As Mental Health First Aiders, knowing how and when to support someone who is experiencing a distressing situation is vital, but can also be difficult to navigate in the moment. The Mental Health First Aid (MHFA) Action Plan (ALGEE) is a step-by-step approach to deliver safe and effective support to those in need, taking into account that each person and their identity, experiences and challenges is unique.
The Action Plan is designed to be used in many different scenarios, including a situation in which an individual has developmental disabilities.
According to the Centers for Disease Control and Prevention (CDC), developmental disabilities are a group of conditions resulting from an impairment in physical, learning, language or behavioral areas. These conditions begin during childhood development, may impact day-to-day functioning and usually last throughout a person’s life. There are many types of physical or intellectual developmental disabilities, like epilepsy, vision impairment, autism spectrum disorder (ASD) and Down syndrome. This is just a small selection of a wide range of disabilities, and all impact a person in different and sometimes challenging ways.
You should use the MHFA Action Plan (ALGEE) when you believe someone is experiencing a mental health or substance use challenge or crisis. If that person may also have a developmental disability, you’ll need to take special assistance and other considerations into account too. If the person is OK with it, you might want to speak to a family member, caregiver, or legal guardian to share what you have noticed and learn if they have similar concerns. If the person does not have the ability to make their own health care decisions, you should find out who is permitted to give consent for these decisions on their behalf.
The MHFA Action Plan has five steps, which can be used in any order.
A – Approach, Assess for Risk of Suicide or Harm, and Assist.
Try to find a comfortable place to start a conversation with the person, keeping their privacy and confidentiality in mind. Ask them if there is anyone they want to be a part of the conversation, like a family member, caregiver, professional helper or friend – or if they’d rather meet alone instead.
It is important to determine if there is a communication gap. Ask the person with the disability (or their caregiver or professional helper) about their ability to understand and if they have specific communication needs. If you are having trouble understanding them, ask if they would allow someone else to be part of the conversation to help you understand. If someone else is present, like a translator or caregiver, be sure to speak directly to the person with developmental disabilities and not to that other person.
If the person appears to be at risk of harming themself or others, call 911 immediately.
Tell the dispatcher that responders with specific training in mental health or crisis de-escalation are needed and remind responders that the person has a developmental disability. If they’re not already present, try to locate the person’s family, legal guardian, caregiver or someone from their support system.
L – Listen Nonjudgmentally
Many people experiencing a challenge or distress want to be heard first, so let the person share without interrupting them. Try to have empathy for their situation. You can get the conversation started by saying something like, “I noticed that …” Give them time to think about what has been said or to express themselves and offer frequent breaks.
Sometimes repetitive behaviors such as repeating movements or sounds, and touching or moving objects can help a person manage their emotions. These are known as “stimming behaviors,” and you should not try and stop them.
G – Give Reassurance And Information
When the person is finished sharing, offer reassuring statements like “thank you for sharing your experience with me” or “thank you for trusting me.” Before offering any specific information, check what support systems and resources are already available to the person. You can provide them or their caregiver with national or local resources.
E – Encourage Appropriate Professional Help
If mental health professionals with expertise in intellectual disability are available in your area, share those resources. Be mindful that the person may not need or want this type of care. If that’s the case, recommend that they or their caregiver speak to their primary care doctor, who can make an appropriate referral.
E – Encourage Self-Help And Other Support Strategies
Ask if the person has used self-help strategies in the past that they found helpful. If they have and they need support to use them, you can provide that support, find others who can or call a national hotline, such as 988 or the National Alliance on Mental Illness (NAMI) HelpLine.
If you want to suggest self-help strategies, carefully consider if the person will be able to use them. If they want to learn to use them, suggest specialized education programs (if available) to help them to learn.
Every individual and situation is unique, and staying calm is the most important thing as you offer support. Remember that your role is not to diagnose someone or solve the problem, but instead to provide support and information. By using the MHFA Action Plan (ALGEE), you can #BeTheDifference and offer much-needed help.
To learn more about taking a MHFA training, the MHFA Action Plan (ALGEE) and how to support someone in a crisis or a non-crisis situation, take a MHFA course.
Centers for Disease Control and Prevention. (2022, April 27). Facts About Developmental Disabilities. https://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html
Medline Plus. (2017, June 8). Developmental Disabilities. National Library of Medicine. https://medlineplus.gov/developmentaldisabilities.html
Mental Health First Aid USA. (2020). Mental Health First Aid USA Manual. National Council for Mental Wellbeing.