mental health first aid

  Site Search


Mental Health First Aid - the CARE Approach

What are you going to do if you’re not feeling well, worried about anything for no obvious reason, or feeling down in the dumps?


Or how about if your spouse or next-door neighbor is acting strange, having crying spells, hearing voices from outer space, or declaring the end of the world?


These conditions may seem difficult to understand but they’re real nonetheless. In fact, they suggest the presence of medical conditions that affect the brain.


What simple steps can you take to face this “mental” problem?


The CARE approach as Mental Health First Aid consists of a four-step process that describes how to recognize an emotional problem, what to do once it is recognized, and how to deal with it. These easy steps involve early recognition of the common signs of mental conditions and early intervention by using practical tips you can apply immediately. 


The CARE approach involves these four steps:


Check for signs of mental illness

Anticipate complications

Remedy with early intervention and

Educate yourself about the illness


This approach has two important prongs: assessment and intervention. The assessment prong includes the first two steps: check for signs of mental illness and anticipate complications; while the intervention prong includes the last two steps: remedy with early intervention and educate yourself about the illness.



Check for signs of mental illness


Early recognition of emotional disturbance is the first step. Generally, you have to look for four signs: 1) changes in mood, perception, cognition, behavior, thought process, and physical state. These changes should be associated with any of the following signs (2 – 4); 2) presence of significant distress; 3) change in daily routine; or 4) impairment in functioning.


Several “red flags” you should look for include self-talk such as:  “Something is not right,” “I don’t feel the same,” “I feel funny,” “He’s kind of weird lately,” “She’s not the same person I know,” or “I have to push myself to do things.”


Once you notice some signs, be alert and observant. Look for any change in patterns. Note the frequency and duration of the changes and determine their severity. Pose the question: how bad do you or your relative really feel? It is crucial to collect as many information as you can.


What’s the main symptom? Is the problem mostly depression as manifested by frequent tearfulness, irritability, or crying spells? Is the predominating concern mostly anxiety as shown by constant worrying about trifles and feeling edgy almost all the time?



Anticipate complications


Recognizing and preventing complications are the next important steps. If not addressed early on, mental problems usually result in some complex conditions such as suicidal behavior or violence, which are more difficult to treat.

Occasionally, the complication may itself be the initial presenting problem. This holds true for some individuals who delay getting help. Without knowing it, they gradually but steadily become engulfed by the illness. Suicidality, homicidality, aggression or violence, functional impairment, and worsening physical condition are some of the common psychiatric complications.



Remedy with early intervention


Early remedy or intervention shows that you should address the emotional problem with the goal of reducing the symptoms or preventing further deterioration.


My suggestion is that once you recognize some signs, you should seek help right away. Seeking help means communicating with close, trusted relatives and friends about your concerns. It may require calling support groups or a 1-800 hot line to seek advice, contacting the nearest mental health services for information, or seeking an early appointment with your family doctor. It may also mean reading relevant literature and visiting helpful websites to learn more on what you or your relative is going through.


As a relative or caregiver, you can help by being supportive and available, showing empathy, and avoiding unnecessary criticisms.


Furthermore, early remedy such as breathing, walking exercises or relaxation techniques should be used while awaiting an appointment with a family physician, psychiatrist, or a mental health worker. 


Any important change in emotional state calls for immediate action.



Educate yourself about the illness


Education is vital in dealing with a mental condition. “Knowledge is power,” as the saying goes. Information lessens misconceptions, shame, blame, and guilt.


Knowledge about the condition promotes a rational understanding of it — allaying fears and reducing tendencies to blame personal weakness and past sins as the probable causes.


So learn as much as you can about what’s going on. Know some coping mechanisms and treatment choices. Try to digest information without feeling overwhelmed. To supplement your knowledge, read self-help books.


In my clinical experience, individuals feel hopeful and blame themselves less when they learn more about the problem. Armed with unbiased information, individuals and their families feel positive and empowered.



Source of CARE Approach:


First Aid to Mental Illness By Michael G. Rayel, MD