PARIS — In September, nine of us gathered in a seminar room in Lattes, in southern France, to begin a two-day first aid training. But the class isn’t about performing CPR or treating burns. We’re here to learn how to respond to mental health issues.
Charlotte Moysan, our trainer and a psychologist specializing in management and entrepreneurship, invites us to choose a card, from a set spread out on a table, that symbolizes mental health for each of us.
I pick a black-and-white image of a woman with a finger to her lips, signaling silence — for me, it represents the taboos, prejudices and unspoken words surrounding mental health. Another participant selects a card of someone in the rain, a call for resilience in mental health, saying “this image makes me think of dancing in the rain, of moving forward despite life’s storms.”
One participant shows a curled-up figure, head in their hands. “When mental health is good, everything is good. When it’s not, it’s a nightmare,” she says.
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“Mental health is as much a pillar of our well-being as physical and social health. Imagine those aspects as three legs of a stool. If one is missing, everything falls apart,” Moysan explains, wrapping up the card introduction. Turning to the board, Moysan draws a horizontal line to illustrate mental health as a continuum, from fragile to robust. She then adds a vertical line that crosses the first and represents the presence of a mental disorder.
The exercise challenges one of my preconceived ideas: Having a mental disorder doesn’t necessarily mean having fragile mental health.
Speaking without fear
The goal of this training is to help us better understand mental health, reduce its stigma and equip us to support someone experiencing a mental health issue.
“Mental health first-aid comes at two key moments: during the development of a disorder or in case of crisis,” Moysan explains. “What’s important to understand is we’re not here to diagnose or replace health professionals, but to learn how to speak openly about mental health.”
Created in Australia in the early 2000s, this training has spread in France over the past five years, with the support of the French Mental Health First Aid (PSSM) association.
One in four people will be affected by mental illness at some point in their lives.
“We are part of the larger family of first responders and share their values — each citizen, without being an expert, should play a role in prevention,” says PSSM France President Muriel Vidalenc. “We have a specific mission: to advocate for the destigmatization of mental suffering.”
Lifting the taboos around mental health is crucial because of how common these disorders are in our societies: One in four people in the world will be affected by mental illness at some point in their lives, according to the UN World Health Organization (WHO). This means that everyone can be affected, directly or through friends and family.
“Mental health problems are the second leading cause of disability worldwide and the leading cause of long-term disability and illness,” Moysan says, noting these issues often occur in adolescence or early adulthood (75% of cases).
Redefining mental disorders
At this point, it’s essential to clearly define what a mental disorder is. Moysan explains it is a condition that develops over time, disrupts daily life and causes significant changes in thinking, emotions and behavior. Major mental disorders include anxiety disorders, depressive disorders, psychotic disorders (such as schizophrenia and bipolar disorder) as well as substance-related disorders (like alcohol or drug use). The causes are multifaceted, encompassing biological, psychological and social factors.
During the training, we will study each of these disorders — not to diagnose them, but to recognize the signs and symptoms to be equipped to provide help. Each time, we’ll apply the “ALGEE” action plan, the mental health equivalent of “Stop, drop and roll.”
The mental health first responder must show a lot of patience and perseverance.
This action plan outlines the key steps in mental health first aid: approach and assess; listen nonjudgmentally; give reassurance and information; encourage appropriate professional help; and encourage self-help and other support strategies.
The first step is especially important, as this is when you assess whether the person is in crisis. If they are, quick action is often needed, such as calling for help in the case of a panic attack (whose symptoms are very similar to those of a heart attack) or a psychotic episode.
If the person is not in crisis, the rest of the protocol can be followed over a longer period. This is one of the major differences from physical first aid, where responders almost always act in emergencies.
“The mental health first responder must show a lot of patience and perseverance,” Moysan says. In fact, it often takes multiple attempts to convince someone experiencing a mental health disorder to seek professional help.
Addressing suicidal thoughts directly
The third step of the action plan, give reassurance, sparks some debate among us at the training. This step involves showing empathy and offering hope for recovery.
“I can’t see myself telling someone who’s really struggling some cliché like, ‘one day, things will get better,’” one participant says. Moysan clarifies that the step is not about minimizing the suffering but also showing a path to recovery is possible. Many treatments have proven effective for mental health disorders: medication, psychotherapy and complementary therapies. The role of the first aider is to discuss these options without making decisions for them.
“They’re the ones holding the steering wheel,” Moysan says.
We discuss applying the action plan to suicidal thoughts and intentions. We begin by debunking myths around suicide, the third leading cause of death among 15-to-29-year-olds worldwide.
“People in these situations aren’t looking to die,” Moysan explains. “For them, suicide has become the only solution to their problems.” If you suspect someone is having suicidal thoughts, it’s best to ask them directly, without evasion or judgment. If they confirm, ask specific questions about their immediate intentions.
“France has a national suicide prevention hotline, 3114, which can be used by both those close to the person and the person in distress,” Moysan says. “If the risk is immediate, don’t hesitate to call.”
Challenging preconceptions
One participant, Aurélie, says she is relieved to learn that this is the correct approach. She is a quality of life consultant and once encountered a similar situation during a conversation with someone battling depression. “I asked him if he had suicidal thoughts, but I wasn’t very confident. I wondered if I was doing the right thing. I left the conversation feeling shaken, and that’s what led me to take this training. I couldn’t keep fumbling in the dark,” Aurélie says.
Mathieu, a technical director at an IT company, previously thought asking such a question was inappropriate. “The training debunked my preconceptions. I now understand that asking directly is the right approach.”
Mathieu considers the training “essential” for those in management roles.
The training challenged many of our beliefs. “I had misconceptions about psychotic disorders, like schizophrenia. I thought it automatically made people dangerous and violent. Today, I know that’s not true, and I have a better understanding of these disorders,” says Romain, who is training to become an occupational psychologist.
To better understand psychotic disorders, which manifest as a loss of contact with reality, delusional thoughts and hallucinations, Moysan shows a video. In it, three people share their experiences with the onset of these disorders, their treatments and their recovery.
“Before, the disorder and I were one. Now, there’s me, living my life, and sometimes the disorder stops by to say ‘hello.’ But it’s important to keep the two separate,” a woman explains in the video.
Impacts of training
The training can be challenging in some aspects. For me, it brought back memories of conversations with loved ones affected by mental health issues. Moysan had warned us at the beginning: “We’ll be discussing topics that we’ve all encountered in some way. If it stirs up emotions, don’t hesitate to step outside for some air.”
Aurélie also found the two days a bit overwhelming. “Certain moments made me reflect on how I interact with my loved ones,” she shares. Now, she feels better equipped to handle these situations in both her personal and professional life.
Mathieu says he considers the training “essential” for those in management roles. “For me, it will help me better detect and manage sensitive situations at work. I’ll also be more mindful of comments that stigmatize mental health issues and those affected,” he says. His company plans to create a small directory to list employees trained in mental health first aid.
At the end of the training, Moysan invites us to conclude with a word to sum up the day. One participant chooses “deconstructed” — the training has broken down his preconceived ideas and the stereotypical image of the “mad person.” Other words echo through the room: destigmatization, legitimacy, necessary and skill.
With that, we say our goodbyes. We are now part of a growing community of over 150,000 mental health first aiders, ready to lend a hand and offer support when needed.
