Imagine waking up with a cough, fever, and watery eyes. Most of us would quickly think, "I've caught a cold or the flu". If the symptoms linger, we know to call the doctor. From childhood, we are taught to recognise signs of physical illness and to respond without hesitation.

But what happens when the symptoms aren't physical, but mental or emotional? What if a colleague suddenly withdraws, a friend struggles to concentrate, or a loved one hints at hopelessness? Unlike with physical illness, few of us have learned to spot these signs of distress - or to know what to do when we notice them.

This is where Mental Health First Aid (MHFA) comes in. Just like physical first aid, it equips people with the skills to identify difficulties, step in with confidence, and guide someone towards professional support. Bringing this training to Malta became both a calling and a responsibility.

How MHFA came to Malta

The idea first reached us in 2014, when a colleague came across MHFA in the UK. Its practical, evidence-based approach immediately struck us as valuable for Malta: a structured way for ordinary people to recognise mental health challenges early and respond appropriately.

Digging deeper, we discovered its origins in Australia. MHFA was created by Betty Kitchener, a nurse and teacher who had experienced depression. Frustrated by how unprepared those around her were, she asked her husband Tony Jorm, a psychiatrist, a simple question: "Why does everyone learn CPR, but no one learns what to do if someone is suicidal or having a panic attack?" That question, in the late 1990s, sparked a movement that has since spread to more than 25 countries.

When we contacted Betty, she was immediately supportive and in early 2015, Betty herself travelled to Malta to train us as the first instructors and adapt the programme to our cultural context.

From the beginning, our courses focused on issues most relevant locally: depression, anxiety, psychosis, substance use, and crisis situations such as panic attacks and what to do when someone is experiencing suicidal thoughts. Importantly, participants are not trained to diagnose or treat. Instead, they learn to notice warning signs, listen without judgment, offer reassurance, and guide to professional help.

Why it matters

Over the years, I've seen how MHFA transforms people's understanding of mental health. It builds what we call mental health literacy - the ability to recognise signs of distress and respond effectively. For non-clinicians, it opens the door to meaningful early intervention.

In May, thanks to the support of the Ministry for Health and the Parliamentary Secretary for Local Government, Richmond Foundation began offering MHFA courses free of charge across the islands. For me, this milestone was the culmination of years of hard work and a recognition of the programme's true value.

What inspires me most are the participants themselves. They leave not only with new knowledge but also with confidence and purpose - the belief that they can step in, reduce suffering, and guide someone towards help before a crisis deepens. MHFA doesn't replace professional care, but it creates a bridge in those early moments when compassion and informed action matter most.

One participant's story has always stayed with me. After completing the course, they noticed a close friend withdrawing. Remembering their training, they asked directly, "Are you having suicidal thoughts?" It is not an easy question, but the course had given them the courage to know it was the right one. Their friend admitted they had indeed been thinking about suicide. That simple, brave conversation opened the door to professional help. Later, the participant told me, "I believe asking that question saved their life." Stories like this remind me daily why MHFA is so important.

A call to action

If you're wondering whether MHFA is for you, my answer is simple: yes. This training is for everyone - parents, teachers, managers, friends, neighbours. You don't become a therapist or a counsellor, but you do become someone who knows how to listen, how to care, and how to act wisely until professional help arrives.

At Richmond Foundation, we remain committed to expanding this network of trained people across Malta. Each new participant strengthens our communities, reduces stigma, and makes it more likely that those struggling will find compassion and support.

Because ultimately, caring for mental health is no different from caring for physical health. Both require attention, understanding, and the willingness to act. And with MHFA, we can all be part of that lifesaving response.

Daniela Calleja Bitar is CEO of the Richmond Foundation

Richmond Foundation are full members of Malta Health Network www.maltahealthnetwork.org