Dec. 8, 2011

Jeff Ellens and Erin Pederson

Jeff Ellens and Erin Pederson lead Iowa State's mental health first-aid training. Photo by Bob Elbert.

Student Counseling Service trains cadre of mental health first-aid responders

by Teddi Barron, News Service

When Howard Tyler joined the Iowa State faculty 20 years ago, he felt prepared for most aspects of his job. But the first time a student in the throes of an emotional crisis walked into his office, he knew he had a lot to learn.

With no formal training on how to respond to mental health issues, Tyler resorted to trial and error, steering the student to find help as best he could. Sometimes it worked, sometimes it didn't. Early in his faculty career, a student committed suicide.

That's why Tyler -- now an associate professor of animal science and biomedical engineering -- was among the first to sign up for Student Counseling Service's (SCS) new Mental Health First-Aid training. The 12-hour program teaches faculty and staff a set of action steps for helping a distressed student until appropriate treatment and support are received.

"Faculty and staff are out there on the frontlines. And they often have questions for us about something they see in a student, wanting to know if they have a reason to be concerned."

Terry Mason, SCS director

"Many students just need someone to notice they are having challenges and ask about their life in a nonjudgmental way," said Tyler, who completed the training in July. "The training gives you the tools to initiate these conversations, recognize the issues and effectively refer students to the appropriate resources. I'm confident that I can handle new situations without resorting to the trial-and-error approach that was my staple in the past."

Need on the rise nationally

Although SCS primarily provides mental health and career counseling services for students, the unit also offers consultation support for faculty and staff, said director Terry Mason.

"Faculty and staff are out there on the frontlines," Mason said. "And they often have questions for us about something they see in a student, wanting to know if they have a reason to be concerned."

There probably is reason for concern. According to Mason, college and university counseling services throughout the country are seeing students with increasingly severe mental health issues, for example more serious cases of anxiety, depression and eating disorders, as well as students with extensive abuse and trauma histories.

"We're part of a national trend. Over the past four years, we've seen a 25 percent increase in attended appointments," Mason said.

"An increase in numbers is actually a good sign. It means students are dealing with these issues and trying to get help," he added.

Building mental health literacy among faculty and staff

For some time, Mason and his staff of 12 counselors have recognized the "incredible need" to support faculty and staff in a preventive way, enabling them to recognize when mental health is at the root of an issue a student is experiencing, understand how to approach that person and how to make a referral.

"We don't want faculty and staff out there counseling," Mason said. "But we do want them to feel comfortable in knowing what resources are available and in referring students there to get help."

SCS staff identified an international program from Australia, designed by a nurse and a professor, that teaches and certifies people to train others in mental health first aid. Three Iowa State staff members -- Jeffrey Ellens and Erin Pederson, both SCS-licensed psychologists, and Sally Deters, residence life coordinator -- completed the 32-hour course for certification as mental health first-aid trainers.

"It's a parallel with medical first aid -- being the first responder, not the professional," Mason explained. "You're not going to do a tracheotomy when someone stops breathing, but you want to keep that person going until medics can handle it."

Ellens, Pederson and Deters have trained 83 first responders in the past six months. The program first was offered to groups most likely to deal directly with student behavioral issues, such as residence hall directors, student health center doctors and nurses, dean of students staff, advisers and faculty. SCS intends to offer more sessions as resources become available, Mason said.

Feeling empowered to respond

During training, Pederson and Ellens establish a "safety zone" in which participants discuss openly and confidentially, make mistakes and take risks.

The instructors use role playing, brainstorming and repeated practice of a five-step response plan called ALGEE:

  • Assess for risk of harm, including suicide
  • Listen nonjudgmentally
  • Give reassurance and information
  • Encourage appropriate professional help
  • Encourage self-help and other support strategies

They help participants destigmatize mental health issues and provide background on conditions ranging from depression and anxiety to self-injury and psychosis.

"We throw a lot at them," Ellens said. "But there's already a lot of knowledge within these groups. So we draw from and reflect on their experience. The critical part is building confidence so they feel empowered."

Pederson said she feel enriched by her interactions with the participants.

"Hearing examples of their interactions with students has made me feel proud," Pederson said. "They're doing it so they can be more effective for Iowa State students."