When we think of wilderness medical emergencies, we often focus on physical injuries such as broken bones, cuts, and bruises. However, it’s important to recognize the role of mental health in these situations as well. Just as we must acknowledge mental health in standard medical care scenarios, such as surgeries, hospitalization, or chronic illness, the same applies in wilderness healthcare. 

Mental health issues can arise in the wilderness due to isolation, stress, and uncertainty, and can contribute to medical emergencies. According to wilderness medical training expert Gavin Dawson, “It’s important for us to explore the connection between mental health and wilderness medical emergencies; in addition to proper wilderness medical training, wilderness first responders should understand how to recognize and address mental health issues in an outdoor emergency situation.”

Mental Health Challenges in the Wilderness

The wilderness presents unique challenges to mental health. Isolation, exposure to extreme weather, and physical exhaustion can all contribute to mental health issues like anxiety. Additionally, the stress of navigating unfamiliar terrain or being in a survival situation can also take a toll on a person mentally. 

Sometimes, mental health issues can contribute to or cause medical emergencies in the wilderness. For example, someone experiencing a panic attack may hyperventilate and become dizzy or faint, increasing the risk of a fall or other injury. Similarly, someone experiencing depression or PTSD may become disengaged and less aware of their surroundings, increasing the risk of accidents or getting lost. This is why mental healthcare is a part of medical healthcare in wilderness scenarios.

Recognizing Mental Health Issues

Recognizing mental health issues in the wilderness can be challenging, but it’s important to pay attention to changes in behavior, mood, and energy level. Here are some signs and symptoms to look out for:

• Withdrawing from social interaction
• Changes in appetite or sleep patterns
• Difficulty concentrating or making decisions
• Irritability or anger
• Feelings of hopelessness or despair
• Increased anxiety or fear

If you notice these symptoms in yourself or someone else, it’s important to initiate a conversation about mental health. This isn’t always easy in the wilderness, where there may be limited privacy or distractions, but it’s important to create a safe and supportive environment for these conversations. First responders should especially be aware of how to recognize and respond to a panic attack. Some key signs that indicate a panic attack include rapid heartbeat, sweating, hyperventilating, trembling, and nausea. 

Addressing Mental Health Issues

Firstly, if an individual is having a panic attack, these are the immediate steps you should take:

1. Help them breathe deeply: guide the person through a deep breathing technique and breathe with them.
2. Reassure them that it will pass and that the symptoms are temporary. Use words of affirmation to encourage and calm them.
3. Speak in short, simple sentences: try not to appear flustered or talk too quickly; instead speak in a calm manner using short sentences.
4. Ask them what they need or if there’s anything specific you can do for them.
5. Help them focus on something like repeating a simple physical task such as raising their arms over their head.

Even when not responding to a mental health emergency, first responders should provide emotional support during any medical emergency. Simply being present and checking in with everyone can make a big difference for someone struggling with mental health issues in the wilderness. Listen actively, show empathy, and offer validation and encouragement.

Consistent self-care is a key preventative measure to avoid mental health emergencies in the outdoors. When traveling in the wilderness, all parties should take care of themselves emotionally and look out for each other. Being open and accepting is essential to make space for conversations about mental health and ensure that everyone feels comfortable and safe. Avoiding exhaustion is also an important part of this; never over-extend yourself physically in the wilderness. Always get enough rest, eat well, stay hydrated, and have some fun.

If an emergency does occur, you should have a way to contact professional help. Consider carrying a satellite phone or other communication device that can connect you with mental health professionals or emergency services if needed.

Mental health issues can play a significant role in wilderness medical emergencies. By recognizing and addressing mental health issues in the wilderness, we can help prevent medical emergencies and create a safer and more supportive environment for everyone in the outdoors.