Peer Psychological Aid Handbook

Table of Contents
Introduction 1

Too Long; Didn’t Read 2

Emergency Aid 3

Referrals 5

Recognising Symptoms 6

Approaching People 10

Helping 12

Self-Care 14

Thanks 15
Introduction

This handbook is meant to help you develop knowledge and skills that will help you provide support
for people suffering from mental health issues, both during your time in education and outside of it.
It is focused on increasing effective peer-to-peer support by introducing students to ways to help
others.

Why is it needed?
Peer-to-peer support is something that is often forgotten in education, but that doesn’t mean that
it’s useless. Students are just as capable of empathy as school staff, and that should be recognised.
Unfortunately, often it isn’t, meaning that students can lack knowledge and skills which would help
them to help others.

Why is this better than the alternatives?

This handbook was designed by students working with a counsellor in training in order to provide a
document which has both the student perspective and recognised qualifications. Most other
handbooks and courses are written solely by experts or education staff, and so often lack an
understanding of how students actually feel.
It’s also written as a handbook for students, not just education staff, so it’s much more applicable to
your situation.
And, of course, it’s also free, something that a lot of courses and books aren’t.

Disclaimers
1. This book does not qualify you to provide counselling.
2. It also does not qualify you to diagnose mental health problems.
3. Confidentiality is of utmost importance; it must be respected at all times, unless in extreme
circumstances 1.
4. are others needed?

1 For extreme circumstances, check the Extreme Circumstances subheading in the Referrals section.

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Too Long; Didn’t Read
A summary for when quick reminders are needed, or for people who don’t want to read the
whole book.
will fill in once all sections are completed

• If there is a situation where someone is likely to be badly hurt:

➢ Distract them; get them to focus on something else.
➢ Delay them; try and stop them (don’t use force).
➢ Alert others; tell the police or an authority what is going on (only if it’s really
needed).
➢ After, make sure to show you care about them; ask them if they need anything, or if
they want to talk about what happened.

• Always get consent from someone before doing anything, especially before telling someone
else.
➢ Unless there are Extreme Circumstances; i.e. they are likely to perform actions which
will result in severe or long-term harm to themselves or another person.

Ηλεία

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Emergency Aid
How to help in emergency situations.

In this handbook, emergency situations refer to those where someone is likely to badly hurt
either themselves or others due to mental health issues, such as a suicide attempt or an
attack on others. Remember that if there is a likely risk of harm to you, don’t involve
yourself and call the police.
The steps below are possible actions to take. Physically delaying or alerting others should be
avoided unless absolutely necessary to avoid harm.

Distract
Most emergency situations happen as an act of impulse, instead of a well thought out plan,
so calming them down or distracting them for long enough can stop them from whatever
they are attempting to do. If you can, try and distract them through letting them talk to you,
talking to them, or just being with them.

Delay
If distracting them doesn’t work, and if you are there in person, try to stop them. This can
range from just asking them to stay with you, which they might do, to taking or hiding the
equipment they need for what they are trying to do (e.g. a noose or a weapon). If they are
violent or likely to hurt you, stay out of reach and do not do anything which might
encourage them to attack you.

Alert
If distracting or delaying them doesn’t work or isn’t possible, and especially if you are not
with them in person, alert someone who can help, such as the police or a nearby authority
figure. Try and delay them until help arrives. Again, if they are violent or likely to hurt you,
stay away.

Aftercare
After the emergency situation is over, it’s very likely that they will be distraught, angry, or
otherwise suffering, so make sure you talk to them and ask if they need anything, especially
checking if they want to talk about what happened. If they do, listen, and if not, avoid the
subject.

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If you got to the stage where you felt you had to alert others, while they may be grateful,
there is a chance that they might be angry at you for betraying their trust or exposing their
privacy. If so, let them calm down before trying to speak to them again. Try to be
understanding about why they are angry and avoid telling them that they should be grateful
or that it was “for their own good”. However, if you did everything you could before alerting
others, you shouldn’t feel guilty about it.

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Referrals
Places where people can go if they need more aid than you are able or willing to provide.

Extreme Circumstances
You should only refer someone without their consent if under extreme circumstances.
This is when there is a high risk that their actions will result in severe or long-term harm to
themselves or another person.

Places to Go
This isn’t an exhaustive list, just a few places to start.

Personal Resources
Friends
Parents

Teachers
In-school/out-of-school counsellors

Hotlines in the UK
https://www.samaritans.org/

https://giveusashout.org/

Hotlines outside of the UK

https://www.suicidestop.com/call_a_hotline.html

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Recognising Symptoms
Common symptoms of mental health issues, and how to recognise them.

Mental health issues come in many different forms, and don’t necessarily fit perfectly within
the symptoms of disorders. Because of this, the symptoms below aren’t categorised in
terms of disorders.
If someone is experiencing a symptom, they might bring it up in conversation, especially in
the form of jokes. If you notice someone repeatedly joking or mentioning one of these
symptoms, it’s probably a good idea to check if they’re alright.

Some symptoms are very similar to feelings not related to mental health issues, and so a
feeling doesn’t necessarily mean someone has a mental health issue. As well as this, not
everyone has every feeling listed in a symptom, and there will be some symptoms that
aren’t listed. It’s important to remember that the goal of recognising symptoms is to see
when people are struggling, not to diagnose them with a certain symptom or disorder.
Note: although learning disabilities are sometimes listed as disorders, this handbook will not list
them or their symptoms, as it does not recognise them as “mental health issues”.

Need to re-order this list, and there are probably some I’m missing/haven’t explained well

Symptom How it feels How to recognise it in others

Irritability - A constant feeling of - Lashing out at people for
irritability towards no reason
other people, - Pushing people away
especially when
undeserved
Chronic Emptiness - A constant feeling of - Stopping activities which
and Loss of Interest emptiness they previously enjoyed
- Lacking interest in
activities which you
previously enjoyed
Use of Substances - Reliance on - Use of substances more
substances than would be expected
- Felt as a need for a
specific substance for
daily functions or to
feel like yourself
Insomnia - Inability to sleep - Seeming extremely tired
- Can be difficulty throughout the day
falling asleep,
difficulty staying

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 asleep, or waking up
early
Mood Lability - Sudden, extreme - Sudden and exaggerated
emotional changes changes of the mood
- Feeling of having no someone is in
control over your
emotions
Appetite Changes - Drastic change in - Extreme change in eating
appetite, such as habits, such as regularly
binge-eating, avoiding avoiding eating meals or
meals, or doing both regularly binge-eating
at different times snacks to the point of
- Can also show as a feeling ill
fluctuating weight - Other examples include
not eating meals in public,
often going to the
bathroom after eating, or
giving their food to others
Panic Attacks - Rapidly beating heart - Heavy breathing
- Chest pain - Looking scared or panicked
- Trembling - Difficulty responding
- Nausea
- Intense fear
Anxiety - Feelings of fear or - Avoidant of specific
worry when not situations
expected or when
much stronger than
expected
- Anticipating and
imagining the worst
- Panic attacks
Dissociation - Feelings of being - Lack of response
detached from reality - Often “zoning out” or
- Can show up as “staring into space”
depersonalisation,
which is feeling like
you don’t exist or
aren’t in control of
your body
- Can show up as
derealisation, which is

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 feeling like your
surroundings aren’t
real
- Blurry vision, feeling
like the world is
“foggy”, and not
feeling like you can
feel your sense of
touch, taste, smell
etc.
Delusions - Having thoughts - Acting as if they have
which seem to thoughts which seem to
contradict reality contradict reality
- e.g. thinking that - Sudden rants on things
people are out to get that don’t seem to make
you or that you have sense
superpowers
Hallucinations - Having experiences - Acting as if they are having
from your senses these experiences
which seem to
contradict reality
- e.g. hearing voices or
seeing things which
don’t exist
Withdrawal - Wanting to avoid - Avoiding others, especially
others friends
- Can be because of - Avoiding social situations
irritability, feeling - Sudden cancellations of
“not good enough”, social events without a
or just losing interest reason
in socialising
Guilt - Recurring feelings of - Apologising often,
guilt, either for no especially for personal
reason or much qualities, such as being
stronger than they “annoying” or “clingy”
should be
- Feeling “not good
enough” for others
Sadness - Feeling sad - Seeming sad for long
periods of time

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Self-harm - Intentionally causing - Consistently covering areas
harm to yourself, e.g. of the body when it does
cutting, burning, not make sense, such as
repeatedly getting wearing a long-sleeved
into fights jumper in hot weather
- Often comes with a - Flinching on contact with a
reliance on this certain area of the body
behaviour
Suicidal Ideation - Recurring thoughts or - Evidence of a suicide plan
images of carrying out or note
suicide or dying - Consistent jokes or
- Can lead to coming up mentions of suicide
with a plan and/or
writing a suicide note

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Approaching People
How to start conversations about mental health.

Beginning a conversation with someone about mental health issues can be difficult,
especially if you haven’t done it before. While it isn’t really possible to give a set of openers
for these conversations, since everyone is different, here are some tips to help:

Be Understanding
Mental health issues are sensitive topics, and one of the worst mistakes you can make is to
have someone feel as if they or their issues are being ignored or devalued.
When starting a conversation, don’t be dismissive. Make sure you respect that the person
you’re talking to is suffering, and that their problems are important to talk about, no matter
how small they might seem.
Avoid being skeptical. For example, delusions or hallucinations might seem silly from your
perspective, but from someone who has them, they can seem very real, and dismissing
them without listening can drive them away from you. Try to balance being understanding
and not feeding their delusions, such as logically showing them that their beliefs are unlikely
instead of just telling them that they’re wrong.

Conversation Starters

Are They Lying?

A worry that sometimes comes up when discussing someone’s mental health with them is
that they might be lying. Don’t take this as true. It’s much better to help someone who turns
out not to need it then to refuse help to someone who does end up needing it, and if
someone is lying about a mental health issue, they probably still have some. Also, the vast
majority of people aren’t lying.
Of course, this doesn’t mean you should do anything you’re asked to because the person
asking you claims to be suffering. You should prioritise your own mental health over others,
because you can’t help anyone if you yourself are breaking down; more on this later.

What can make it worse?

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Excess work load, unhealthy relationships with family/friends/relative,

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Helping
Techniques to help people.

Helping people is difficult, and the methods to do it vary completely between people, but
there is one technique which works for everyone:

Listening
(or reading if you use text to communicate)
Listening to people is the easiest, best, and only (other than trial and error, which doesn’t
work very well) way to find out what kind of help someone needs. If someone tells you that
they’d like your help, listen to them to see what they would like you to do. Sometimes this is
just listening to them rant; sometimes it’s alerting others to their situation or talking them
down if there’s an emergency situation.
If they ask you to do something that you’re willing to do, make sure to be encouraging and
tell them that you’re willing to do it, since often they’ll be hesitant about asking for help.

If they ask you to do something that you can’t or aren’t willing to do, it’s completely ok to
tell them no.
If they tell you that they don’t want or need help from you, you should accept that and
don’t force it on them or pressure them, and don’t do anything “for their own good”. 2

If they aren’t sure how you could help, try suggesting things. The best ones are to let them
rant or to offer to talk to someone for them. Obviously, don’t do something that they don’t
want you to do. If you are suggesting things, try to phrase them in the form of questions,
such as “Do you think it would help to try X?” or “How would you feel about Y?”.

Encouraging People to Talk

Sometimes people will find it difficult to talk or won’t know what to say. If this happens,
there are some ways to encourage them to talk more. However, if they don’t want to talk,
don’t make them.
1. Staying silent – a pause in the conversation can make them want to fill it, and they’ll
often do that by continuing to talk, giving you some more insight into their concerns
2. Asking questions – asking a follow-up question to something that they’ve just said
can get them to give you extra information on their concerns. Don’t interrupt to ask
them, and avoid topics that they seem uncomfortable with (this is common with

2 Unless this is in Extreme Circumstances or an Emergency Situation

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 topics such as “how does it feel?”, and might make them want to stop talking about
it)
3. Summing it up – telling them what you think they mean (about what they feel, what
they’re going through etc.) and then asking them if you’re right will make them feel
as if they are more important to you, and will also mean that you can correct
anything that you got wrong. If you do this, avoid making value judgements, and
accept that you might be wrong.

Other Ways
While you should listen before trying to help, there are some ways that you can help after
you have listened to what they would like you to do. If you give advice, phrase it as a
question or suggestion instead of a command or instruction. Make sure not to pressure
people into anything.

Grounding
Grounding is a way to focus on reality. It’s especially helpful for anxiety or panic attacks.
There are lots of different techniques, but a few are listed below:
➢ Box Breathing – Breathe in for four seconds, hold your breath for four seconds,
breathe out for four seconds, then hold your breath for another four seconds.
➢ Using a Chair – While sitting in a chair, focus on the way you’re sitting, the material
of the chair, how the floor feels on your feet etc.. You can do this while standing as
well.
➢ Counting – Count objects that you can see that have something in common, e.g. blue
things.

(add “observe surroundings”)

Counselling
While it’s very important not to pressure anyone into going to counselling or therapy, it can
be good to suggest it, as well as be able to give some good reasons if you’re asked to.

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Self-Care
Remembering to take care of yourself.

The first thing you should think about before helping others with their mental health is your
own.

You can’t help other people if you’re struggling too much yourself.

Focus on improving your own mental health if you feel like you’re struggling.
Don’t give favours that you don’t think you can actually carry out.
Don’t do things you can’t/don’t want to do.
Don’t let yourself be manipulated by people using mental health issues.
If you feel that someone is bad for your mental health, it’s ok to cut them off.

If helping others is taking too much of a toll on you, it’s ok to tell them you can’t help them.
Don’t blame yourself for not helping someone.

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Thanks
Those who helped with planning, writing or reviewing the book.
I’ll fill this in at the end, unless you say that you tell me that you want to be anonymous

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