The ‘FIRST’ Incident Procedure
Mental Health First Responders (MHFRs) play a crucial role in supporting individuals who are experiencing mental health distress. In moments of crisis, first responders are often the first point of contact, providing initial support and guiding individuals toward the help they need. To effectively respond, Mental Health First Responders can follow a structured approach, like the FIRST Incident Procedure. This procedure outlines clear steps for identifying, investigating, and addressing mental health concerns in a calm, supportive, and methodical manner.
The F.I.R.S.T. framework consists of five steps: Find out, Investigate, Reassure, Support/Signpost, and Take care. Each step plays a pivotal role in guiding the mental health first aider through the process of providing support while maintaining a caring and empathetic approach.
Step 1: Find Out – Recognising a Problem
The first step in the FIRST incident procedure involves determining whether an person is exhibiting signs of mental health distress. It is crucial to observe changes in behaviour that may be out of character or inappropriate for the situation. These changes may include mood swings, withdrawal from social activities, changes in performance at work or unusual emotional reactions.
When these signs are noticed, it is important to reflect on whether the behaviour indicates underlying distress. The goal of this step is to figure out whether there is a potential issue that requires further investigation. At this stage, assumptions should be avoided, and efforts should be made to understand the behaviour from the individual’s perspective. Transitioning to the next step, a conversation can help to gather more information and assess the seriousness of the situation.
Step 2: Investigate – Starting the Conversation
Once it has been determined that a problem might exist, the next step is to initiate a conversation with the person in distress. The objective here is to gain a deeper understanding of how the person is feeling and what might be behind their behaviour. It is essential to approach the conversation with empathy and openness, allowing the individual to feel safe and understood.
During the conversation, open-ended questions should be used to explore what the person is experiencing. Questions such as “How have you been feeling lately?” or “Is there anything that has been particularly difficult for you?” can encourage the individual to share their thoughts. It is important to listen without judgment and refrain from offering solutions too early.
If the conversation leads to evidence suggesting suicidal thoughts, it becomes crucial to ask directly about suicide. Though this might feel uncomfortable, asking about suicide in a calm, straightforward way does not increase the risk of it happening. Instead, it opens up an opportunity for the individual to express their feelings and seek help.
Step 3: Reassure – Offering Emotional Support
Once the conversation has allowed the First Responder to gather relevant information, the next step is to reassure the individual. At this point, it is critical to remind the person that they are not alone and that help is available. Reassurance provides comfort by emphasising that the way they are feeling will not last forever, and that there are effective ways to improve their mental well-being.
Statements like “It’s okay to feel this way,” or “You’re not alone; there are people who can help you” can provide significant emotional relief. It is important to reinforce the fact that recovery is possible. Most people experiencing mental health challenges do recover with time, support, and treatment. Therefore, the person should feel encouraged to take the next steps toward recovery.
This step also helps to reduce the person’s sense of isolation and reassures them that their feelings are valid. Through reassurance, the Mental Health First Responder creates a foundation of trust, which is essential for moving on to the next step—supporting and signposting.
Step 4: Support/Signpost – Guiding the Next Steps
After reassurance has been provided, the First Responder should work with the individual to plan the next steps toward seeking help. This stage involves discussing the available resources and support systems that the person can access. Mental Health First Responders are not expected to provide clinical solutions but should be equipped to guide the individual toward professional help, such as counselling, therapy, groups or other mental health services.
The conversation should focus on creating a clear plan of action. Questions such as “What kind of help do you think you need?” or “What steps can we take to ensure you get the support you deserve?” can guide the person in determining what resources are most appropriate for them.
The First Responder may also offer to help the individual access the resources, whether that involves providing contact information for mental health professionals, suggesting employee assistance programs (EAPs), or even helping to schedule an appointment. The process should be collaborative, with the First Responder acting as a supportive guide rather than taking full control.
In some cases, individuals may need help with immediate resources such as helplines or crisis intervention services. Signposting to these services is crucial in ensuring that the person gets the right level of support as soon as possible.
Step 5: Take Care – Encouraging Self-Care
The final step in the F.I.R.S.T. incident procedure is to encourage the individual to take care of themselves. Self-care plays a critical role in mental health recovery and resilience, and the Mental Health First Responder should emphasise its importance. Small actions, such as practicing mindfulness, maintaining a routine, engaging in hobbies, or even spending time with supportive friends, can all have a significant and positive impact.
Additionally, the person should be reminded that self-care involves recognising their own needs and taking steps to address them. Encouraging the individual to focus on the simple things that make them feel better can help rebuild their resilience. This process is about empowering the person to take control of their mental health journey through actionable, self-directed strategies.
Finally, Mental Health First Responders must also be reminded to take care of their own well-being. Supporting someone in distress can be emotionally challenging and it is important for the First Responder to engage in self-care after the intervention. This ensures that their own mental health remains intact, preventing their own burnout or emotional exhaustion.
Conclusion
The FIRST Incident Procedure provides a clear and structured approach for Mental Health First Responders when supporting people in mental health distress. Through each stage—Find out, Investigate, Reassure, Support/Signpost, and Take care – First Responders can effectively offer initial support, guide the individual to appropriate resources, and ensure that both the person in distress and the First Responder themselves are cared for.
By following this procedure, Mental Health First Responders can offer compassionate and practical support while maintaining professional boundaries. The ultimate goal is to ensure that individuals experiencing mental health distress receive timely help and feel empowered to take control of their mental well-being.
Want to learn more about Mental Health First Aid?
The First Aid Training Co-operative runs a suite of private first aid courses that can be delivered at your choice of venue, at a time and date to suit you. We’ll come to you and tailor your course to suit your specific situation, based on one of the core course types that we have in our portfolio. We now have a range of courses available for those looking to become Mental Health First Responders in the workplace, raise awareness of mental health amongst their staff plus specialist mental health training for outdoor professionals. Check out our mental health first aid course suite.
