Mental health first aid: putting theory into practice
To mark World Mental Health Day, CSW asked two of the civil service's mental health first aiders to reflect on what they've learned so far
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The first thing to know when administering mental health first aid is that it shouldn’t be about you.
That was one of the first lessons Daveena Solanki, a project support officer in the Government Communications Service, learned when she completed the two-day training course in May. Like many people who see a colleague struggling in the office, up until a few months ago her first instinct would have been to offer advice or reflect on a time when she’d encountered a similar problem.
But the trainees – who now make up some of the more than 2,200 mental health first aiders across the civil service – instead learned to put their own experiences aside and simply to listen.
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When a colleague shares a problem, Solanki says, “It’s a natural thing to say ‘I’ve been through it’. But rather than comparing what they’re going through to your own experience, one of the things we learned was to just listen to what they’re saying and almost repeat it back to them, so they feel like they’re been heard.”
Shelby White, an executive assistant at the Cabinet Office, says this point is critical because “Sometimes people don’t need solutions; they just need support.”
Listening and communicating without judgement is the second step – after “approach, assess, assist” – in a five-step process the first-aiders are taught during the training. The ALGEE framework (assess for risk of suicide or harm, listen nonjudgmentally, give reassurance and information, encourage appropriate professional help, and encourage self-help and other support strategies) is taught much like CPR in regular first aid training, to be employed by the first responders on the scene when help is needed.
Solanki says the steps have taken much of the uncertainty out of how to approach someone who looks like they might be struggling. They also provide much-needed permission not to try and solve people’s problems for them, but rather to point them to relevant mental health services. The training stresses that first aiders are not expected to give advice or take the place of medical professionals.
In the civil service, first aiders might direct those they help to various support networks, workplace adjustment passports that allow employees to ask for changes to be made to their working environments, and line management support from senior civil servants who have received training to help them take mental wellbeing into account when making decisions.
It is a framework the two civil servants put into practice when they noticed a colleague was acting out of character. “It was quite obvious from the way they acted, they were late to work near enough every day and sometimes didn’t make it into work,” says White. Consistent lateness, a lack of motivation and overtiredness are all symptoms the first aiders are taught to look out for.
White and Solanki helped their colleague seek a therapist and access workplace support – the final steps in the ALGEE framework. What followed was a best-case scenario: a grateful colleague who got the help they needed.
Had the two of them not been on the look out for signs that can point to depression or problems at home – and willing to approach without judgement – this encounter might have gone a very different way. “In a lot of workplaces [mental health] is not a big focus,” says White, acknowledging the uneasy truth that many symptoms of mental ill health are often written off as laziness, which can only worsen the situation.
The training also plays an important preventative role, adds Solanki. “If someone’s been having a stressful time at work that could eventually turn into mental non-wellbeing,” she says.
Even knowing trained first aiders and support services are on offer can make a different; both White and Solanki say they feel better knowing that they can access services if they need to. This nut is not yet fully cracked, and there are still many within the civil service who aren’t aware of the extent to which services are available.
The myriad posters that have appeared around the office since the Cabinet Office launched its health and wellbeing plan this week should go some way to addressing this, says Solanki.
Both she and White say they can see the difference the training and the wider push for mental health awareness have made within their department.
“It’s created an open environment where people seem to feel more able to talk about mental health,” says Solanki. This can only be a good thing, she says. “If someone is struggling they might be so caught up in their own bubble that they don’t know help available unless you stick it in their face.”
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