Preliminary Discovery Observations & A Reflection on the NRN’s First Aid Mental Health Training 

DISCOVERY OBSERVATIONS & NEXT STEPS

It has been exciting to see the Discovery Sessions take place! Most NRN leaders have held their Discovery Sessions and sent in transcripts. As the final transcripts come in, the research team will:

• Begin sending summaries of the transcripts back to the NRN leaders (Week of March 17 & 18). The summaries will outline key takeaways from the subnetwork discussion and suggest messaging for sharing back the learnings to communities.

• Finalize codes for the comparative analysis across groups. Findings will enable the Cohort as a whole, and our community’s MH stakeholders, to identify shared values & challenges, liaison groups’ differential needs/assets, and gaps in services.

While we wait to receive the remainder of the audio/transcripts, it is possible to share some very broad, preliminary observations based on what has come in so far:

• Associations with mental health: These vary greatly, however there is some alignment around the ideas of emotional wellbeing and balance. All subnetworks so far have mentioned some form of MH stigma, and interpretations of this often differ for individuals within each community.

• Definition of mental health: General themes of balance and ability to function.

• Support systems: Groups broadly agree that family, friends, community, religion and co-workers are “protective factors” for mental health. Several communities place high emphasis on the fact that identity communities need support and acceptance from the larger society…and lack of this is a major stressor.

• Knowledge/Resources: People who are more involved with the town or working for the town are much more likely to know about resources (beyond the schools) compared to other groups within NRN. Some people knew some mental health resources in Needham such as Riverside, Needham Youth and Family Services but believed them to be inaccessible or discussed distrust. 

• Hopes & aspirations: So many hopes and aspirations going forward in regard to mental health in Needham! A lot of suggestions for programs with youth and adults. In general, there is a need for more information. 

FIRST AID MENTAL HEALTH RECAP

The group reviewed the basic tenets and function of the Mental Health First Aid (MHFA) program, emphasizing the prevalence of youth mental health challenges (for example, 1 in 5 youth experience MH challenges; suicide is the 2nd leading cause of death ages 10 - 14) and the need for the community to expand access to resources. 

Being a “first aider” can be a great resource for the community in the “gatekeeper” function, which includes: 

• noticing change and concern in others’ behavior or affect
• asking, listening, and doing a preliminary assessment of risk and suggesting resources

In this role it’s critical to stay within the confines of one’s capacity, of the law, and of safety, always keeping in mind that a first aider is not a trained clinician.

NRN reviewed a brief summary of the training. 

Some of the Signs and Symptoms of Mental Health Crisis:

• Changes in behavior, routines (eating, sleeping, activities) and connection with others 
• Taking extreme risks or being immobilized 
• Seeming inconsolable and depressed for an extended time period
• Talking, reading, writing about hopelessness, being trapped, suicide or death
• Expressing a sense of being a burden to others 
• Giving things away

Some of the Signs & Symptoms of a Substance Abuse Challenge:  

• Falling asleep or losing consciousness
• Small constricted pupils/dilated pupils 
• Slow, weak, or no breathing
• Nausea, vomiting, choking or gurgling sounds
• Tremor/foaming at mouth 
• Cold, clammy, discolored skin  

As we imagine working to create a culture of wellness in the community, it’s important and useful to keep in mind the positive impact of building protective factors to combat the predisposing risk factors, like preexisting mood disorders, poor relationships, serious health conditions, and the polarized and divided global and national climate. 

PROTECTIVE FACTORS include: 

• access to mental health care, and being proactive about mental health
• feeling connected to family and community support
• problem-solving and coping skills
• limited access to lethal means
• cultural and religious beliefs that encourage connecting and help-seeking, discourage suicidal behavior, or create a strong sense of purpose or self-esteem

SMALL GROUP REFLECTION & LARGE GROUP SHAREBACK

In small groups of 4, NRN leaders explored the following questions. Below, we summarize their reflections in blue. 

1) What reactions did you have to the training? (surprises, questions, concerns)

• The data on youth mental health and suicide was surprising and concerning.

• While at times disturbing, it feels so important to learn the information and skills.

• We’re feeling better equipped to identify and respond to concerns.

2) What is your role as a mental health first aider within Needham? Within your subnetwork (does it change in any way)? What questions or concerns do you have about the role? 

• Aware that being a first aider, especially in the beginning may feel uncomfortable.

• Appreciate that the role of a mental health first aider is to NOT be diagnostic but instead focus on listening and connecting youth/adults to resources as needed.

• Appreciate the need to keep in mind that responses should be delicate and culturally sensitive, in terms of a community’s priorities and values. Awareness that those who did not grow up in the US express themselves differently.  

• Wondering how to manage barriers, for instance when talking about emotions is not practiced or taboo?

• Anticipation of approaching situations differently after being trained and expanding the language around mental health.

3) What are some key facts, themes, skills, language or ideas that stood out to you in the training?

• We need to be curious and ask a lot of questions to truly get a sense of how someone is feeling. 

• We need to support ourselves in taking on this role.

• The training information is something to be relayed to the community and amplified. People considered vehicles for messaging and sharing information regularly via the NRN website, social media, and potential sharing of resource lists through cards to households/information sheets/email lists.

• Might we make more Mental Health First Aid training opportunities available? 

Next month, we will begin to focus on programming that each of us can build out within our subnetworks. To think about: How might the themes identified above be incorporated into the creation of leaders’ subnetwork activities, practices and events?

GROUP BIO  

NEEDHAM HUMAN RIGHTS COMMITTEE (NHRC) -

Marlene Schultz

NHRC is a town body. The committee is charged with: 

• Education - To advocate appreciation and respect for human and civil rights in our town 

• Community Outreach - To organize and recommend events to promote respect for human and civil rights 

• Community Response - To sponsor and organize community events and monitor a Discrimination Complaint Form that can be filled out by residents whenever they feel they have experienced discrimination.

NEEDHAM YOUTH & FAMILY SERVICES (NYFS) - Sara Shine 

NYFS is also a town body, charged with:

• Providing education and clinical services around mental health (e.g., parenting supports, rapid assessment, support those with a range of need, offering community presentations and programs, including speakers and workshops).  

• Partnering with many town organizations including Needham Community Council, Parks and Recreation, the YMCA and many community-based programs. In addition to providing clinicians that can serve the community, it has hired a training coordinator to create curriculum per town needs (e.g., school avoidance; youth support around divorce, etc.), and is offering Mental Health First Aid to organizations and residents, and training all Needham High School 10th graders in Teen Mental Health First Aid.

TOWN of NEEDHAM COMMISSION ON DISABILITIES -

Tatiana Swanson

The Needham Commission on Disabilities includes 9 members who have or have children with disabilities, as well as police and school liaisons. Its mission is:

• to offer compliance guidance to any Town buildings

• provide resources for compliance (i.e., audio traffic signals, town hall ramps, renovation of every single town building so in compliance with current building laws)

• to advocate and build awareness around providing access for people with disabilities. 



Onward!

Bala and Ramin (NRN Co- Facilitators) 

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