Spreading mental health first aid awareness

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The substantial client list of a winner at last year’s Irish Healthcare Awards is growing, and Mental Health First Aid Ireland is now teaching mental health first aid skills to blue-chip companies’ employees, Peter Doyle reports.

It has been a busy 10 months at Mental Health First Aid Ireland (MHFAI) since it was honoured at last year’s Irish Healthcare Awards, the so-called health Oscars.

After winning the Patient Lifestyle Education Project of the Year prize at last November’s award ceremony, the training body refused to rest on its laurels, and rolled out course after course at workplaces around the country.

Their substantial client list now includes blue-chip employers such as AirBnB and Vhi Ireland, while members of the Defence Forces are also learning mental health first aid (MHFA) skills alongside their basic training.

And MHFAI’s Manager Donal Scanlan has revealed to the Irish Medical Times that next month they will being teaching the art of MHFA to the ranks of An Garda Síochána.

MHFA skills
But to understand how MHFA skills will benefit gardaí in their day-to-day duties, it is perhaps best to get an insight into what MHFA actually is — and, more importantly, what it is not.

Developed in Australia around the turn of the century, MHFA is defined as the help provided to a person who is developing a mental health problem, experiencing a worsening of an existing mental health problem or in a mental health crisis.

To provide this help, people are trained in the skills and knowledge to recognise when a colleague is going through a difficult time.

This does not mean that a MHFA practitioner steams in at the first sign of a problem with, as Scanlan said, their “super-hero cape on and saying ‘I have all the answers’”.

“It is about giving people the tools to recognise when somebody might be having a difficulty, (and) the confidence to be able to offer them some support,” he added.

“We don’t want people coming away from a mental health first aid course thinking they are a therapist or a counsellor. They are not. They are coming away with a little bit more expertise, and a bit more knowledge, to be able to help each other on a person-to-person level.

“We do an awful lot of work in workplace settings. You do not want people going round, diagnosing. This is not about diagnosis, in any way. We are not sending people out to say, ‘I see you have depression, I see you have anxiety’. It’s not that.

“It’s about helping people to be able to respond to what someone’s experience might be like.”

There are obvious parallels with physical first aid and Scanlan hopes that the mental health first aider will become as ubiquitous in the workplace as the designated first aider armed with a box full of bandages and sticking plasters.

But he is aware that the stigma that still surrounds mental illness may make people wary of admitting to feeling stressed or anxious at work, fearing that they will be perceived as weak or unbalanced.

It is something that many of the employers MHFAI works with are aware of too, as Scanlan revealed: “Some organisations have gone so far as to properly highlight that there is a mental health first aider, and because they have other roles (in human resources, for example) we are not clearly delineating people as being mental health first aiders.”

As for the so-called stigma, Scanlan hopes MHFA’s rising popularity — a recent survey by Laya Healthcare revealed that 91 per cent of parents of primary school children believe teachers should receive MHFA training — will bring about a cultural change, whereby people will no longer feel they can not admit to feeling stressed or anxious at work.

He further claims that employers are also keen on changing ingrained workplace attitudes and “are using mental health first aid to underpin that change”.

“A much more successful way of looking at mental health first aid training was, yes, have mental health first aiders, but maybe not confine it to a small group of people,” he said. “Let’s have a cultural shift instead, and use mental health first aid in a way that broadens the knowledge and the approach to mental health in organisations.

“In our mind, talking about mental health doesn’t cause mental health problems,” he added. “There is no evidence to suggest that. We shouldn’t be shying away from those conversations. If anything, we should be encouraging them.”

Strong evidence
There is, however, strong evidence in support of MHFA as something that can have a positive impact for staff.

For example, a recent meta­-analysis of MHFA training found that mental health first aiders were able to support their colleagues “up to six months after training”.

“Given low rates of treatment-­seeking, and evidence that people are more likely to seek help if someone close to them suggests it, the support that people receive from those in their social networks is an important factor in improving mental health outcomes,” Morgan et al concluded in their paper, ‘Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour’, published in Public Library of Science Journal, May this year.

Another paper reported that mental health first aid course were responsible in significant improvement of knowledge in participants, “which has the potential to increase understanding and support for those suffering mental illness”.

“Mental health first aid courses potentially enable individuals who are not otherwise involved in mental health to assist people in need,” Morrissey et al added in their paper, ‘Do Mental Health First Aid courses enhance knowledge?’, which was published in The Journal of Mental Health Training, Education and Practice last year.

While, in 2016, a study focusing on the effectiveness of MHFA training for financial counsellors recognised that there was a “significant link between financial difficulties and mental health problems”.

And Bond et al noted in ‘Mental health first aid course for Australian financial counsellors: an evaluation study’ published in Advances in Mental Health Journal 2016, that financial counsellors in Australia were well-placed to help vulnerable clients get appropriate care and that MHFA was “an appropriate form of training for them” to enable them to do so.

The body of evidence in support of MHFA could well explain why over the past four years the number of mental health first aiders in Ireland has soared from several dozen to more than 3,000, as more and more organisations embrace the concept.

With research from the Economic and Social Research Institute revealing that 18 per cent of workplace absences were due to stress, anxiety and depression, there is little wonder that employers are now embracing the MHFA credo as a method of early intervention.

Arming communities
As Scanlan notes, this can only be good news for the primary care sector, especially general practitioners (GPs).

“Professionals are not always immediately available. Some people do not even recognise that what is going on with them is even mental health related,” he commented.

“This [MHFA] is an opportunity to arm our communities to respond to each other’s mental health first, and to see us as being part of the solution, rather than it always having to be about the medics, the doctors, and the nurses solving the problems.”

He added: “GPs need all the support they can get, and doctors and mental health professionals need support. It is not about increasing referrals to these services, it’s about being able to respond in the moment, so hopefully being able to prevent people ever being referred to professionals. Or if they do need it, then it is done appropriately.”

As MHFAI continues to develop courses for workplaces across Ireland, it has not neglected the growing need for the delivery of MHFA training for teenagers.

With this in mind, they are hoping to appoint a trainer in the very near future to help design and deliver courses for that particular age group.

Scanlan said: “One of the things I am really excited about is MHFA Teen, which is peer-to-peer support teaching young people themselves in secondary schools.”

“The idea of MHFA Teen is having adults, first of all, undergo MHFA youth training so you have one good adult supporting young people,” he explained.

“We have the material ready to go; we just have to redesign it for an Irish context. That’s what the new person is going to be doing, heading up this project.”

Guardians of peace
Meanwhile, the first of five MHFA courses for gardaí will be rolled out next month.

The pilot courses are part of a project they launched in conjunction with the Health Service Executive in April 2017 to make MHFA more widely available in Ireland.

And this was the project that was honoured at last year’s Irish Healthcare Awards. Scanlan said police forces around the world are turning to MHFA as a tool not only to help officers in the workplace but to help them also carry out their duties.

“We will see 100 gardaí trained in mental health first aid. It is just the start and we don’t know where it is going to go just yet,” he added.

“From the perspective of an internal support service, there is a lot of really good work going on in the gardaí that doesn’t always get highlighted.

“However, I think they need a little bit more support in not only supporting each other but also in relation to the guidance they might get on how to support the mental health of the people they are dealing with.”

A large proportion of the cases the gardaí are dealing with in the public realm are related to mental health, and MHFA has been used to train police forces around the world in the topic of mental health.

The Federal Government in the United States, the Western Australia police force, the Royal Canadian Mountain Police, are all using MHFA as part of their training.

Scanlan added: “We would like to have that same kind of impact in Ireland. The gardaí themselves are interested in expanding that project afterwards, but we will see where that goes.”

For more information, visit www.mhfaireland.ie.

Or book in to a first aid course with Canberra First Aid at www.canberrafirstaid.com