Bernard Adelsberger, the Old Dominion District Special Needs Coordinator, National Capital Area Council provided the following description, which has been edited for publication.

Statistics from 2009 to 2019 have shown a continuous rise in suicide and in suicide attempts by high school age youth. Suicide has become the second leading cause of death among youths behind accidents. Suicide attempts are the most reliable predictor of death by suicide. (Morbidity and Mortality Weekly Report, 21 August 2020, vol 69, pp 47-55)

These trends are leading Scouts BSA units to actively address the issue of youth mental health. In the National Capital Area Council units are partnering with public health officials to deliver a well-recognized training program to Scouters. Called Youth Mental Health First Aid, the class has been offered to Scouters in the Patriot District. The district introduced the program after Scouters realized there had been at least three suicides by Scouts in the district over a five-year period.

Mental Health First Aid is an international training program operated in the United States by the National Council for Behavioral Health in partnership with the Missouri Department of Mental Health. It is available for teachers, law enforcement, and others who might come in contact with distressed youth. The Scouting community can certainly use and apply such training, given the lengthy associations developed during youths’ Scouting careers.

The eight hours of instruction include discussion and role-playing. Trainees receive an information book and other handouts. The course results in a three-year certification and a patch. Officials hope someday it will be as common as CPR training.

Members of the Fairfax County Community Services Board (CSB) presented the Patriot District class at a Northern Virginia church’s troop meeting room. Enrollment was capped at thirty and all the slots were taken. The CSB instructors said the course is not intended to teach prevention or treatment of mental illness. They compared it to medical first aid. Scouters learn to treat injuries or illnesses before they become serious and until professional help is available.

Basic Symptoms

Symptoms of mental illness can be more difficult to pinpoint than a broken bone or a fever. General signs can include withdrawal, absenteeism, emotional or mood changes, and substance abuse. These may appear before significant red flags such as talk or threat of suicide, or missing prescription medicines, or weapons.

The instructors discuss differences between typical youth behavior versus potential warning signs:

• Withdrawing from family vs. withdrawing from not just family, but also friends and once-favored activities.
• Seeking privacy vs. behaving secretively.

Basic Actions

The first aid practice itself is summarized in five steps, under the acronym ALGEE:

• Assess the risk for suicide or harm.
• Listen non-judgmentally when you speak with a youth who seems to be having mental health difficulties.
• Give the youth reassurance and information that might be helpful to a situation that’s troubling him or her.
• Encourage the youth you perceive to be at risk to seek professional help, whether from a school counselor or psychologist, county services, or private services, often covered by family health insurance.
• Encourage self-help strategies, such as identifying supportive friends and family, managing immediate symptoms and appealing to the youth’s interests.

The bottom-line advice after you’ve gone through the ALGEE steps and suspect that a youth is considering suicide is discuss your observations (“I notice you’ve been pretty quiet lately” or “I haven’t seen you at many meetings – everything OK?”) rather than stating your assumptions.

If, based on warning signs in behavior and conversations, you think a youth is considering suicide, the CSB instructors advocate being blunt when you talk to him or her: “Are you thinking about killing yourself? Do you have a plan?” Which, admittedly, is unnerving to do, even in a training course practice session. Let the youth know such thoughts are not uncommon and that help is available. Involve the youth in a decision to get help. Finally, by calling 911, you can alert health officials. Many communities have teams specially trained to help in life-endangering episodes.

The course covers other nuances in talking to youth who might be having mental health issues. Routines that can help a youth include exercise, communal meals, sleep, personal interests, healthy self-esteem and feeling in control of one’s life.

Another statistic presented by the instructors: People are much less likely to commit suicide if they have at least three people in their lives they feel they can engage with. One of our jobs as Scouters is to make sure every youth we support in the program has such a network of people they can trust.

For more information

Visit the Mental Health First Aid web site at www.mentalhealthfirstaid.org. Check your local public health office for information on mental health issues and services such as suicide prevention. Information and help are also available 24/7 nationwide by calling Psychiatric Rehabilitation Services (PRS) at 800-273-8255; or by texting “CONNECT” to 85511.