People are generally familiar with emergency response. If it’s physical, that is. Broken bones, cuts, flesh wounds, and even choking will trigger trained and practiced responses from everyday people who have taken one or more first aid or CPR workshops.
Mental emergencies don’t fare so well, though. Breakdowns, depressions, panic attacks, even the blues tend to make other people pull back. Or even walk away.
Jacqueline Bienenstock, a psychiatric nurse and the director of the acute care unit at Carrier Clinic in Belle Mead, wants to change that. For Bienenstock the urge to intervene in mental health emergencies should be as commonplace as those little posters you see in the break room that tell you what to do if someone should suffer an electric shock.
That is why Bienenstock became certified to teach mental health first aid, and it is why she is hosting a course on “Mental Health First Aid Training” on Saturday, October 21, from 8 a.m. to 5 p.m. at Carrier Clinic, 252 County Road 601, Belle Mead.
Bienenstock does a few of these courses every year, in part to keep her certification from the National Council for Behavioral Health valid and in part to spread the word that people suffering mental health emergencies need the same kind of caring response as someone who has been in an accident.
Bienenstock’s course is designed to give a layperson a better understanding of potential risk factors and warning signs for a range of mental health problems, a plan for handling those crises, and a working knowledge of the resources available to help someone with a mental health problem. Or, as Bienenstock says, “To prepare people to interact with someone in crisis, and then call for help.” Cost to attend the course: $25. Visit www.carrierclinic.org.
The concept of mental health first aid started in Australia in 2001 and made its way to the United States about seven years later. In 2016 Carrier Clinic CEO Donald Parker asked Bienenstock if she wanted to become certified to teach the program, and she says she jumped at the idea. That is not a surprise when you learn that Bienenstock knew at age 12 that she wanted to be a mental healthcare professional. Her parents, a businessman and a mother who worked in a doctor’s office, were quite supportive, she says.
It actually started with a mystery ailment found during a routine doctor’s office visit. “My parents took me for a physical for a sleepaway camp,” she says. The doctor found high blood pressure. He figured it might be white coat syndrome and asked to see the girl again the following day. But the next day, young Jackie’s blood pressure was still high, for no discernible reason.
Bienenstock then became the subject of a six-week study at Cornell Research Center in New York, where she learned she enjoyed helping the (stumped) doctors and nurses do things, like take her blood pressure. The problem turned out to be a small blockage in her kidney.
She was drawn to the compassionate side of medicine and decided then that she wanted to do that for a living. She went to Middlesex County College to study nursing, and then joined Carrier in 1990 as a staff nurse. She has never left — “I feel like I grew up here,” she says — but does also teach at Middlesex County College and Hackensack Meridian Health. She later got her bachelor’s and master’s from the Chamberlain University College of Nursing. In 2010 she was named director of Carrier’s acute care unit, where she is in charge of a staff of 75.
Bienenstock has been a psychiatric nurse since there was still a USSR, so she has seen no shortage of mental health crises. Though she says she did not see much in the way of mental illness while growing up in the Edison-Highland Park area, she can’t quite conceive of a person who has had no exposure to mental health issues, either as the person going through something or as a person around someone who has. Sadly, though, she can conceive of the stigma surrounding issues like depression or anxiety. Some people mock, some just don’t get it, and some understand it all too well but choose to stay away from someone coping with emotional strife.
It is often not that people want to flee out of malice from someone mentally sick, she says. It is more that the lack of familiarity with tending to a mental crisis often leads to its own form of mental crisis.
“People get scared,” Bienenstock says. “They don’t know what to do with someone who is having a panic attack.”
What you can do. Instead of panicking yourself, think of ALGEE, a five step process that stands for:
• Assess for risk of suicide;
• Listen non-judgmentally;
• Give reassurance and information;
• Encourage appropriate professional help; and
• Encourage self-help and other support strategies.
Those five steps are the bedrock of mental health first aid training, Bienenstock says. It doesn’t matter what type of illness: whether serious depression or general angst these steps work to at least keep a crisis contained until professional help can come along.
It is noteworthy to mention that a lot of the people who attend Bienenstock’s class are the types of professionals people would call in the first place — police officers are a large contingent of her student population. Bienenstock is happy to see them and not surprised. Often even first responders, she says, do not know what to do with someone who is having an emotional breakdown.
What not to do. A lot of the reason most attempts at intervening or helping during someone’s mental crisis fail is because of good, but misguided, intentions. People do try to help, Bienenstock says, but they often say exactly the wrong things. “I know what you’re going through” is high on the Hit Parade but is, she says, absolutely one of the worst things to tell someone.
“You don’t know what they’re going through,” she says.
Other common bits of well-meaning-but-terrible advice include “Just snap out of it” and “Just sleep it off.” In fact, if it sounds like advice, it’s almost certainly not a good idea to dole it out to someone legitimately getting lost mentally.
A better approach, Bienenstock says, is to just be with the person. Make sure she is not alone; be as positive and supportive as possible. And something that works wonders: Take a walk with her.
And if the person in crisis does not feel like talking, the best way to handle that is to keep your lips shut, too. “I’ve had patients say to me, ‘I’m not talking,’ then, guess what?” she says. “Five minutes later they see I’m going to stay and they start talking.”
In short, the best thing you can do as a mental first aid measure is just be there and be compassionate, Bienenstock says. It might sound cliche, but like most cliches there’s a lot of truth in it.
“Try to put yourself in the other person’s shoes,” she says.