BADN Chief Executive Pam Swain reviews the Mental Health First Aid programme.

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Background

The Mental Health First Aid programme was originally developed at the Centre for Mental Health Research at the Australian National University in Canberra, Australia by educator and mental health consumer Betty Kitchener, together with mental health researcher Tony Jorm, with the aim of extending the concept of first aid training to also encompass mental health issues. The programme was adopted by the Scottish government in 2003 and then by England in 2006. By 2015 it was also being used in Bermuda, Canada, China, Denmark, Finland, Hong Kong, Ireland, Japan, Malta, Nepal, New Zealand, Northern Ireland, Pakistan, Portugal, Saudi Arabia, Singapore, South Africa, Sweden, USA and Wales, with the programme being adapted by mental health agencies in those countries to their own culture and health system.

The English edition of the course manual was originally funded by the National Institute for Mental Health (NIMH) in England. The course covers depression, anxiety disorders, eating disorders, psychosis, substance abuse, self-harm, panic attacks, and suicidal thoughts and behaviours.

What is Mental Health First Aid?

Mental Health First Aid (MHFA) is help given to someone developing a mental health issue, or experiencing a worsening of an existing mental health issue (or is in crisis) before professional help is obtained - help offered by someone who is not a mental health professional but is usually in that person's social network, or is in a public facing role. The course teaches people how to spot the early signs of a mental health issue, including warning signs of common mental health crises, how to offer and provide initial help and how to guide someone towards appropriate treatment/sources of help. Mental Health First Aiders DO NOT provide a diagnosis, therapy, counselling, etc.

The aims of Mental Health First Aid are adapted from the general first aid principles:

  1. a.

    Preserve life - where a person may be at risk of harm to themselves or others

  2. b.

    Provide help to prevent the mental health issue from becoming more serious

  3. c.

    Promote recovery of good mental health

  4. d.

    Provide comfort to a person with a mental health issue.

Mental Health First Aiders use the ALGEE mnemonic:

  • Approach/Assess/Assist

  • Listen non-judgementally

  • Give support and information

  • Encourage getting appropriate professional help

  • Encourage other support.

Why Mental Health First Aid?

The wider aims of MHFA are to raise awareness of mental health issues and to reduce the stigma and discrimination still associated with mental health issues which - especially depression, anxiety and issues associated with misuse of alcohol and other drugs - are increasingly common. It is estimated that one in four people will experience mental health issues during the course of one year; major depression is considered the second leading cause of disability worldwide and a major contributor to the suicide burden; and the direct annual cost to European businesses of depression alone is estimated at £77 billion, due to lost productivity.

Due to the stigma still associated with mental health issues, many people are reluctant to discuss their issues with family, friends and colleagues and often hide their difficulties from others. The prevalent lack of understanding and knowledge on mental health issues may result in those family, friends or colleagues avoiding someone with mental health issues, or ignoring the signs, or avoiding professional help themselves. This lack of knowledge means that, when faced with a mental health crisis, many people don't know how to respond or are reluctant to help in case they do the wrong thing.

The wider aims of MHFA are to raise awareness of mental health issues and to reduce the stigma and discrimination still associated with mental health issues...

Even when people do seek treatment, our overburdened NHS means there may be long waits for actual treatment. A few years ago, when I began to experience panic attacks and sleeplessness after having been the target of a bullying campaign, my doctor referred me for counselling - for which I had to wait nearly six months. By the time I was allocated a counsellor, the bully had moved on and my attacks stopped, although the counselling did help me to deal with the aftermath... and to accept that I had had a mental health issue - anxiety. Until that point, I didn't think that 'people like me' (a strong and independent professional woman, then in my late 50s) had mental health issues - surely that was the province of neurotic housewives, bag ladies on street corners, overwrought teenage girls? I had a lot of support - not always from the people I had expected it from! - but if I hadn't had that support, six months is a long time to wait for professional help.

The course

The Adult Mental Health First Aider course is normally a two-day workshop, but has been adapted for delivery as a four x two-hour sessions online course plus individual learning. I did mine through Remploy, although there are other providers. The course is interactive and is delivered by an approved MHFA England Instructor using a combination of videos, slides, activities, case studies and discussion. The individual learning is done at your own pace via the Online Learning Hub and consists of videos, reading and activities - an estimated total of 6.5 hours.

Session 1 covers various mental health legislation, definitions of mental health, a look at the terms used ('issues' not 'problems', 'experiencing' not 'suffering from', no 'victims' or 'survivors'), discrimination, and depression. Session 2 looks at suicide, alcohol/drugs, self-care and non-judgemental listening skills. In Session 3, we moved on to anxiety, personality and eating disorders, and self-harm; and in Session 4 we finished with psychosis, schizophrenia, bipolar disorder, crisis first aid and resources.

Course participants receive a hard copy manual and workbook and, at the end of the course, various resources are made available. Those who complete the course receive a MHFA certificate. Each course has up to 16 participants and there is a great deal of emphasis on looking after yourself during the course - each participant has to identify a support person they can go to if they find any part of the course emotionally upsetting.

Who does the MHFA course?

Anyone! Particularly if you are in a public facing role, or if you volunteer. Even if that's not the case, it's likely that someone near to you could use your support. In my home town of Fleetwood, for example - a former fishing port of around 26,000 people with more than 5% unemployment spanning three generations and three of whose five wards fall into the 5-10% of most deprived wards in England - mental health is a big issue. It is likely that someone you know is experiencing mental health issues right now - and may need support, but doesn't know where to get it.

I must emphasise again - a Mental Health First Aider does NOT provide a diagnosis, therapy, counselling or advice... just support until appropriate professional help is provided or the crisis is resolved.