriate professional help’

(Give me another) E is for ‘Encourage self-help and other support strategies’

And at least some of that didn’t even sound half bad… I mean… not the ‘listenALGEE nonjudgmentally’ part anyway. By the way, as it turns out, ALGEE is also the name of MHFA’s Koala bear mascot.  (I always love when tools to push people along the ‘mental health’ pipeline masquerade as ‘help’ and are marketed with cute little stuffed animals… don’t you?)

Really, it was all to be expected, though. (I’d actually even met a live version of ALGEE all dressed up and cheerfully taking photos with conference attendees at a National Council conference just a year or so before.)

What I absolutely didn’t expect, though, were some of the exercises that encouraged us to sink to truly bizarre levels of judgement and MHFA’s own brand of ‘disordered thinking.’ Here’s one of my favorites: Early on in the day, the trainers literally asked participants to arrange a list of ‘disorders’ by severity.  No, seriously. (Stop it! I’m so not kidding!) The list included (in no particular order):

  • Moderate depression
  • Severe depression
  • Non-invasive breast cancer
  • Severe asthma
  • Epilepsy
  • Low back pain
  • Uncomplicated diabetes
  • Severe schizophrenia
  • Severe dementia
  • Gingivitis
  • Severe vision loss
  • Severe post traumatic stress syndrome
  • Paraplegia
  • Severe chronic bronchitis or emphysema

Here’s the list re-ordered by Mental Health First Aid from (supposedly) least to most severe:

  • Gingivitis
  • Low back pain
  • Uncomplicated diabetes
  • Epilepsy
  • Non-invasive breast cancer
  • Moderate depression
  • Severe asthma
  • Severe vision loss
  • Severe post-traumatic stress syndrome
  • Paraplegia
  • Severe chronic bronchitis or emphysema
  • Severe depression
  • Severe schizophrenia
  • Severe dementia

That’s right, folks. So-called ‘moderate depression’ is seen as worse than breast cancer, but both ‘moderate depression’ and breast cancer still trump blindness or not having use of one’s legs. And, at least three potentially fatal medical illnesses (cancer, severe asthma, and emphysema) are apparently all preferable to schizophrenia. Hell, apparently just about everything is preferable to the devastation wrought by ‘schizophrenia!’ (Unfortunately, this last point is a theme that continues throughout the training.)

If you’re feeling particularly masochistic, you can actually watch a video of people participating in this exercise (third one down), although the instructor in this version refers to the ordering as being based on ‘least to most disabling’ (as opposed to least to most severe). Not that that improves anything. At all.

a to z listThere were a host of other strange exercises, including relatively inexplicable requests to ‘draw’ representations of the symptoms of depression and anxiety, and to alphabetically call out words that we commonly hear in our culture related to ‘mental health.’ (My friend snuck in ‘pharmaceutical industry’ when we reached the ‘P’!)

And then there was their handling of all things ‘psychosis.’ While the curriculum required the instructors to parrot the line about ‘people with psychosis [being] more at risk of being victims of violent crime,’ literally everything else flashed a virtual neon sign of ‘danger.’ For example, only when reviewing the section specifically labeled ‘psychosis’ did we come across any tips for ‘de-escalation.’ And, while film clips (oh yes, there were film clips for each diagnosis!) for earlier labels portrayed people benignly immobilized on couches, the ‘psychosis’ clip compounded the already readily apparent fear and agitation with echo-y effects, and featured two women who were clearly afraid to enter their neighbor’s home when they realized he was ‘arguing with someone who wasn’t there.’

Check out this segment of said clip (starting about 50 seconds in).

It charmingly focuses on the fact that ‘psychotic’ neighbor man has stopped taking his ‘medications.’  The full clip (sadly, not available in its entirety on-line) also concludes with one of the women threatening this man (who they lured out of his home against his protests and who was not making any of his own threats toward himself or others) with calling the police if he doesn’t agree to call crisis evaluation services or go to the hospital (a perfectly satisfying ending for the MHFA set).

Finally, at the end of the day, when we were given what amounted to our MHFA certification exam (passing grade required to become official), both questions focused on this particular area were clearly written with fear, danger and violence in mind:

#4: You’re outside the pre-school waiting to collect your child when you notice another adult behaving strangely. He’s walking in circles and having a heated argument with someone who isn’t there.

Do you:

  1. Ignore him. He’s not your problem as long as he doesn’t come anywhere near your child.
  2. Assess the situation for risk of harm to yourself or others. If needed, encourage others not to be confrontational with him. If you feel safe and able to approach him non-confrontationally, ask if he’s OK and what help he might need. Consider notifying school personnel.
  3. Approach him directly, standing squarely in front of him and making clear eye contact. Put your hand on his shoulder and be assertive, telling him that he needs to leave the area.

#8: You’re at a party when one of the guests becomes violent. She has a knife and it’s obvious that she’s responding to voices only she can hear.

Do you:

  1. Try to gain her trust by pretending you can hear the voices too. Agree with everything she says until you can get close enough to take the knife away from her.
  2. Take her down physically be whatever means possible and have someone call the police.
  3. Call 911. While you’re waiting for the police and mental health crisis team to arrive, turn off the music and encourage people not to confront her or get too close; make sure your exist is not blocked. Perhaps speak calmly to her, but don’t argue with her.


Interestingly, several people (from trainers to the general public to some of my Facebook acquaintances) have attempted to defend MHFA as ‘worthwhile because it teaches compassion to the average citizen’  (or some variation on that theme). Most of them have acknowledged it has its shortcomings (though, they may still argue as to whether MHFA is more or less severely impaired than cancer or diabetes).  Few of them seem to have even the slightest inkling of just how dangerous such mass-marketed tools can become.

In fact, I might argue that it’s the guise of ‘teaching compassion’ (along with the few other benefits it might genuinely purport) that is precisely what makes it so dangerous for all the masked misinformation those benefits allow it to slip in unnoticed.  Haven’t we yet learned that teaching people that so much human distress boils down into illness does nothing to reduce ‘stigma,’ and in fact, makes discrimination worse? Aren’t we now wise enough to see that the more medicalized we become, the more disability and despair plagues us, as well?

There is no benefit to teaching more people that this is all ‘mental illness,’ or playing part in increasing its numbers and count. There is no benefit to ‘one million Mental Health First Aiders’ further cementing knowledge based on fiction or assumption, or creating higher walls between us and unlearning. The suggestion that all of this loss may somehow be ‘worth it’ because we’re teaching people to talk openly, comfortably and with care about ‘mental health’ is beyond foolish if it’s tied inextricably to labels and language that damage us at the same time.

There are other options to teach ‘compassion,’ and ways to talk to people about their distress or unusual experiences. There’s no reason to talk about MHFA as if it’s this or nothing. And, hell, if you don’t have access to one of those other alternatives, create your own! Anything would be better.

At the end of the day, I completed this training and I also completed the final exam. But, in true-to-me form – for about half of the questions – instead of choosing from among the answers available, I added a fourth option. I turned in my test that way, and seeing it was ungradable and that I would inevitably fail and not earn my certificate, one of the trainer’s asked me:

“Could you just answer the questions how you think Mental Health First Aid would want you to answer them?”

No, I’m sorry. I can’t. It’s not worth it. Not even for a second. I refuse to fall into that trap of feigning belief in something harmful for the sake of some perceived or implied gain. And, I can only hope that you’ll come to see that it’s not worth it, too.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


  1. Wow! Thank you so much for this article. Much as it amused me, it also scared me to the core. I recently read an evaluation report of the use of MHFA in “supporting people working with the Prevent agenda.” The Counter-Terrorism and Security Act 2015 contains a duty on specified authorities in England, Scotland and Wales to “have due regard to the need to prevent people from being drawn into terrorism.” This is known as the Prevent duty. There is much going on in the UK about the link between “mental illness” and “radicalisation” (the link itself is not clear, does radicalisation cause mental illness or does mental illness cause radicallisation – the mind boggles). And this section (among many) from the report seemed especially problematic:
    “I would never as a Police Officer explain to a supervisor I needed guidance on how to investigate a crime, because the first question they would ask is ‘what sort of crime?’ If you know the type of crime i.e. Fraud, the supervisor can signpost you to the Fraud Team.”
    “I have been in multi-agency meeting where a delegate suggests there is a mental health problem, the mental health practitioner correctly asks what sort of mental health problem to which the delegate had to admit they did not know, other than it was a mental health problem!”
    The MHFA course is supposed to be helping the concerned person identify the correct mental health problem just as they would be able to correctly identify the type of crime. More than that, it is the juxtaposition of “crime” and “mental health problem” that spoke volumes to me.

  2. That quiz reminds me of an incident many years ago, when I encountered a gent reciting his life history to the sky. I chose to leave him alone, as he was obviously talking to God and didn’t need some chump interrupting his conversation with the Divine.

    • I was one of those who was DSM defamed and drugged for belief in the Holy Spirit and God, and by a paranoid of a non-existent malpractice suit PCP, a child abuse cover up profiteering “holistic Christian talk therapist,” a couple of Jewish psychiatrists, and at an ELCA Lutheran hospital. The psychiatrists in this country apparently don’t know it’s illegal in the US to torture Christians for belief in God and the Holy Spirit, and they believe Jesus’ theology of treating others in a manner that they would like to be treated, does not apply to them. Glad you are wiser, bcharris.

      “No, I’m sorry. I can’t. It’s not worth it. Not even for a second. I refuse to fall into that trap of feigning belief in something harmful for the sake of some perceived or implied gain. And, I can only hope that you’ll come to see that it’s not worth it, too.” Good for you, Sera.

      It strikes me that since the DSM was confessed to be lacking in validity and reliability by the head of NIMH in 2013, that this country should be getting rid of the scientifically invalid DSM stigmatization system all together. I know the problem is the whole iatrogenic illness creation system, that is today’s DSM theology, is very profitable. (The ADHD drugs and antidepressants create the symptoms of “bipolar.” And the “bipolar” drug cocktails create “psychosis,” via anticholinergic toxidrome poisoning. And the neuroleptics create both the negative and positive symptoms of schizophrenia,” via NIDS and anticholinergic toxidrome.)

      But creating “mental illnesses” in people with drugs is neither ethical behavior, nor “mental health care.” And the medical evidence is in proving “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).” Which basically means today’s psychiatric industry is really nothing more than one giant child abuse covering up industry. The psychiatrists just changed from claiming Jews were “mentally ill,” to claiming child abuse survivors are “mentally ill.”

      So how much longer are this fraudulent DSM classification system, and the toxic torture drugs of the psychiatrists, going to be propagandized, used, taught in our universities, and forced onto innocent child abuse victims and those who dealt with easily recognized iatrogenesis? It strikes me the entire system should just be scrapped. And all in this country, including the psychiatrists, should return to an understanding that “all people are created equal.” And profiteering off torturing and murdering child abuse victims, or those who dealt with easily recognized iatrogenesis, based upon scientifically invalid “mental illnesses” is no better than profiteering off torturing and murdering Jews based upon the insane notion being a Jew is a “mental illness.” It’s time for “the dirty little secret of the two original educated professions” to end.

  3. I’m arguably part of the establishment. That said, I took mental health first aid. 8 hours of my life I will never get back. And I was appalled at the lack of understanding of even the misinformation (if that makes sense?) that is generally available. Nobody understood the 10,000 plus ways people cope (which I expected), but nobody understood traditional old school treatments either. More than a few people offered the “hold them down” answers, as though a person experiencing some form of non-consensus reality should be treated like they are having a seizure or something.

  4. Wow, the first thought I had after reading this was, “Sheep!”, but of course I’m trying now to think about it as “people acting like sheep”, rather than “people actually are idiotic sheep”, thanks to Richard and Steve.

    Still, how much faith can I have in my fellow humans after reading this? If they are not mindless simpletons, most of these people certainly act like it. I guess it’s just hard to see that these people really don’t know what they don’t know. They have no idea what they are missing. I do have to wonder if people drawn to this sort of thing are those who want to deny the real causes of distress in others/their family using the simplistic biological model.

    The koala bear thing is pretty perverse. It’s a cute, harmless animal. But the people using it as their mascot will increase your chances of getting diagnosed and drugged with all the bad – and sometimes deadly – outcomes that follow from those things on average. This is one case where the presence of a koala bear may correlate with a deadly outcome.

    The part about psychosis is particularly upsetting. As has been repeated ad nauseum, there is no such thing as lifelong schizophrenia, but a syndrome or continuum of psychotic states that may be more or less severe, last more or less long, have many different causes at different times. And those states are not brain diseases, although the extreme distress people experience is expressed in brain chemistry.

    This motivates me to keep working on my own site about psychosis so I can put it out there as an alternative to this neurotrash.

    • YO!, “BPDT” – go to “”, and read Frank Zappa’s “I Am the Slime”, from his album “Overnight Sensation”. It explains how the American people have been propagandized, and literally brainwashed, for decades. I myself prefer the “sheeple” metaphor!…. LOL

  5. Another great article Sera…although this one is just so sad…

    The saddest part of Mental Health first aid is the fact that “ordinary citizens” are being taught to identify people behaving strangely and than are encouraged to recruit them for medicalized treatment, with the assumption that this will be helpful. Feels fascist to me.

    People should be taught to be polite, or otherwise just leave other people alone if the potential “helper” lacks the intelligence, courage, and/or resources to be of real assistance. Yes, we will see homeless and ranting people on our streets under such circumstances, but I’m uncertain that American society has developed a less harmful alternative. If you feel so guilty, have a conversation, give them some money or buy them some food (or bring them into your own home if you’re THAT guilty).

    Personally, I wouldn’t want anyone’s “help” under these circumstances. I’d be perfectly happy handling my suffering on my own, considering the cultural climate available to me.

    Spiritual teachers GI Gurdjieff and Chogyam Trungpa both spoke of “idiot compassion”, “compassion” without courage or intelligence. This is the ignorant mentality we are seeing promoted by these cultural overhauls led by the faceless MH establishment.

  6. Thank you Sera for this article. And notice, the article is primarily about psychotherapy issues, not drugs, electroshock or lobotomy.

    In my opinion psychotherapy is where we need to set the bar of zero tolerance.

    I had this friend before who had worked for a long time in various mental hospitals as a technician. There was a time in my life when some extreme things were happening, and it showed in my countenance. So this guy used to talk to always talk to me, “****name***, so how are you feeling today?”

    Finally I just said to him, “***name***, you are talking to me like you talk to your mental patients. I’m not going to put up with that ( very clear baiting, taunting, and open ended threatening tone, letting him know I was ready to take his head off right then. ), and they shouldn’t put up with it either!”

    We need to organize. The main problem I see in the routines for talking to the suspected crazy is that the questioner is not really listening, not really taking it seriously. They are talking the position that everything the suspected crazy is saying is just about what goes on in their head. That kind of talk, like it is all just in your head, enough of it, would drive anyone into the behaviors we label as schizophrenia.

    So we need to organize and offer assistance in getting fairness and redress in life’s various situations. We won’t be able to solve all problems, but we should be able to take on some of the bigger ones.

    Our society has become very informal. Okay, but people misuse that to torture and torment people.

    Thank you Sera again, for a wonderful article.


  7. Sounds creepily like the Peer Support course I did in Reading, Berks, UK.

    I complained to the head office who promptly sent my complaint to the trainer who asked to meet me in a cafe. Stupidly I agreed and she was angry that I had not told her directly.

    It’s times like this when I think custard pies and glitter bombs are in order

  8. … I had already conjured it up in my mind to be big, bad and terrible…

    When I first saw that lead-in it sounded like it would be leading to the conclusion that actually it wasn’t that big, bad & terrible after all, and thought “this should be interesting”… but I do the same kind of “know your enemy” stuff, like listening to Limbaugh & co. to understand how the enemy reasons.

    Three observations, nothing too controversial:

    — What prompts one to decide that someone else needs to be “assessed,” or is it totally random?

    — The ALGEE formula seems to mandate “appropriate professional help” in every case. So as soon as you “assess” someone you will inevitably be recommending they get “help”?

    — Instead of a bear shouldn’t the mascot be some sort of seaweed?

  9. I was taking these classes to work at a drug and alcohol treatment center. The called it behavioral or mental health tech basically “counselor lite”.

    It seems that for every hour I would get to work with a client using what I learned from recovering myself I would be basically working 7 hours for “The Department of Children and Families” doing paperwork “documenting” . The Department of Children and Families… think about that name for a second, talk about Orwellian police state, how about stay away from my family and kids ??

    But here is the real kicker, I would be expected to work with probation officers and RAT OUT clients if say one of them had an anxiety attack and ran to the bar or liqueur store trying o make it go away. Happens all the time. I know how those feel, its hell.

    Hi authoritarian terd with the usual IQ deficiency, glad you called… (social niceties go here) I am a scumbag back stabber and the client I am trying to “help” was caught drinking last night…

    Never in a Zillion years.

    I want to help people not be part that wrenched system that led many of them to having problems spiral out of control in the first place.

    The class I took pushed the usual psychiatric lies and bull too.

    • “We believe that our findings of rising suicide risk with increasing recency and frequency of contact point toward a strong independent effect of criminal justice history,” the authors write. “Thus, exposure to the criminal justice system in itself may contribute to elevating a person’s suicide risk, rather than simply reflecting the traits and characteristics of people who come into contact with the system.”

      Well thanks capt obvious for writing this paper. But anyway “just doing my job” (A Nazi Quote) I have to tell your PO you drank yesterday and add more misery to your life.

      I find some dark humor in the fact that those who engage in victimless crime don’t create any real victims until they are put behind bars, at which point they cause the State to steal $47,000 a year from the tax paying public.

      I guess that’s enough posts from me. I kind of over do it sometimes.

  10. I did have fun in my class though.

    Asking questions like how does a ride in a police car to a psychiatric facility to be strip searched and locked up getting cell phone and cigarettes confiscated and getting forced into nicotine withdrawal for 72 hours in an environment full of violence help a depressed person ???

    • Yeah, I always wondered about throwing someone into nicotine withdrawal during a depressive crisis. For all their yammering about “chemical imbalances,” they don’t appear to understand the first thing about the impact of drug withdrawal. Can’t think of a worse time to force someone to quit smoking against their will!!!

      Not to mention those other “minor” trauma…

      —- Steve

      • And caffeine withdrawal too. The depressed patients must get worst of that.

        We used to call a crisis a nervous breakdown. Anyone that’s ever lived it knows that it’s just that, an overload from trying to solve what seems unsolvable problems and breaking.

        I got to think my way out of this, I got to think my way out of this…. I just need a cigarette to get my head straight … I can’t focus. Wow I made a mess of things and I am in a psychiatric facility, I really did it this time. I need a cup of coffee like I have had every morning my entire adult life so I can think… And who is going to feed my cat wile I am stuck in here ? All my numbers are in my phone and its “in the safe”.

        NO, line up shut up and at 9:30 you have to fill out some papers then then at your evaluation where we record your reaction to this whole ordeal as “symptoms of the illness”.

        Well this post was kind of a fail, but I was trying to explain how the can’t focus part of withdrawal prevents you from coming out of the crisis , nervous breakdown , mania psychosis or what ever. Just a 30 second break from this anxiety and I will snap out of it…

        Never again, if a breakup or family death or anything leads me to a hotel room and a week of solo drinking again screw the ER , call my buddies at AA and say dudes sorry I disappeared but I am really screwed up , hang out and help me walk it off.

        I realize these places can’t be vacations but my ordeal was a kidnapping and the bill was extortion after I was stuck there a month for refusing to be drugged into Zombie oblivion only to go home and have rebound withdrawals from all that crap ( 2 anti psychotics and an epilepsy mood pill) and be no better off then the day I went in. Zyprexa withdrawal, fool me once shame on you twice shame on me.

        Oh and for anyone reading this when they make the standard threat of injection if you refuse your Haldol and other pill lobotomy, they say that to everyone so don’t have massive anxiety over the impending assault with no place to run like I did. They need a court order or for you to react badly.

        They came at me with that after I came out of it and was regrouping and feeling better. No longer am I stuck in a hotel going back and forth to the alcohol store, no now I am told have to ingest massive amounts of disabling drugs or they assault pull down my pants like rapists and then stick in a needle !

        And detox meds, never got those. Never Again.

      • When I was last “hospitalized” many years ago, taking lots of Thorazine and chain-smoking Kools (1-2 packs a day), I decided to stop smoking, which I successfully did cold-turkey on a locked ward. One of my psych student monitors “advised” me that given the stress level I was dealing with that stopping smoking was not the best use of my energy. I did anyway. And stopped the Thorazine immediately upon being released. Both of theses steps away from dependency would probably have been considered “symptomatic” behavior.

          • Stopping smoking was just one symptom of Sucking Up to Psychiatry syndrome. When I finally realized the game I needed to play to get out — and the (unacknowledged) rules — I announced to someone “watch how straight I can get and how fast.” I also got my hair cut and became president of the “patient government” lol. None of these things were officially acknowledged as having anything to do with my release several weeks later.

          • Here in Melbourne they cut out smoking in a prison after a short warning period. They too offered patches that people ate then there was a riot. The place was locked down for days, millions of $ damage, but the prisoners took the blame. Talk about stupid! Smoking bans are fine if you can get away from the banned area, they’re cruel oppression if you can’t. It’s bad enough to be shut away without rights but it’s wicked to add avoidable pain.

          • Steve

            Since we are a “state” facility the entire “hospital” was forced to go smoke free. Up until about seven years ago people were allowed to smoke. And of course, you can go to the private “hospital” in town and smoke all you want. Smoke breaks are one of the ways that private “hospitals” control people and get compliance with the “program”. If people act up or are not compliant you don’t get to have any smoke breaks that day. Smoke breaks are used as rewards. I was held in a private “hospital” for seventeen days and since I didn’t smoke I asked for a reward different from smoke breaks. They got angry with me and told me that I’d better quit trying to cause trouble for the staff! They told me to get my ass out there with the smokers and enjoy the fresh air and quit causing trouble!

          • Nothing is more trouble than the patients having individual needs they have to deal with!

            Kind of disgusting, really. Both making people stop cold turkey, and denying smoke breaks as a punishment for “misbehavior.”

            Not sure what else to say. These staff people are the ones who have the mental problems!

  11. As Phil Hickey says> “Pharma-psychiatry’s tentacles are everywhere, always masquerading as something helpful and benign.’ Well Plato said it too:
    “This and no other is the root from which a tyrant springs; when he first appears he is a protector.” – Plato
    And Martin Luther King Jr: `Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity.” A succinct version of C.S. Lewis’ “Of all the tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under the omnipotent moral busybodies. The robber baron’s cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience…Their very kindness stings with intolerable insult. To be ‘cured’ against one’s will and cured of states that we may not regard as disease is to be put on a level with those who have never reached the age of reason and those who never will’ (C.S. Lewis, 1970
    It’s about creating fear of the `other’ by manipulating these ignorant, trusting people in order to increase power and money of the select few.

  12. Good job Sera. Some of you may know that a group of us with lived experience originally created Emotional CPR as an alternative to MHFA. We now just try to create alternative ways that anyone can help anyone through distress or just communicate to lessen the distress of living in such an oppressive world. We avoid all references to diagnostic or other mental health terms other than saying we hope eCPR will help prevent people being labeled and processed by the system.

  13. Thanks so much for this important article Sera. In addition to Emotional CPR ( there is also Intentional Peer Support ( Both teach people to tap in to our humanity and better connect with people in distress, thus avoiding entrapment in the “mental health” system.

  14. Thanks, Sera. I just finished reading all 70+ comments, in addition to your article. I don’t feel better, yet, but I’ll be ok, after I eat something. “MHFA” is SCARY STUFF. Did you notice that the short-haired, gray-t-shirt student is a *COP*? And, the supposed ‘psychotic” person was a really, REALLY bad actor?

    Anyway, I found 2 cartoons today. The first is by “Glasbergen”, and it shows a Doc., talking to the patient:
    “We can’t find anything wrong with you, so we’re going to treat you for symptom deficit disorder”…..

    In the second, by Streeter, 2 people are talking:
    A.”My meds spoke to me this morning”
    B.:”What did they say?”
    A: The meds aren’t working”.

    THANK-YOU, Sera!
    (God-DAMN, that MHFA shit scares me!…..

    • I think we need as much humour as we can find. It;s very difficult to be taken seriously when your flies are undone. When the rush is over I’m getting onto it. Short stories, sketch comedy, cartoons, short fims, a TV series set in a mental health institution…come on folks get laughing!

  15. FIrst Aid is for general first aid, about what to do before medical help arrives. I see a person in need of assistance, I call emergency services, and it is about what do I do between calling emergency services and emergency services arriving.

    Mental Health First Aid to my understanding was started in my own country of Australia, at least 10 years ago. I am truly sorry it has been taken overseas, although pleased to know it only goes for 7 hours. Our courses continue to go for 20+ hours, over 3-4 days. Our courses teach nothing but the DSM criteria for the conditions and the pharmaceutical treatments for them, because they are chemically imbalances in the brain!! While Australia bands drug companies from advertising directly to the public, the names of medications are mentioned in this course, minus the side effects of course. ECT also often gets a mentioned. The testing is on being able to diagnose the person and know what medications they need. The only useful thing said, although I questioned whether it is of any use is that if you see a person in acute distress, assumed to be acutely psychotic or suicidal you should apparently call emergency services, something the average person would already have done anyway.

    They claim the success of the course is that on average 60 -70% of people who participate in the course, take themselves to the doctor after realising they have anxiety or depression. Yet before the course they were working full time, raising a family, socialising with friends, etc., etc., without issues!!

    The government here will even fund people doing the course and employers training all staff in in, which is not of any use really, because then they wonder why the whole population becomes mentally ill, when we are doing first aid, and then they all suddenly need disability pension and cannot work anymore!

    There is absolutely NOTHING first aid about the course, and the most useful thing to teach people in how to be around people in acute distress is de-escalation training, yet no such thing is taught and it is still not taught to anyone working in our mental health services.

  16. “They claim the success of the course is that on average 60 -70% of people who participate in the course, take themselves to the doctor after realising they have anxiety or depression. Yet before the course they were working full time, raising a family, socialising with friends, etc., etc., without issues!!”

    “The government here will even fund people doing the course and employers training all staff in in, which is not of any use really, because then they wonder why the whole population becomes mentally ill, when we are doing first aid, and then they all suddenly need disability pension and cannot work anymore!”

    Belinda, this is so awful, it’s almost funny! People need to wake up and see what we are doing to ourselves. I wish it was unbelievable, but I believe it because I’ve seen this sort of thing over and over again.

    “Mental Health” education or “treatment” is often “iatrogenic” meaning that it causes the very issues that it purports to cure. (This happens often in “training analysis, but can be present at any level of the Psych/MH tradition, clearly here in “MH First Aid”).

    It’s like a snake oil salesman who poisons people and than cures them of a disease that he actually caused. The biggest problem is that the snake oil hawker is almost always better at infecting people than he is at curing them of that infection!

  17. Sera,
    I always enjoy reading your posts and savoring your wit and your sharp mind. The MHFA article did not disappoint. Although I have not gone through the training I knew a lot about the original US curriculum that they starting using, e.g., 3 smiley faces next to the recommended ECT intervention (UG, promoting brain damage!!). I don’t know if that is still in the training manual. I see from your blog that MHFA has taken language from Emotional CPR (eCPR) which they have been doing for years and perhaps they have “integrated” others trauma-informed language. Based on your article it appears that the MHFA approach is the same-old-same-old fear-based, linear pathology-think that actually makes the world a less safe and less compassionate place.

    Thank you so much for sharing your experience.

    eCPR Co-founder/Trainer

  18. I wish I had time to read all the commentary, but I don’t. Again…Why is starvation ignored? What if the person had not eaten for days? Nothing about eating disorders, apparently….Oh, that doesn’t count? No, ED has to call 911…That “doesn’t count.” Falls between the cracks…AGAIN.

    Dear Creators of First Aid, Did you forget about the skinny adolescents? No wonder the kids are dying. I’m not expecting the death toll to get any lower anytime soon at this rate. Or, do you think we are all taken care of at horse farms or busy with fashion mags? Oh, please…….

  19. Well done Sera,

    I mean, how much can a Koala bear? lol Actually a koala is not a bear but ….. how appropriate that they pick an animal which spends it’s days eating eucalyptus leaves and gets off it’s head and sleeps for a mascot.

    I’d proudly display a big fail on my wall from such a course if it was marked. They do one in how to identify witches too? lol

    Take care and regards

  20. Big Pharma are desperate for money, full stop. How, who cares, why, who knows? Money for money’s sake. The profits made by big pharma could educate the world. Imagine what universal literacy alone could achieve? But it won’t. It needs ignorance, it feeds off superstition and the powerless. Why? To make more money. It’s obscene.

  21. “They claim the success of the course is that on average 60 -70% of people who participate in the course, take themselves to the doctor after realising they have anxiety or depression. Yet before the course they were working full time, raising a family, socialising with friends, etc., etc., without issues!!” You know why doctors traditionally didn’t want to give people a list of the adverse effects of the medicines they were giving them? Because if they knew about them too many would complain that they HAD them! It’s a variation of the placebo effect. Then there are those who used to be called hypochondriacs, isn’t that a disorder now with a new `scientific’ name. Since the drug companies fund these disease fests, they have probably used some very expensive psychologists to devise a system that encourages people to believe they `have’ something. It disgusts and demoralises me that so many people fall into the trap, then I remember that I did too.

  22. I’m very glad to revisit this article & topic. The Director of the local “community mental health center” took this course – “MHFA” – back in April or so, and there was a little story in the local paper. I know this Director personally, and he’s really a nice guy, but he’s drank TOO MUCH Kool-Aid, if ya know what I mean! Funny thing is, he’s been here on MiA, reading about some TRUTHS, too! He’s “conflicted”, as they say. One of my best friends was raped and sexually abused as a young girl, by her Dad, and now as an adult, she’s being forced to take psych drugs. Recently, she was driven to the State loony bin, in handcuffs and shackles, by the Sheriff’s. 3 days later they sent her home in a frickin’ taxi-cab! Her “symptoms” were AKATHISIA. I try to tell this Director guy that he needs to get her off the drugs, and he knows I’m right – but he’s brainwashed. He would talk to her, but he’s the Admin.Director, and not the prescribing M.D.
    My point in writing this too-short, and somewhat confusing little TRUE STORY, is that yes, “MHFA” probably does far more harm than good. “MHFA” is largely funded by PhRMA, as our friend “jorwig” links to above…. And there’s no doubt that long-term use of psych drugs always does more harm than good. And “MHFA” is just another marketing scam by the pseudoscience drug racket of psychiatry & PhRMA…. I guess it helps me when I tell the TRUTH like this…. But I’m afraid things could get worse before they get better….

  23. I first looked at a Mental Health First Aid site here in UK yesterday and no surprise, none of the problems with the approach were flagged up on the website. In fact I didn’t manage to find any specific information about the approach on the website – something that would make me reluctant to take the 8 hour course.

    Five years ago I took early retirement from the NHS after many years working as a mental health nurse. Sadly in the NHS the reliance on medication seems to be increasing rather than reducing. Before they got rid of them all, I spent 10 years working at a therapeutic community where use of medication was minimal. I later worked at another in-patient adolescent unit which was not a therapeutic community and there I saw just how much drugs were a part of treatment in mainstream psychiatry. (And this was in a unit where the medical staff in charge always refused drug lunches unlike the adult units nearby!)
    I now work as an aromatherapist and do one evening a week with adolescents in a project aimed at reducing attendance at Accident and Emergency departments with self harm. Others in the project work with psychotherapy/counseling, cooking, money management and other life skills etc. I contrast this with the last unit I worked at where touching the young people was only allowed if restraint or patching up after self harm were needed!

    And that last was in a unit where they refused to use the term BPD, referring instead to complex PTSD. which was inevitably the case.

    An anecdote involving a psychiatrist I worked with during my training sums up my thoughts on the phrase, “personality disorder.” A junior doctor was presenting details of a new admission and as ever included BPD as a diagnostic possibility. The consultant’s reply was, “Well when it comes down to it we all have personality disorders. What is actually wrong with him?”

    I do still think that despite their horrible side effects psychiatric drugs do have a place but they should be the exception rather than the rule. Sorry I have been a bit rambling but there are so many points in what you have written that strike chords with me.