First responders: why every department needs a system for mental health first aid

Mental health first aid can save lives and support better mental wellbeing, but it’s not just a case of training staff and hoping for the best. Kath Cheer and Paul Horsman advise on building structures that help mental health first aiders to support their colleagues


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Like physical first aid, the primary aim of mental health first aid (MHFA) is to preserve life, but it also aims to provide support to prevent a mental health issue from becoming more serious, to promote recovery, to increase awareness of mental health issues and to reduce stigma and discrimination. MHFA is not about being a mental health caseworker for someone. It is about intervening, offering initial help, and signposting to more appropriate services and organisations.

Since 2016, we have been working with Civil Service Local to deliver cross departmental Mental Health First Aid training. We have met wonderful people from across the civil service – all concerned about mental health in the workplace and committed to supporting their colleagues.

The two-day training course teaches people to listen to and understand someone who is struggling and to recognise the early signs of mental ill-health. As in physical health first aid, participants are taught an acronym – ALGEE (see below) – to cement their learning about how to support someone, and give a framework to conversations.

Approach, assess, assist. Here participants consider how to approach someone and how to assess whether there is a crisis which might need immediate medical or other intervention.

Listen and communicate non-judgementally. We consider this to be a vital step. Research suggests that the biggest problem in communication is not listening and also that people are much more likely to be able to accept suggestions for assistance if they feel they have been listened to and not judged.

Give information and support. Mental health first aiders are not expected to give advice.

Encourage the person to get professional help.

Encourage other supports

How does MHFA work in reality? Models of good practice exist. The BBC has trained over 700 of its staff who are identified as mental health first aiders by a coloured lanyard. Information on their intranet and on posters explains what MHFA is and who the first aiders are. The first aiders are part of the BBC’s Mental Health Network, which provides them with recognition and support.

On the course, we also hear about civil service departments that have recognised the value of training first aiders and considered how it will work in reality. For example, we have learnt that the DWP plans to have more than 700 mental health first aiders in place by 2019 and is training its own instructors to make this happen. It has developed a half hour addition to the two–day course which is DWP specific, and will also be designing refresher training to ensure skills and knowledge are maintained. There will be a national database of DWP mental health first aiders and they will be available face-to-face or by phone, Lync or email.

Sadly, some people who attend the training have no knowledge of other mental health first aiders in their department; they may doubt their organisation’s commitment to the agenda or fear that there will be unreasonably high expectations placed on them after the course. On every course we have delivered, people have raised concerns about what happens after the training.

We believe that first aiders will be most effective in the departments and at the sites where the structure and support has been considered and where leaders proactively promote a culture of openness and understanding. We hope that across the civil service there will be a commitment to training more staff and developing structures which both promote mental health first aid and support the first aiders.

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