If you cut your finger at work, or slip and hit your head in a shopping centre, chances are you’ll be greeted by a first aider who will assess the situation and administer the appropriate care. However, when the issue concerns mental health rather than the physical, people are often left not knowing what to do or who to turn to, leading to serious or even fatal consequences.
Mental health issues are far from uncommon. One in four people in the UK will suffer from a mental health issue each year and yet two-thirds of Brits have no one to speak to about their mental health, according to a poll to mark Time To Talk Day.
While it’s a legal requirement to have physical first aiders in every workplace and in many public places and events, we’re still a long way off to seeing mental health treated in the same way. Mental Health First Aid England (MHFA England) hopes to change that by training people to be able to assist those suffering with mental health issues - whether that’s depression, anxiety or even suicidal thoughts - and supporting them to get the right professional help.
Stuart Skinner delivers courses as a MHFA instructor and works as a Health and Wellbeing Consultant for World Challenge Expeditions, leading large groups of challenging overseas trips.
When he began working in the adventure industry, Skinner noted that while all leaders are fully trained and extremely comfortable offering physical first aid, mental health was lagging behind. Now, he works with expedition providers to deliver MHFA courses, and campaigns to make the course compulsory in the outdoor education industry.
“It’s the same with taking a physical first aid course, if you see someone who’s had an accident you have a responsibility to them,” he told HuffPost UK. “It’s not about fixing someone or diagnosing them, it’s just about helping people with whatever they’re going through.”
Skinner believes of the biggest hurdles stopping people taking mental health as seriously as physical health is stigma and fear of not being able to support someone when the time comes.
“We worry we’ll say or do the wrong thing, but support can be as simple as asking the question: are you OK?,” he told HuffPost UK. “It can break the cycle of suicidal thought or just get people vocalising what’s going on with them. People are worried about having conversations that make them feel uncomfortable. We need to talk about things that make us uncomfortable and get over it.”
The MHFA training equips people with the skills and confidence to recognise common mental health issues and provides a vital framework, which acts as a guide to having a conversation with someone about their mental health. It includes guidance on non-judgemental listening, asking open questions to assess the individual’s needs and signposting them to the professional help. The framework is returned to again and again throughout training, to encourage its use in a variety of scenarios.
In November last year, I enrolled on a two-day MFHA England adult training course to qualify as a mental health first aider.
I was motivated by a number of factors including friends who have been signed off work due to mental health issues and colleagues who have confided in me when going through something difficult, as well as feeling a wider duty, as a journalist who reports on mental health, to practise what I preach. Yet, despite having interviewed countless experts and people living with mental illness, the idea of taking on a supportive, rather than reporting, role felt like a daunting task.
Reassuringly, you don’t have to be a mental health expert to go on the course. While some people in my group had more knowledge than others, the instructor spent a lot of time going back to basics to make sure everyone was up-to-speed and did a lot myth-busting to break down any misconceptions we may have had.
The training took place in a classroom set-up and was peppered with interactive exercises, such as games of true or false, role play and watching short films and animations. At the end of the course we were given the weighty textbook we had been working from for future reference.
Natasha Devon, author, mental health campaigner and Youth MHFA Instructor, told HuffPost UK: “There is so much information about mental illness and mental health. The course takes the away the confusion and complication, breaking it down to something really simple so that you can proactively help people.”
It’s impossible, due to confidentiality issues, to know how many people have been helped by mental health first aiders. But since launching in 2009, the organisation has trained 235,000 adults in England and has an ambitious aim to train one in every ten people in the country. Having launched in Australia in 2000, MHFA now exists in 24 countries across the world, with a total of two million mental health first aiders currently qualified globally.
Since taking the course, I’ve found the the skills learnt extremely useful. When faced with loved ones or colleagues going through difficult situations, I have been able to offer support through listening and assisting them in taking the next steps for support - whether that’s directly related to mental health or another issue which could cause issues later on. I feel confident that, should someone approach me with a mental health concern, I would be able to support them.
The elephant in the room when it comes to mental health, of course, is suicide. It is the biggest cause of death for men under 45 and in the UK female suicide rates are the highest they’ve been in a decade. Suicide forms a major part of the two-day course, including dealing with someone who may be having suicidal thoughts and assessing whether they are in immediate risk to themselves.
MHFA teach people to not to be afraid to ask the question ‘are you having suicidal thoughts or feelings?’ and finding out whether the person has made any plans around taking their own life. Once they’ve assessed how far along someone is in their decision making, you can decide the best course of care - which may involve calling emergency services.
According to Poppy Jaman, CEO of MHFA England: “The biggest myth we need to bust is that talking about suicide increases the risk of someone taking their own life, when in reality talking is the most powerful first step towards safety, yet the hardest thing to do when we are distressed.”
Skinner was working on a group trip with gap year students in a jungle in Belize, when one of them became suicidal. “He started withdrawing from the group and wasn’t eating. He had high levels of anxiety and was openly talking about his suicidal thoughts,” Skinner recalled.
When approached by Skinner, the young man was “very open” and started to talk about his feelings. But after monitoring the student for some time and learning about a history of mental health issues, Skinner made the “tough decision” to repatriate the student. While it may seem a daunting prospect to support someone who is suicidal, Skinner says: “It’s the same with physical first aid, your job is to keep that person alive until professional help arrives.”
Devon returned to the fact that many wouldn’t hesitate to become regular first aiders. “With physical first aid you’re not training to be a surgeon or a paramedic or GP, it really is no different with mental health first aid.”
The situation in Belize taught Skinner a hard lesson about self-care. The 37-year-old, who has bipolar disorder, found supporting someone who was suicidal made his own mental health suffer. “My anxiety levels went through the roof. I was constantly worried that he would self-harm or he would take his own life. I was beginning to lose sleep.”
Anyone who has supported someone through mental health issues, will know the toll it can take on your own wellbeing. This is why a large part of the training course is centred on self-care. Not only are participants given permission to leave the room during training session should it be at all triggering, but we were encouraged to remember to look after yourself while supporting another person - think of it as putting your own oxygen mask on first.
This is especially important given that some of those attending undertaking may have their own mental health issues or be faced with them in the future. Some people in my group chose to speak openly about their own diagnoses or living with those who had mental illness.
When I attended the course in London, there were people from a variety of professional backgrounds - HR business partner working for a large bank, someone working in higher education, a fellow journalist - many of whom had been sent on the course by their employer. (Your employer might also be able to help with funding.)
The two-day adult MHFA course currently costs £300 RRP, which covers course materials and overheads for the instructor, including travel and venue hire. But a spokesperson for MHFA said there are many subsidies available through local authorities and charities to help make the course affordable.
The MHFA Instructor Training programme is accredited by the Royal Society for Public Health and it works closely with mental health charities such as Mind. The course is a robust evidence-based training that has been extensively positively evaluated in a large number of studies. Find out more about the course here.
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
- Get Connected is a free advice service for people under 25. Call 0808 808 4994 or email: firstname.lastname@example.org