Mental Health Facilitator

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A Mental Health Facilitator ("supporter" as opposed to a full professional) is a lay helper or paraprofessional who knowledgeably helps people suffering from psychological problems, traumatized, grieving, addictive, bullied people or victims of domestic, criminal and political violence, psychological impairments, suffering and Reduce stress by referring them to professional help or assisting them with integration or rehabilitation , e.g. B. in cooperation with social psychiatric services .

General

A training model of the Mental Health Facilitator (MHF) was designed by the National Board for Certified Counselors (NBCC) in the USA at the request of the World Health Organization as an international training curriculum for first aiders and supporters. Facilitator training is not a therapeutic or emergency psychological training, but a sensitization and qualification of lay helpers or an additional qualification for medical staff.

Areas of application of the MHF are the recognition of and immediate help in the event of psychological problems and crises, the improvement of access to community psychiatry facilities and, if necessary, referral to specialists, first aid in the event of disasters with large numbers of traumatized people, participation in occupational health prevention and in corporate integration management and the promotion of mental health and resilience of disadvantaged groups.

Competences that are required and to be trained in this context include: a .: The ability to observe, empathy , conversation and questioning techniques, a culturally sensitive approach to reduce religious or cultural resistance to professional help, as well as the use of simple intervention techniques in crisis situations and the knowledge of institutions, networks and competent specialists. It is an important competence of helpers to be able to protect themselves personally from the possible negative consequences of constantly dealing with traumatized or suffering people.

The NBCC training, which usually comprises 19 modules and which is methodically based on Carl Rogers' interviewing techniques, is adapted in duration and content to the respective national and regional cultural characteristics. In doing so, it must be taken into account that ideas about mental health are never culturally neutral and that emergency situations are often characterized by intercultural communication problems. Therefore, the approach developed in the USA was supplemented by aspects of culturally sensitive advice.

Western thinking assumes that certain life events almost inevitably have a traumatic effect or that the articulation of emotions is “healthier” than bearing suffering in stoic calm. All of these assumptions can suddenly be called into question when e.g. B. Western helpers in Botswana are confronted with the practices of spiritual healers who try to drive away the possessive spirits associated with strangers, especially with the appearance of Europeans or Americans, or when they even compete with them or have to cooperate with them to be effective.

A fundamental element of the training is therefore to awaken an understanding of the universal forms of expression of basic emotions (joy, surprise, anger, disgust, fear, sadness according to Paul Ekman ), to make them aware and at the same time to understand that 'emotion management' and thus the 'modulation' of the expression of feeling are subject to culture-specific rules - a fact that z. B. in light of the tsunami disaster in Japan in 2011 in Europe still met with incomprehension. The concept of the MHF has met with great interest in the Buddhist cultural field.

Target groups

Target groups are u. a. Social workers and case managers , recruitment agencies , nurses and other specialized medical personnel who have not always learned how to address traumatized or suffering people in their training; B. Counseling teachers, study advisors, health workers, social workers, paramedics, police officers, fire fighters ( on-site helpers ), disaster relief workers, development workers and clergy of all denominations as well as people who work with migrants, the elderly or people with disabilities. It is also about the self-protection of the people working in these areas (including burnout prevention).

Internationally, the MHF is in demand primarily from organizations involved in health and disaster relief and development cooperation. In Germany, too, good experiences have been made with volunteer lay helpers in supporting people with mental health problems. It is considered advantageous if they work in groups and can thus support one another.

history

The starting point for the considerations on the development of the MHF were originally the difficult access to therapeutic services and psychiatric facilities as well as the small number of qualified professionals and the lack of municipal facilities in the mental health sector in many underdeveloped and emerging countries. The developers of the curriculum included a. Donna Henderson ( Wake Forest University ) and Scott Hinkle (Coordinator of Clinical Training, NBCC). The pilot training for MHF took place in September 2007 in Mexico. MHF trainers were trained for the first time at a university in Penang (Malaysia) in 2008. The first pilot training in Europe was held in Sofia (Bulgaria) in 2009 . The German version was edited by NBCC Germany and, since 2009, by Barbara Weißbach (IUK-Institut Dortmund) and Hans-Jürgen Weißbach in cooperation with the specialist agency for addiction prevention in the state of Berlin pad eV of the Landstelle für Suchtfragen Schleswig-Holstein eV and at times with the technical college Frankfurt am Main offered.

The MHF according to the standards of the NBCC is now widespread or in use in several developed and emerging countries as well as especially in third world countries. a. in Bhutan (where there are only two psychiatrists), Botswana , Bulgaria , Germany, Liberia , Malawi , Malaysia , Mexico , Portugal , Romania , Zambia , Tanzania and Uganda . The English language curriculum has also been translated into Spanish and Chinese. MHF started operating in China after the earthquake on May 12, 2008.

In 2019 well over 2000 MHF were registered worldwide, of which more than 250 were in Germany. The courses in Germany can also be financed under the Prevention Act . A shortened version for students, teachers and employees has been carried out several times at a North Rhine-Westphalian university since 2019 by the IUK-Institut Dortmund .

Related approaches

The MHF builds on older traditions of lay aid in Germany, France, Italy and the Netherlands, which have been partially displaced by the pressure to professionalise psychiatry.

In the entire Anglo-Saxon region, the involvement of Mental Health Support Workers in community psychiatry (in Ireland : Mental Health Matters Facilitators ) has been intensified since the 1990s . It is characteristic that with recruitment and subsequent short training, particular attention is paid to personality traits and experience in dealing with the target group and less to formal qualifications. As a training method, the discussion in the peer group plays an important role. However, the training times of the various concepts differ greatly: The spectrum ranges from 16 hours to eight days and more.

The model is often used, particularly in rural regions where medical and therapeutic care is inadequate. B. in Canada and Australia for lay helpers. Mental Health First Aid Australia (MHFA) has developed another approx. 5-day training concept that does not start with interviewing like MHF training, but rather provides symptom- or disease-related guidelines for first aid in case of mental problems and crises as a download, e.g. . B. also for dealing with confused elderly people. The Nossal Institute for Global Health at the University of Melbourne is committed to providing primary care training for the mentally ill in India by improving mental health literacy . H. knowledge of mental health.

To the extent that a labor market for MHF develops (as an additional qualification to relevant training), the model was adapted by some American universities and training institutions, which lay people not only for voluntary but also for paid activities in the municipal care of mentally problematic people to qualify.

Similar courses have long been offered in the United Kingdom and Australia as an additional qualification for general practitioners with the aim of avoiding objectively unnecessary drug treatment.

Effectiveness of lay and semi-professional help

Various studies (including by Joseph A. Durlak ; Hattie, Sharpley and Rogers; Bashir and others as well as the Swiss health sociologist Peter C. Meyer) have shown the effectiveness of lay intervention, but also the need for careful training. So were already at the Kobe earthquake in 1995 and again in 2011 earthquake and tsunami in northern Japan volunteers (so-called. Heart Comforter ) trained and used the talks with the traumatized victims led to contribute to the processing of emotions and the risk of a protracted post-traumatic stress disorder to to reduce. Durlak's findings were confirmed and defended against criticism by Hattie, Sharpley, and Rogers. Bashir et al. a. (2000) showed that the use of Mental Health Facilitators can increase the chances of identifying psychological problems in the practices of general practitioners and family doctors. Jorm et al. a. (2005) showed in an Australian study that 78 percent of the trainees had applied the knowledge they had acquired in the courses within 19 to 21 months. Most of the respondents reported an improved understanding of people with mental health problems and improved crisis handling as a result of the short training. There were no indications that the respondents overestimated their skills in providing assistance ( i.e. for so-called overconfidence ).

literature

  • Lucio Decurtins, Peter C. Meyer: Spontaneous and organized help among Italians in the city of Zurich. In: Healthcare. 58, 1998, pp. 36-43.
  • JA Durlak: Comparative Effectiveness of Paraprofessional and Professional Helpers. In: Psychological Bulletin. (86), 1979, p. 8092.
  • JA Durlak: Evaluating Comparative Studies of Paraprofessional and Professional Helpers: A Reply to Nietzel and Fisher. In: Psychological Bulletin. 89, 1981, pp. 566-569.
  • JA Hattie, CF Sharpley, HJ Rogers: Comparative effectiveness of professional and paraprofessional helpers. In: Psychological Bulletin . 95, 1984, pp. 534-541.
  • K. Bashir, B. Blizard, Bosanquet, A. et al. a .: The evaluation of a mental health facilitator in general practice: effects on recognition, management, and outcome of mental illness. In: The British Journal of General Practice. 50 (457), Aug 2000, pp. 626-629.
  • JS Hinkle: International disaster counseling: Today's reflections, tomorrow's needs. In: J. Webber, JB Mascari (eds.): Terrorism, trauma, and tragedies: A counselor's guide to preparing and responding. 3. Edition. American Counseling Association, Alexandria 2010, pp. 179-184.
  • J. Scott Hinkle, Donna Henderson: Mental health facilitation. ed. from NBCC-International, Greensboro, NC.
  • Anthony F. Jorm, Betty A. Kitchener, Stephen K. Mugford: Experiences in applying skills in a mental first aid training course. In: BMC Psychiatry. 2005, 5. p. 43 ff.
  • Jürgen Matzat: On the relationship between profession, lay help and self-help. In: H. Klingemann (Ed.): Self-help and lay help. Alternatives to a future health policy. ISPA-Press, Lausanne 1986.
  • Peter C. Meyer, Monica Budowski (ed.): Paid lay aid and voluntary neighborhood help. Seismo, Zurich 1993.
  • Peter C. Meyer, Monica Budowski: Effects of Organizing Voluntary Help on Social Support, Stress and Health of Elderly People. In: Clinical Sociology Review. 13, 1995, pp. 106-119.
  • Frank Nestmann: Theories of social support and an investigation of everyday helpers from four service professions. de Gruyter, Berlin 1988.
  • D. Paredes, WK Schweiger, S. Hinkle, S. Kutcher, S. Chehil: The Mental Health Facilitator program: An approach to meet global mental health care needs. In: Temas Selectos en Orientación Psicológica. Vol. III: Discapacidad [Selected Topics in Psychological Counseling III: Disabilities]. 2008, pp. 73-80.
  • Shoba Raja, M. Kermode, K. Gibson et al. a .: An Introduction to Mental Health: Facilitators Manual for Training Community Health Workers in India. BasicNeeds and The Nossal Institute of Global Health, University of Melbourne 2009.

Web links

Individual evidence

  1. ^ Christian Hannig: Intercultural communication in the rescue service. In: Dagmar Kumbier, Friedemann Schulz von Thun (ed.): Intercultural communication. Rowohlt, Reinbek 2006, pp. 229–247.
  2. ↑ Ethan Watters: The Americanization of Mental Illness. In: The New York Times Magazine. January 8, 2010.
  3. ↑ Katarina Greifeld (ed.): Ritual and healing. An introduction to medical ethnology. Berlin 2003.
  4. ^ P. Ekman: Facial expression and feeling. 20 years of research by Paul Ekman. Junfermann, Paderborn 1988.
  5. ↑ On Japanese emotion management cf. M. Ziková: The culture-specific shaping of feeling: Japan in an intercultural comparison. (= Cologne ethnological contributions. Volume 19). University of Cologne, Institute for Ethnology, 2006.
  6. ↑ Görlitzer Anzeiger
  7. ^ Government of Lower Franconia ( Memento from May 12, 2012 in the Internet Archive ), accessed January 23, 2016.
  8. ↑ Counselors Address Mental Health Crisis in Developing Countries at: medicalnewstoday.com
  9. ↑ NBCC International: First MHF pilot training held in Mexico ( Memento from November 19, 2008 in the Internet Archive ), accessed January 23, 2016.
  10. ^ Website of NBCC Germany
  11. ↑ Newsletter of the NBCC and ongoing updates on the homepage www.mhf-global.org
  12. ^ China-Australia training on psychosocial crisis intervention: response to the earthquake disaster in Sichuan. In: Australas Psychiatry. 17, 1, 2009, pp. 51-55. doi: 10.1080 / 10398560802444069 . PMID 19137468 .
  13. ↑ http://www.forum.lu/pdf/artikel/1346_63_forum-Redaktion.pdf Accessed October 14, 2013.
  14. ↑ MMHM Facilitators (pdf) - Accessed January 23, 2016.
  15. ↑ E.g. job advertisement from CharityJOB UK: we are looking for warm, flexible and motivated individuals to provide person centered support - accessed February 10, 2013.
  16. ↑ www.reddeer.cmha.ca , accessed February 11, 2013.
  17. ^ Mental Health First Aid Australia , accessed October 17, 2015.
  18. ^ University of Melbourne: Mental health literacy in rural Maharashtra, India ( Memento from April 30, 2013 in the Internet Archive ), accessed January 23, 2016.
  19. ↑ http://www.indeed.com/q-Mental-Health-Facilitator-jobs.html, accessed February 11, 2013.
  20. ↑ See IB Hickie et al. a .: Treatment of common mental disorders in Australian general practice. In: Medical Journal of Australia. Vol. 175, Supplement, July 16, 2001, pp. 525-S30.
  21. ↑ Studies and arguments on lay competence at www.bts-wuppertal.de ( Memento from February 22, 2014 in the Internet Archive ), accessed October 18, 2017.
  22. ↑ derstandard.at