Have you ever encountered a situation where a friend confided in you, and you find yourself at a loss of what to say after your friend poured out all his emotions? As much as you would like to help your friend, you are not sure how to help and you are afraid of making things worse. Sometimes, situations like this can feel a little overwhelming – and it is normal to feel that way. This article shares useful psychological first aid skills that can help you respond adequately.

Psychological First Aid

What is it?

According to World Health Organisation (WHO), psychological first aid is a humane and supportive response to someone who is suffering and needs psychological support. It is essentially the emotional version of the first aid you know of, but applied to psychological pain instead of physical pain. Just like physical first aid, basic knowledge and skills training can help to increase the effectiveness of help administered.

What is the purpose?

The aim of psychological first aid is to (1) stabilize the emotional state of the person (2) reduce the acute distress experienced by the person (3) bridge access to professional care, if necessary.

When is it useful?

Psychological first aid can be useful in a wide variety of situations. In a crisis situation, such as a terrorist attack, psychological first aid can be used to alleviate the acute distress experienced by victims or witnesses of the traumatic event. Even in the workplace or school setting, psychological first aid can come in handy when we observe a co-worker or classmate in psychological distress. On a more personal level, psychological first aid can be useful when a close friend is undergoing a psychological crisis (eg. depression or suicidal ideation).

You can refer to our previous article on how to identify the early signs of mental health issues here.

3 Basic Steps of Psychological First Aid

(Note that this section will highlight basic pointers for improving psychological first aid skills in daily settings rather than crisis settings.)

1. LOOK

To identify if a person is in need, you can look for signs of distress including:

• Emotional symptoms like anxiety, fear, anger or irritability.

• Bodily symptoms like fatigue, loss of appetite and headaches.

• Behavioral symptoms like weeping, jitters or restlessness.

2. LISTEN

Firstly, approach the person and introduce yourself if you do not know them. Express your concerns and ask the person if they need help. If so, ask if you can provide help and how they would like you to help them. If there is nothing that you can do, inform the person to let you know if there is something that you can do to help at a later point, even if it is just listening. Remember to keep the tone of your voice calm and soft, but confident. Your confidence reassures the other person and helps them to gain confidence.

Secondly, encourage the person to talk about what happened. If the person is unwilling to share, do not pressure them into talking. Respect the decision and simply inform them of how to obtain help if they need it in the future. If the person is willing to share, listen non-judgmentally and with compassion. Do not interrupt or rush the person.

You can listen with compassion using your:

• Eyes – give the person your full attention and maintain some eye contact

• Ears – listen carefully to the person’s concerns

• Heart – be caring and show respect to the person

If the person is feeling very distressed, reassure them that you are there to help and remind them that they are not alone. As much as possible, help the person to remain calm. For instance, you can ask them to focus on their breath and to breathe slowly.

After you have heard what the person has to say, you may be motivated to ease the suffering of the person. However, do not be in a rush to respond or diminish the problem. You can simply respond with, “I’m sorry that you are going through that, is there any way that I can help?” Do not rely on your preconceived notion of what the person needs. More importantly, do not make promises that you cannot keep by making statements such as “everything will be okay”.

3. LINK

After the conversation, it is important to follow up with the person. If you know the person, make it a point to check on the person again. Ensure that the person has the social support that they need. For instance, you may help the person to contact a family member or friend. If the person requires professional support, do encourage them to seek further assistance (You can find tips on how to encourage one to seek professional help here).

If you are interested in learning Mental Health First Aid, there are courses provided by Singapore Red Cross and Singapore Emergency Responder Academy. You can also find out more on how mental health first aid can be useful here.

References

World Health Organization, War Trauma Foundation and World Vision International (2011). Psychological first aid: Guide for field workers. WHO: Geneva.

Article written with Tay Shi Ying. Shi Ying is a psychology undergraduate at the Nanyang Technological University (NTU) and aspiring clinical psychologist who has completed an internship with ImPossible Psychological Services. She is supervised by our senior clinical psychologist, Haikal.