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Mental health first aid

Mental health first aid

Mental health first aid – challenges for organisations

This month’s Parliamentary debate shone a spotlight on the issue of Mental Health First Aiders in the workplace, calling for Mental Health First Aid (MHFA) to be given equal status as physical first aid in the workplace. An Early Day Motion tabled in October 2016 asked the Government to commit to the principle of equality for mental health in the workplace by amending first aid regulations and guidance to require every organisation to have trained Mental health first aiders, and to ensure that employers are aware that their first aid obligations relate both to physical and mental health issues.

However, recent research published by Nottingham University and subsequent guidance by Institution of Occupational Safety and Health (IOSH) seem to question the merits of this and organisations could be forgiven for feeling confused.

Nottingham University and IOSH argue that MHFA should be only a part of a much wider business approach. We would agree with this and have written extensively about the need to be strategic, for example check our article at Continuity Central on building an effective strategy. MHFA is just one component of a strategy and may or may not be appropriate for an individual organisation.

An important part of the rationale for implementing any peer support system is identifying what the organisation is trying to achieve and how this will be measured. We spoke recently with a national organisation who had invested substantially in MHFA only to find sickness absence levels rocket. Yet, an NHS Trust we worked with found that an in-house crisis response team reduced sickness levels, from 4% to 0.5%. The difference? Strategy, planning and tailoring of intervention was considered prior to implementation in the NHS case.

Peer mental health support after a crisis or traumatic event in the workplace predates the introduction of MHFA to the UK in 2007 and is often referred to as Psychological First Aid, Critical Incident Stress Management or crisis support. ISO 22330 Guidelines for people aspects of business continuity use the term Psychological First Aid.

It differs from the generic MHFA in its specific use immediately after a crisis event with a focus on managing acute stress and trauma – a specialist area.

One danger of using any kind of workplace peer support is that the organisation, managers and colleagues abdicate responsibility for mental health to the trained staff. This can actually reduce social support in the workplace and add to stigma.

According to the House of Commons Library, “key evidence reviews of the impact of mental health-type training in a workplace environment show that there are a number of knowledge gaps which mean it is not possible to say whether the training is effective in improving the management of mental health in workplaces, or whether it is the only effective mechanism for support.”

This certainly supports the stance that mental health training should be part of a comprehensive approach rather than a stand-alone intervention. There is a lot of positive clinical evidence available, but many organisations fail to adequately measure and evaluate any implementation – again not being strategic.

When it comes to managing the impact of crisis and trauma, research consistently shows that good peer support, organisational culture and leadership can all positively influence both resilience and recovery. Every organisation is different in its attributes and challenges so a one-size fits all is unlikely to be achieved. We’re sure the debate will rumble on and it’s important we question the validity and rationale behind calls for mandatory use of any intervention.