MANKATO — On a sunny afternoon in October, a Mankato police officer carefully approached a man sitting on the ledge of the North Star Bridge overlooking the Minnesota River. Within an hour, the officer talked the man into walking off the bridge to an ambulance waiting to take him to the hospital.

When someone is going through a mental health crisis, remaining nonjudgmental, using words carefully, listening and showing compassion are just some of the techniques Mankato Clinic psychiatric nurse Mary Beth Trembley teaches as part of a daylong Mental Health First Aid training. Her students range from parents to social workers, teachers and law enforcement.

“This training provides techniques that are extremely beneficial in dealing with that type of a situation,” said Jeremy Clifton, assistant director of operations for the Mankato Department of Public Safety.

Clifton said the course, which is mandatory for Mankato police officers, has proven to be helpful in resolving situations when someone is having a mental health crisis.

“The real kicker is what it means for a first responder to provide care that doesn’t necessarily equal police force,” Clifton said. “We’re always looking at ideas in how we can increase that expansive knowledge for our police officers to give appropriate responses for people that are having a mental health crisis.”

Trembley said the COVID-19 pandemic has taken a toll on a growing number of people experiencing depression and anxiety. Forty percent of U.S. residents reported struggling with mental health or substance abuse issues, according to the Centers for Disease Control and Prevention’s National Health Interview Survey in June.

“COVID has been really distressing for all of us and particularly people that perhaps would have otherwise had the resiliency to manage symptoms,” Trembley said. “Now they’re particularly challenged because this is another major stress in their life.”

Founded in Australia in 2001, Mental Health First Aid training courses have sprouted up across the United States and internationally in recent years. Their mission is for “Mental Health First Aid to become as common as CPR and First Aid training.”

Trembley, who took a weeklong seminar in Minneapolis in 2018 to teach the course, is one of about 12,000 certified instructors throughout the country.

“It really opened my eyes to the lethality of the illnesses and the underreporting that goes on,” she said. “We know that one in five adults struggle with mental illness, and yet it’s still kind of a hidden issue in our society.”

The course curriculum, developed by the National Council for Behavior Health and Georgetown University, draws from firsthand knowledge of people who have personally struggled with mental illness and provides techniques for early detection and intervention for someone at risk.

Mental Health First Aid courses are intended to demystify the stigma that still too often shapes the narrative, Trembley said, and to emphasize the importance of taking mental health just as seriously as we do with our physical health.

She said mental illness has been a public health crisis for years, and the pandemic has made it even harder for people to get help.

“There are patients that are acutely ill who are sitting in the emergency rooms, or families are taking them back home because there aren’t any beds available,” Trembley said. “It’s not uncommon for people in the Mankato ER to have to go to Sioux Falls or even Iowa to get an inpatient mental health bed.”

Getting help can literally mean the difference between life and death. A University of Minnesota study released in August found the suicide rate increased by 48% in 2020 in the state.

“Men are four times more likely to die by suicide than women,” Trembley said. “Suicide is the leading cause of death in law enforcement.”

As with CPR, Trembley teaches the course in steps, beginning with approaching a person with compassion and using hands-on verbal experimentation to assess whether the person is in imminent danger of harming themselves or others.

Once that’s been established, strategies involve listening nonjudgmentally, followed by giving assurance and resources for long-term help.

“’I’ statements are honest because it conveys what we see, feel and what we’re hoping for that other individual,” Trembley said. “It takes ownership for the issue rather than saying, ‘You seem depressed,’ which puts an individual in a position of having to explain or defend themselves. You want to engage them in a loving and supportive manner to provide information.”

While law enforcement and health care professionals are often on the frontlines during a crisis, family members and close friends have a lot more influence when it comes to encouraging a loved one to get help, Trembley said.

“That’s why we need the grassroots effort of people in their families, communities and workplaces being more comfortable with this process to approach, assess, listen nonjudgmentally, opening a dialogue and giving reassurance that you care about them and have information (to help),” she said.

Sarah Beiswanger, a foster parent who works for the Mankato Area Foundation, took the course in 2018.

“It gives you specific, concrete skills in how to be helpful,” Beiswanger said.

She said she experienced firsthand just how beneficial the course was in applying those skills during a time when more people are reporting panic attacks, anxiety and depression.

Beiswanger and Elizabeth Harstad, community impact director for the Greater Mankato Area United Way, collaborated to establish a Community Response Fund in March to help residents and the nonprofits that serve them stay afloat during the economic downturn created by the COVID-19 pandemic.

“This is a time that finances are difficult not only for the organizations but for the individuals,” said Mankato Area Foundation President Nancy Zallek. “We didn’t want the cost of the session to be a financial barrier because it’s just too important.”

The rise in mental health issues from COVID has led to an unprecedented interest in organizations and individuals who want to learn how to best serve others who may be struggling.

“It’s for anyone in the community to be able to participate,” said Harstad, who said the Community Response Fund, supported through donations, covers most of the $90 enrollment fee.

The response, they say, has been so overwhelming that they are looking into funding the tuition for courses next year as well. Anyone who signs up pays $10 and the remaining $80 is covered by the fund.

Teresa Anderson, who took the course this fall, worked in an intensive outpatient mental health program for adolescents prior to becoming a nurse at Mankato East High School. She said she’s seen just how difficult the pandemic has been for youth in particular.

“Students thrive on connecting with others, and COVID has made that difficult,” she said. “One of my goals in this role is to look for ways to promote healthy behaviors, provide support and identifying students that are struggling with their mental health.”

Trembley said some signs to look for range from changes in social ability, interest level, eating habits, changes in sleep patterns and a change in a general sense of well-being.

The ability to recognize those signs and symptoms was one of the important takeaways Mankato Salvation Army Social Services Director Victoria Heun and her staff discovered during the Mental Health First Aid training.

“It was vital in the individuals that we work with that my team had a better understanding on what we can do to support them,” Heun said. “Someone that’s experiencing distress or mental health challenges may just need support to help navigate them to obtaining the tools needed to help improve their own personal situations.”

As COVID cases are on the rise and as winter approaches, the likelihood of more people needing a sympathetic ear is likely to grow. Trembley said society, from the local to the national level, needs to face the crisis head-on.

“We have to start empowering our families, neighbors, community members and co-workers who are all trying to manage these symptoms that simply might not have access to the services that they need,” Trembley said. “It’s unreal and this has been a crisis for years.”

Dan Greenwood is a Free Press staff writer. Contact him at

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