---
name: mental-health-guide
description: |
  Evidence-informed mental health support guide providing CBT techniques, stress management strategies, anxiety coping tools, mindfulness exercises, and crisis resources. Designed to complement professional mental health care, not replace it.
  Use when the user asks about mental health guide, or needs help with evidence-informed mental health support guide providing cbt techniques, stress management strategies, anxiety coping tools, mindfulness exercises, and crisis resources.
  Do NOT use when the request requires professional medical advice or falls outside the scope of mental health guide.
license: Apache-2.0
metadata:
  author: foundry-skills
  version: "1.0.0"
  tags: "health-wellness mental-wellness guide"
  category: "health-wellness"
  subcategory: "preventive-health"
  depends: ""
  disclaimer: "not-medical-advice"
  difficulty: "beginner"
---

# Mental Health Support Guide

> **Disclaimer:** This skill provides general wellness and health information for educational purposes only. It does NOT constitute medical advice, diagnosis, or treatment recommendations. The information provided is not a substitute for professional medical judgment. Always consult a qualified healthcare professional before making decisions about your health, starting a new fitness program, or changing your diet. If you are experiencing a medical emergency, contact emergency services immediately.

> **CRISIS RESOURCES - If you or someone you know is in immediate danger:**
> - **988 Suicide & Crisis Lifeline:** Call or text **988** (US, available 24/7)
> - **Crisis Text Line:** Text **HOME** to **741741**
> - **Emergency Services:** Call **911** (US) or your local emergency number
> - **International Association for Suicide Prevention:** Visit iasp.info for crisis centre listings
> - **Veterans Crisis Line:** Call 988 then press 1, or text 838255
>
> **If you are experiencing thoughts of self-harm or suicide, please reach out to a crisis professional immediately. You are not alone, and help is available.**

## When to Use

**Use this skill when:**
- User asks about mental health guide
- User needs guidance on mental health guide topics
- User wants a structured approach to mental health guide

**Do NOT use when:**
- Request requires professional consultation beyond educational guidance
- User needs emergency assistance

## Questions to Ask the User First

### Initial Screening (to determine appropriate support level)

```
MENTAL HEALTH SUPPORT ASSESSMENT
==================================

1. WHAT BRINGS YOU HERE TODAY?
   [ ] General stress management
   [ ] Anxiety or worry
   [ ] Low mood or sadness
   [ ] Sleep difficulties
   [ ] Work/life balance
   [ ] Relationship challenges
   [ ] Grief or loss
   [ ] Building resilience
   [ ] Mindfulness/self-care skills
   [ ] Other: ___

2. CURRENT SEVERITY (be honest - this helps provide appropriate resources):
   [ ] Mild - occasional difficulty, manageable
   [ ] Moderate - frequent difficulty, affecting daily life
   [ ] Severe - persistent difficulty, significantly impaired
   [ ] Crisis - immediate help needed (-> direct to crisis resources above)

3. PROFESSIONAL SUPPORT:
   - Currently seeing a therapist/counselor? [ ] Yes [ ] No
   - Currently on medication for mental health? [ ] Yes [ ] No
   - History of mental health treatment? [ ] Yes [ ] No
   - Would you like help finding professional support? [ ] Yes [ ] No

4. WHAT WOULD BE MOST HELPFUL RIGHT NOW?
   [ ] Immediate coping technique for what I'm feeling
   [ ] Understanding what I'm experiencing
   [ ] Building long-term skills and habits
   [ ] Guided exercises I can do right now
   [ ] Resources for professional help

NOTE: If user indicates severity is "Severe" or "Crisis," ALWAYS
provide crisis resources first before any other content.
```

## Cognitive Behavioral Therapy (CBT) Techniques

CBT is one of the most well-researched therapeutic approaches. These self-help techniques are adapted from CBT principles but do not replace therapy with a trained CBT practitioner.

### The CBT Model

```
        SITUATION
            |
            v
    AUTOMATIC THOUGHTS
      /             \
     v               v
  EMOTIONS       BEHAVIORS
     \               /
      v             v
    PHYSICAL SENSATIONS
```

Core principle: Our **thoughts** about a situation influence our **feelings**, **behaviors**, and **physical sensations** - and these all influence each other.

### Thought Record Template

Use this when you notice a strong negative emotion:

```
THOUGHT RECORD
===============
Date/Time: _______________

1. SITUATION: What happened? (Facts only - who, what, when, where)
   _______________________________________________

2. EMOTIONS: What did you feel? Rate intensity 0-100%
   Emotion: _____________ Intensity: ____%
   Emotion: _____________ Intensity: ____%
   Emotion: _____________ Intensity: ____%

3. AUTOMATIC THOUGHT: What went through your mind?
   _______________________________________________

4. COGNITIVE DISTORTION: Which thinking trap applies? (see list below)
   _______________________________________________

5. EVIDENCE FOR the thought:
   _______________________________________________

6. EVIDENCE AGAINST the thought:
   _______________________________________________

7. BALANCED THOUGHT: A more realistic/helpful perspective:
   _______________________________________________

8. RE-RATE EMOTIONS: How intense are they now? 0-100%
   Emotion: _____________ Intensity: ____%
   Emotion: _____________ Intensity: ____%
```

### Common Cognitive Distortions (Thinking Traps)

| Distortion | Definition | Example | Reframe |
|-----------|-----------|---------|---------|
| All-or-Nothing | Seeing things in black and white | "If I'm not perfect, I'm a failure" | "I can do well without being perfect" |
| Catastrophizing | Assuming the worst will happen | "This headache must be something serious" | "Headaches are common and usually benign" |
| Mind Reading | Assuming you know what others think | "They think I'm stupid" | "I don't actually know what they think" |
| Fortune Telling | Predicting negative outcomes | "I'll definitely fail the interview" | "I don't know the outcome yet" |
| Emotional Reasoning | Feelings = facts | "I feel anxious so something bad will happen" | "Feeling anxious doesn't mean danger is real" |
| Should Statements | Rigid rules for self/others | "I should always be productive" | "It's okay to rest; I'm human" |
| Personalization | Blaming yourself for external events | "The meeting went badly because of me" | "Many factors contributed to that outcome" |
| Overgeneralization | One event = always | "I always mess things up" | "I made a mistake this time; I've succeeded before" |
| Mental Filter | Focusing only on negatives | "Only noticing the one criticism, not 10 compliments" | "Let me look at the full picture" |
| Disqualifying Positive | Dismissing good things | "That compliment doesn't count" | "I can accept positive feedback" |
| Magnification/Minimization | Blowing up negatives, shrinking positives | "My mistake was huge, my success was just luck" | "Both deserve fair weight" |
| Labeling | Attaching a fixed label | "I'm a loser" | "I'm a person who had a setback" |

### Behavioral Activation

When feeling low or depressed, the urge to withdraw is strong. Behavioral activation works against this cycle:

```
BEHAVIORAL ACTIVATION WORKSHEET
=================================

Step 1: Rate your current mood (1-10): ___

Step 2: List activities by category:
  PLEASURE activities (things you enjoy):
  1. _______________
  2. _______________
  3. _______________

  MASTERY activities (things that give accomplishment):
  1. _______________
  2. _______________
  3. _______________

  SOCIAL activities (connection with others):
  1. _______________
  2. _______________
  3. _______________

Step 3: Schedule ONE small activity for today: _______________

Step 4: After completing it, rate your mood (1-10): ___

Key: Start VERY small. "Get out of bed and drink water" counts.
```

## Stress Management Techniques

### 4-7-8 Breathing Technique (Dr. Andrew Weil)

```
4-7-8 BREATHING
================
1. Exhale completely through your mouth
2. INHALE quietly through your nose for 4 seconds
3. HOLD your breath for 7 seconds
4. EXHALE completely through your mouth for 8 seconds
5. Repeat 3-4 cycles

When to use: Falling asleep, before stressful events, during anxiety
Start with 4 cycles, work up to 8 over time
```

### Progressive Muscle Relaxation (PMR)

```
PROGRESSIVE MUSCLE RELAXATION (15-20 minutes)
===============================================
For each muscle group:
- TENSE the muscles for 5-7 seconds
- RELEASE and RELAX for 15-20 seconds
- Notice the difference between tension and relaxation

Sequence:
1. Feet - flex toes tightly, then release
2. Calves - point toes toward shins, then release
3. Thighs - press knees together, then release
4. Glutes - squeeze tightly, then release
5. Abdomen - tighten stomach muscles, then release
6. Chest - take deep breath, hold, then release
7. Hands - make tight fists, then release
8. Arms - flex biceps tightly, then release
9. Shoulders - shrug up to ears, then release
10. Neck - gently press head back, then release
11. Face - scrunch all facial muscles, then release
12. Full body - tense everything, hold 5 sec, then release

End: Take 3 slow breaths and notice how your body feels
```

### Box Breathing (Used by Navy SEALs)

```
BOX BREATHING
==============
    INHALE (4 sec)
    +-----------+
    |           |
HOLD|           |HOLD
4sec|           |4sec
    |           |
    +-----------+
    EXHALE (4 sec)

Repeat for 4-5 minutes or until calm
```

## Anxiety Coping Strategies

### Grounding Technique: 5-4-3-2-1 Method

When anxiety feels overwhelming, use your senses to ground yourself in the present:

```
5-4-3-2-1 GROUNDING
=====================
Notice and name:
  5 things you can SEE    (e.g., blue wall, wooden desk, green plant...)
  4 things you can TOUCH  (e.g., smooth desk, soft shirt, cool air...)
  3 things you can HEAR   (e.g., fan humming, birds outside, traffic...)
  2 things you can SMELL  (e.g., coffee, fresh air...)
  1 thing you can TASTE   (e.g., mint toothpaste...)

Speak them aloud if possible. Take your time with each one.
```

### Anxiety Ladder (Gradual Exposure Concept)

```
ANXIETY LADDER
===============
Rate feared situation 0-10 and work from bottom up:

10 |________________________| (most feared)
 9 |________________________|
 8 |________________________|
 7 |________________________|
 6 |________________________|
 5 |________________________|
 4 |________________________|
 3 |________________________|
 2 |________________________|
 1 |________________________| (least feared)

Start by practicing coping skills with level 1-2 situations.
Only move up when the current level feels manageable.
Note: Formal exposure therapy should be guided by a therapist.
```

### The STOP Technique

```
S - STOP what you are doing. Pause.
T - TAKE a breath. One slow, deep breath.
O - OBSERVE. What am I thinking? What am I feeling? What am I doing?
P - PROCEED with something that will help (coping skill, reaching out, etc.)
```

## Journaling Prompts

### Daily Check-In Template

```
DAILY MENTAL HEALTH CHECK-IN
==============================
Date: _______________

Morning mood (1-10): ___
Evening mood (1-10): ___

3 things I'm grateful for:
1. _______________
2. _______________
3. _______________

One thing that went well today:
_______________________________________________

One thing that was challenging:
_______________________________________________

How I coped with the challenge:
_______________________________________________

One thing I'll do for self-care today/tomorrow:
_______________________________________________
```

### Themed Journaling Prompts

**For Anxiety:**
- "What is within my control right now? What is outside my control?"
- "What would I tell a friend who was feeling this way?"
- "What is the worst case? Best case? Most likely case?"

**For Low Mood:**
- "What small thing brought me even a moment of joy recently?"
- "What is one kind thing I can do for myself today?"
- "What strength did I show recently, even if small?"

**For Self-Compassion:**
- "If my best friend made this mistake, what would I say to them?"
- "What would a compassionate observer notice about my situation?"
- "What do I need to hear right now?"

**For Stress:**
- "What are the top 3 stressors right now? Which can I influence?"
- "What is one boundary I need to set?"
- "What am I saying yes to that I need to say no to?"

## Mindfulness Exercises

### 3-Minute Breathing Space (from MBCT)

```
MINUTE 1 - AWARENESS
  Notice: What thoughts are present? What feelings? What body sensations?
  Don't try to change anything. Just notice.

MINUTE 2 - GATHERING
  Narrow your focus to just the breath.
  Feel each inhale and exhale at the belly or nostrils.
  When the mind wanders, gently return.

MINUTE 3 - EXPANDING
  Widen awareness to include the whole body.
  Sense your posture, facial expression, and surroundings.
  Carry this awareness into the next moment.
```

### Body Scan (Brief - 5 minutes)

```
QUICK BODY SCAN
================
Sit or lie comfortably. Close your eyes.

Bring attention to:
  Your feet... notice any sensations... (15 sec)
  Your legs... any tension, warmth, tingling... (15 sec)
  Your hips and lower back... (15 sec)
  Your stomach and chest... notice breathing... (15 sec)
  Your hands and arms... (15 sec)
  Your shoulders and neck... (15 sec)
  Your face and head... (15 sec)

Notice your whole body breathing as one... (30 sec)
Gently open your eyes.
```

## When to Seek Professional Help

### Seek help if you experience:
- Persistent sadness, emptiness, or hopelessness lasting more than 2 weeks
- Anxiety that significantly interferes with daily activities
- Panic attacks (intense fear with physical symptoms)
- Thoughts of self-harm or suicide (seek IMMEDIATE help - call 988)
- Significant changes in sleep, appetite, or energy
- Withdrawal from relationships and activities you used to enjoy
- Difficulty functioning at work, school, or home
- Substance use to cope with emotions
- Trauma responses (flashbacks, nightmares, hypervigilance)
- Hearing or seeing things others do not
- Feeling disconnected from reality

### Types of Mental Health Professionals

| Professional | Training | Can Prescribe? | Best For |
|-------------|---------|----------------|----------|
| Psychiatrist | Medical doctor + psych specialty | Yes | Medication management, severe conditions |
| Psychologist | PhD or PsyD | No (most states) | Testing, therapy, complex conditions |
| Licensed Therapist (LMFT, LPC, LCSW) | Master's degree + supervised hours | No | Talk therapy, coping skills, relationships |
| Counselor | Master's in counseling | No | General counseling, adjustment issues |
| Psychiatric NP | Nursing + psych specialty | Yes | Medication management |

### How to Find Help
- **Psychology Today directory:** therapists.psychologytoday.com
- **SAMHSA helpline:** 1-800-662-4357 (free referrals)
- **Insurance provider:** Check your plan's behavioral health network
- **Primary care doctor:** Can provide referrals and initial screening
- **Employee Assistance Program (EAP):** Many employers offer free sessions
- **Community mental health centers:** Sliding scale fees
- **Crisis support:** 988 Suicide & Crisis Lifeline (call or text 988)

## Self-Care Framework: The NEST Model

```
N - NOURISHMENT
  Physical: nutrition, hydration, sleep, movement
  Emotional: activities that bring joy, creative expression

E - ENVIRONMENT
  Physical space: declutter, natural light, nature exposure
  Social space: supportive relationships, boundaries with toxic ones

S - STRUCTURE
  Routine: consistent sleep/wake times, regular meals
  Purpose: meaningful activities, goals, contribution

T - THERAPEUTIC PRACTICES
  Regular: journaling, mindfulness, breathing exercises
  As needed: crisis coping skills, reaching out for support
```

## Building a Personal Coping Toolkit

```
MY COPING TOOLKIT
==================
Fill in with strategies that work for YOU:

When I feel ANXIOUS, I will:
  1. _______________
  2. _______________
  3. _______________

When I feel SAD, I will:
  1. _______________
  2. _______________
  3. _______________

When I feel ANGRY, I will:
  1. _______________
  2. _______________
  3. _______________

When I feel OVERWHELMED, I will:
  1. _______________
  2. _______________
  3. _______________

People I can reach out to:
  1. _______________ (phone: ___)
  2. _______________ (phone: ___)
  3. _______________ (phone: ___)

Professional support:
  Therapist: _______________ (phone: ___)
  Doctor: _______________ (phone: ___)
  Crisis line: 988

Activities that reliably help me feel better:
  1. _______________
  2. _______________
  3. _______________
```

## Important Reminders

- Mental health exists on a spectrum; everyone struggles sometimes
- Seeking help is a sign of strength, not weakness
- Recovery is not linear; setbacks are normal and expected
- Self-help tools work best alongside professional support
- You deserve support and care, regardless of how "bad" things seem
- Small, consistent steps matter more than dramatic changes
- What works for one person may not work for another; be patient in finding your approach


## Output Format

```
MENTAL HEALTH GUIDE OUTPUT
==========================

Section 1: Assessment / Analysis
- Key findings
- Recommendations

Section 2: Action Plan
- Step-by-step guidance
- Timeline if applicable

Section 3: Resources
- Relevant references
- Next steps
```

## Example

**Input:** "Help me get started with mental health guide"

**Output:** A structured mental health guide plan tailored to the user's specific situation, following the process outlined above.

## Edge Cases

- **Incomplete information:** Ask clarifying questions before proceeding. Do not assume details the user has not provided.
- **Out of scope requests:** Redirect to appropriate professional resources when the request exceeds educational guidance.
- **Conflicting requirements:** Present trade-offs clearly and let the user decide priorities.
