MHFA
Sally Trembath
Manager, Mental Health & Safer Community Programs
Health Wellbeing & Development
Aims of introducing Mental Health
First Aid (MHFA) at Monash
 Reducing stigma associated with mental health
 Increasing mental health literacy and confidence in order
to reduce anxiety when dealing with mental health issues
 Promoting pro-active and early intervention strategies
 Building capacity to respond in crisis situations
 Promoting culture of care and safer community
Summary of Feedback
Overall themes
Change in
attitude
Change in
behaviour
Reducing stigma
Early interventions
Building capacity
Improved communication
Improved workplace outcomes
Tracking these aims …
Survey Monkey demographics
Composition of staff
Numbers
n = 145
Academic Staff
Numbers
n = 146
Berwick
8
Caulfield
26
Clayton
83
Gippsland
16
Peninsula
12
Malaysia
1
South Africa
0
19
Professional Staff
79
Student
19
Monash Residential
Services
Campus
39
Changing attitude
Since completing MHFA, do you believe you are:
n = 141
Response
percent
Response
count
More able to recognise mental
health problems
34.8%
49
More confident in offering help
39.7%
56
More inclined to actively engage
with those effected by mental
illness
25.5%
36
Changing attitude
Since completing MHFA, what action(s) have you taken to
assist someone?
Listening non judgmentally
n =122
Provided advice and reassurance
n = 100
Called CAT team
n=9
Educated someone about mental health
n = 54
Feedback from respondents
Reducing stigma & building capacity
• Avoid engaging in mental debate with those having a mental
health illness.
• Increased awareness has helped boost my confidence and
tips about how to communicate and respond have helped.
• Very positive experience, will be useful in my role as a First
Aid/Safety Officer and in my life outside of work.
• I have changed my approach to people since the workshop.
I am much more understanding of those with depression and
anxiety.
• Has given me practical advice for dealing with people who
suffer from mental illness.
Change in behaviour
Q: Since completing MHFA, have you done anything differently to help others?
60
50
40
Family (n=45)
Colleague (n=39)
Student (n=61)
Friend (n=59)
30
20
10
0
Assisting others post MHFA training
(n = 119)
Change in behaviour
Q: Since completing MHFA, have you helped someone with:
90
80
Panic/Anxiety attack
(n=40)
Suicidal thoughts/
threats (n=25)
Psychotic episode
(n=7)
Depression (n=94)
70
60
50
40
30
20
10
Threats to inflict self
injury (n=10)
0
Specific interventions post MHFA
training (n = 110)
Change in behaviour
Q: Since completing MHFA, what action(s) have you taken to assist someone?
Listened non
judgmentally (n=122)
140
120
Provided advice and
reassurance (n=100)
100
Referred for
professional help
(n=63)
Called CAT team
(n=9)
80
60
40
20
0
Specific interventions post MHFA
training (n=134)
Consulted a
university counsellor
(n=36)
Educated someone
about mental health
Feedback from respondents
Early interventions, Improved communication & workplace outcomes
• Helped to have strategies for dealing with panic attacks – I
actually helped someone while they were having an attack.
• I had to call a CAT team and I was more confident in dealing with
them because of the training.
• I dealt with a student suffering severe depression, including
being suicidal and was able to convince them to see a professional.
• A staff member was suffering an anxiety attack and after having
attended the workshop I was able to suggest methods of getting
them through the anxiety episode.
• As a member of the Halls of Residence, I have found MHFA to be
the single most beneficial professional development activity I
have ever participated in.
Q. Have you done anything differently to improve your own
mental health? (n=145)
43% answered Yes
Comments:
• I exercised more, went to a doctor & psychologist
• I’m far more mindful of negative mental behaviour on my behalf
• I’ve seen a counsellor & improved my mental health
• I make sure I get 30 mins exercise a day – usually walking my dogs
• I sought assistance for depression whereas I wouldn’t want to admit it
previously
& the ultimate
I’m keeping mood notes, more regular exercise, yoga & pilates, more time with
friends & family, less workload, more time at home relaxing, gone on a short
holiday interstate
Reducing staff stress
Testimonial
I feel more able to deal with any unexpected
mental health problems that I may be
confronted with in my daily working with
students. Coming to work in the morning is less
stressful because I know that when there is a
problem I will be able to help in a constructive
and safe manner. I have recommended to my
colleagues that they should attend the course
as well.
General concerns and recommendations…
• MHFA is a fair introduction into mental health but it only
scrapes the surface. I worry that it may make the trainees
feel overly confident in dealing with people who have mental
health issues that are not as mild as those portrayed in the
training.
• Very useful and I think all those dealing with students should
attend this program. Further, it might be useful to run a
refresher program (half day) each year for those who have
done it.
• Whilst MHFA is valuable, I have found getting management to
understand and acknowledge things is the greatest challenge. …
The failure to acknowledge changing situations and symptoms
seems to be common and managers being older or more
experienced overrides their willingness to listen to the advice
of a mental health first aider.
SOCIAL AND ACADEMIC FUNCTIONING (SAF) SCALE
Adapted from Global Assessment of Functioning (GAF) Scale – DSM IV
Score
Level of
Functioning
Cognitive &
academic
functioning
Social
functioning
Coping
behaviours
Psychological
functioning
Response &
recommendation
s
100
Superior
functioning in a
wide range of
activities
High achieving
student
Engaged in a
range of activities
Positive coping
skills
No symptoms,
resilient, generally
happy
90
Good
functioning in
all areas
Good student
Active socially,
positive
friendships, good
network
Good functioning
overall
Minimal
symptoms,
resilient, generally
happy, may have
some anxiety
related to
assessment tasks
May benefit from
opportunity to
enhance stress
management eg.
counselling or
group program.
Provide
information on
available services
and resources
80
Slight
temporary
impairment.
Symptoms are
short lived and
understandabl
e in the
circumstances
Capable student
experiencing
minor problems
May have
temporary
setback due to
challenge of
unfamiliar
academic task
Occasional
arguments or
minor ups and
downs in
relationships
Actively engaged
in network
May withdraw
briefly
Understandable
stress reaction to
difficult situations
Returns to normal
once situation
resolved
Brief period of
understandable
reactive low mood
or irritability
Short-term
anxiety symptoms
such as brief
sleep disturbance
Needs: Common
sense support and
problem solving.
Peer support
Advise: to talk to
someone trusted
and/or see a
counsellor if no
improvement after
2 weeks
SOCIAL AND ACADEMIC FUNCTIONING (SAF) SCALE
Adapted from Global Assessment of Functioning (GAF) Scale – DSM IV
70
Some mild
symptoms or
difficulty in
social or
academic
functioning.
Slightly
diminished
selfmanagement
in some
areas and
may seem
less
organised
Generally
functioning
adequately
Academically
related stress
Some doubt
about academic
ability
May become
demanding of
help or avoidant
Some
difficulties such
as missing
classes, late
work
Seeking
extensions
Concentration
and focus may
be affected in
short term
Some
meaningful
personal
relationships
May see others
as critical and
rejecting
Some
difficulties in
usual social
functioning, eg
some avoidance
of friends and
activities.
May be
increased
dependency on
others
Increased
hours engaged
on internet
General
functioning is
reasonable
Occasional
irritability
Maybe
episodes of
binge drinking
May appear
less organised
May appear
less cooperative
than usual
Stressed and
negative in
response to
additional
expectations
Self critical,
self doubt
Pre-occupied
or worrying
Coping
difficulties eg
increased
anxiety,
irritability,
avoidance
May show
disorganised
patterns in
eating, sleeping,
attendance
Moody
Occasional
loss of
objectivity
Guilt, anxiety
about letting
others down
Needs:
Supportive
consultation
with
academic/facult
y staff regarding
difficulties and
problem solving
strategies
Encourage:
self care and
accessing
support
Refer:
counselling for
positive coping
strategies and
how to get back
on track
Consult:
counselling if
problems
continue
SOCIAL AND ACADEMIC FUNCTIONING (SAF) SCALE
Adapted from Global Assessment of Functioning (GAF) Scale – DSM IV
60
Moderate
symptoms,
moderate difficulty
in social or
academic
functioning.
May appear
disorganised and
unreliable.
May be denying
any problems
and/or
responsibility for
difficult behaviour
Unlikely that
issues will
resolve without
intervention.
Action required to
prevent serious
deterioration
Impaired study ability
due to reduced
concentration and
learning capacity
Unable to prioritise
tasks
Difficulty meeting
course requirements
Stress of assessment
period may result in
concerning writing,
drawing on exam
papers
Conflict in group
assessment tasks
Poor decision making
Inconsistent
behaviour
All or nothing thinking
Ruminating/circular
worrying
Few friends
Conflict with peers
May be withdrawn,
Isolated
Increased hours
engaged on internet
Behaviour may be
having negative affect
on others
Others may express
concern or make
complaints
Inappropriate sexual
or provocative
comments
Generating targeted,
harmful rumours
Low level use of
written, verbal or
physical abuse eg
pushing, shoving
Concerning
unwelcome
relationship seeking
Poor coping
May be demanding of
others to find solution
Overall functioning
compromised
May be inappropriate
emotional outpourings,
eg tearful, aggressive
outbursts, maybe hints
of self injury
Excessive coping
through on-line chat
and other internet
activity
Substance abuse
Impulse control
problems may lead to
high risk behaviours eg
unsafe sex,
overspending,
gambling
Intentional theft
Damage to property
Threatening
communications (nonviolent)
Sleeping on campus
Pornography use
contravening Monash
IT policy and/or
affecting others
Persistent
complaining
Unstable mood and
emotion
Mood swings,
depression to manic
May feel out of
control
Panic attacks
May be eating
disorder
Sleep disturbance
Self-medicating eg
excess alcohol and/or
other substances
Addictive internet use
Impaired judgement
and decision making
Impaired organisation
and planning
May appear chaotic
Guilt and fear
regarding poor
performance, letting
others down
Thought sof escaping
situation, possibly of
suicide
Non suicidal self
injury
Needs: Psychological
assessment,
intervention and
additional support.
Encourage: student to
inform and enlist
support of family and
close others.
Negotiate reduced
academic expectations
reducing academic
stress to aid recovery.
Refer: counselling,
health service or GP.
Medication may be
indicated.
Consult: counselling if
not accepting help
Where immediate
threat call security ext
333
Where risk of harm to
others consult
community care on
9905 1599.
A safety plan may be
recommended
SOCIAL AND ACADEMIC FUNCTIONING (SAF) SCALE
Adapted from Global Assessment of Functioning (GAF) Scale – DSM IV
50
Serious
impairment in a
number of areas of
functioning.May be
avoiding reality of
situation.
May have high
investment in
staying a student
and gaining
degree.despite
reduced capacity
Issues will not
resolve without
intervention.
Action required
to prevent further
serious
deterioration
Unable to focus on
academic tasks eg in
tutorials
Missed classes and
deadlines
Confused, ineffective
decision making and
communication
Concerning written,
drawn material on
exam papers
No friendship group
Unresolved conflicts
interfere with daily
functioning
Others may express
concern or make
complaints
Poor self- care in
decisions regarding
social group and
activities
Unresponsive to
efforts to support
Might be very
demanding of others
Isolated and
withdrawn
Overly dependent on
friends
Repeated episodes of
physical aggression
Physical attack
Stalking behaviour
Threats of violence
and/or suicide
Unwanted attention:
physical, written,
verbal
Serious struggling
If faced with
seriousness of
situation may become
very demanding of
solution or threaten
self injury
Likelihood of alcohol
or other substance
abuse, self-medicating
non suicidal self injury
Compromised selfcare
Possibly eating
disorder
Compulsive
behaviour eg hand
washing,
cleaning, use of
pornography
Obscene exposure
Thoughts of suicide
and may have plan
and means
Suicide attempt
Feeling hopeless
Ineffective problem
solving
Vulnerable and
withdrawn
Extreme emotional
pain eg possibly
severe eating
problems
Severe depression
Impaired self control
Excessive hours
sleeping
Unable to sleep
Shame and guilt
regarding perceived
failure and letting
others down
Feelings may be
masked by addictive
behaviours such as
excessive internet use,
alcohol, drugs
Needs : Assessment
and treatment with
psychiatrist, possible
specialist forensic
assessment. Reduced
stressors so reduction
or removal of
academic expectations
while recovering.
Recommend:
University Community
Care-line and
counselling services to
be involved in
developing a
coordinated
intervention to facilitate
assessment and care
of the person and
safety of community.
A behaviour contract
may be recommended
including informing
parents should an
emergency occur.
If not accepting
recommendations
Statute 6.3 exclusion
on health grounds may
be indicated
Inform: parents
Action: consult
community care-line or
community care dropin on your campus for
advice.
Where immediate
threat call security ext
333
SOCIAL AND ACADEMIC FUNCTIONING (SAF) SCALE
Adapted from Global Assessment of Functioning (GAF) Scale – DSM IV
40
Major impairment
in several areas of
functioning
May have high
investment in
staying a student
and gaining
degree.despite
reduced capacity
Significant
impairment in
reality testing and
communication.
Some bizarre
behaviours
Action required
to prevent further
serious
deterioration
30
Delusional or
impaired
judgement.
Inability to function
in most areas
May have high
investment in
staying a student
and gaining
degree.despite
reduced capacity
Action required
to prevent further
serious
deterioration
Failing
Unable to attend
classes
Unable to meet
deadlines
Unable to put in
consistent effort
Communication
problems
Appears vague, not
with it
Not capable of
making use of
academic advice or
help
Unable to maintain
relationships
Poor self- care in
decisions regarding
social group and
activities
Hostile or irrational
interactions
Severe
communication
problems
Unable to respond to
support or guidance
Others may express
concern or make
complaints
Appears out of
character
Ongoing physical
aggression and
attacks
Not attending class
Unable to study
Unable to manage
timetable or academic
requirements
Unable to function as
student
 No friends
 Withdrawn, isolated
 Unable to engage
with others
 Unable to function as
part of community
Hostile or
unpredictable
engagement and
communications
Ongoing physical
aggression and
attacks
Inconsistent
adherence to
treatment
recommendations eg.
medication
Odd, bizarre
behaviour
Aggressive, defiant or
withdrawn behaviours
Presents as
“dissociated”, cut off,
disconnected
Disorganised
No routine
May not be capable
of using advice to
prepare for appeals
process
Speech sometimes
illogical, obscure or
irrational
May appear
confused, disoriented
Contact with reality
unstable
May show paranoid,
bizarre thinking
Depression and
suicide plans and
intent
Needs: Psychiatric
treatment. Reduced
stressors including
removal of academic
expectations to
facilitate recovery.
Safety plan.
Statute 6.3 is indicated
to facilitate treatment if
not responding to
advice and
recommendations.
Assessment and
treatment with
psychiatrist essential
to continue.
Facilitate
administrative tasks to
enable re- enrolment if
and when appropriate.
Not adhering to
treatment
Behaviour is erratic
and inappropriate
May stay in bed all
day
Inability to function in
almost all areas
Homeless
violent
Suicidal
preoccupation with
plans and intent
Delusional thinking in
form of grandiose or
paranoid themes
Impaired judgement
May appear
despairing and cynical
Needs:
If not accepting
treatment, implement
assessment and
treatment through
Statute 6.3
Treatment and low
stress for recovery.
Support of family and
close ones.
Facilitate
administrative tasks to
enable re- enrolment if
and when appropriate.
Where immediate
threat call security ext
333
SOCIAL AND ACADEMIC FUNCTIONING (SAF) SCALE
Adapted from Global Assessment of Functioning (GAF) Scale – DSM IV
20
Danger of
hurting self or
others.
Gross
impairment in
communication
and interaction
Not attending
class
Unable to function
as student
Friends and
peers alienated,
unable to
understand the
person, may feel
afraid
Unable to
function as part of
community
Disorganised lack
of boundaries
Not adhering to
treatment
Largely
incoherent
Neglects basic
self care, eg poor
hygiene, poor diet
Psychotic
thinking: delusions
and hallucinations
Chaotic
Suicide attempts
Needs:
Hospitalisation for
assessment and
treatment. Low
stress for recovery.
Support of family
and close ones.
Facilitate
administrative
tasks to enable reenrolment if and
when appropriate.
Where immediate
threat call security
ext 333
10
Persistent
danger of
severely hurting
self or others
Persistent
inability to
maintain
hygiene.
Serious suicidal
act with clear
expectation of
death
Unable to function
as a student
Unsafe
Danger to self or
others
Unable to
function
independently
Behaviour is
unsafe
Not adhering to
treatment
Suicidal or violent
Unable to function
independently
Serious suicidal
act with a clear
expectation of
death
No attachment or
concern for others
Recurrent
violence
Needs:
Hospitalisation,
case management.
Facilitate
appropriate
administrative
tasks to enable reenrolment if and
when appropriate
Where immediate
threat call security
ext 333
INTRODUCING COMMUNITY CARE-LINE
Community Care-line: 990 51599
Email: communitycare@adm.monash.edu.au
Community Care-line is not an emergency response.
For emergency response phone security on ext 333
Community Care-line is a new service providing a central point of
enquiry by phone or email to Community Care staff who will provide
advice and support for managing concerning or threatening
behaviour and situations within the Monash University community.
Students and staff are encouraged to ask for assistance if they:
 Feel threatened or unsafe
 Have concerns about someone else’s behaviour
 Are worried about someone harming themselves or someone else
 Wish to clarify issues of responsibility, confidentiality or duty of care
INTRODUCING COMMUNITY CARE-LINE
Community Care-line: 990 51599
Email: communitycare@adm.monash.edu.au
The Co-ordinator Community Care programs will provide leadership and
support at all stages of responding to complex and sensitive situations.
At all times the welfare of both the individual and the Monash community
will be considered and all recommended action will be in accordance with
university statutes and policies.
Community care drop-in times for your campus in HWD
Berwick (Monday & Friday)
10.00-11.00am
HWD Hub Bldg 930
Caufield (Wednesday)
9.00-9.30am
HWD Hub Level 1 Bldg B
Clayton (Daily)
9.00-9.30am
HWD Hub Western end Campus Centre
Gippsland (Monday)
10.30–11.30am
HWD Hub Room 102 Bldg 3N
Parkville (Monday)
10.00-10.30am
HWD Hub Ground Floor, Sissons Bldg
Peninsula (Tuesday & Thursday)
10.00-11.00am
HWD Hub Level 1 Bldg A
Future directions …
• Tutor training
• MHFA for students
• Speakers on mental
health issues during
mental health week
• Health Wellbeing &
Development webpage
MHFA@Monash