This week marks the 25th anniversary of World Mental Health Day, which was introduced to promote awareness and tackle stigma related to mental health. On 10 October, Public Health England announced that a new £15 million programme to train 1 million people in basic mental health ‘first aid’ skills over three years, would be launched in 2018. The programme is intended ‘to improve personal resilience and help people recognise and respond effectively to signs of mental illness in others’.
Mental Health First Aid (MHFA) began in Australia and was introduced in Scotland in 2005 and in England in 2007, as part of a national approach to improving public mental health. In order to qualify as a Mental Health First Aider (MHFA), participants undergo a two-day course, which covers an understanding of mental health and the factors that can affect wellbeing. The programme also focuses on practical skills to spot the triggers and signs of mental health issues; while helping participants to develop the confidence to step in, reassure and support a person in distress. It also focuses on enhanced interpersonal skills such as non-judgemental listening and knowledge to enable someone to access further support, including self-help support services, through their employer or through the NHS.
Over the past ten years, MHFA has provided a service for young people in schools, workplaces and with front-line services, as well as members of the general public. At the University of Birmingham, MHFA training has been provided to a small number of students and support staff by the Birmingham branch of the charity Mind, with opportunities to expand this to staff more widely currently being explored. Potentially, this could strengthen the development of a healthy workplace, and improve the capacity of staff to manage their own mental health, support colleagues and access appropriate support early, thus reducing the risks of developing entrenched mental health problems.
So far, the evidence suggests that people attending MHFA training report improvements in their knowledge and understanding of how to help others with mental health problems. There is also emerging evidence that with a good mental health strategy (of which MHFA is the literacy component), staff are more willing to report mental health as the reason for absence, thus facilitating a return to work, with employees returning more quickly. However, the impact on help-seeking and the economic benefits have yet to be evaluated. Despite its reported success, Mental Health First Aid is not universally welcomed and has attracted some criticism. It is seen by some as a sticking plaster solution to the deeply entrenched problems that influence our mental health, with under-developed approaches to preventing mental health problems and ensuring access to effective services. This is in a context of well-publicised under-investment and a reduction in spending on mental health support, therefore creating a concern that the programme might increase a demand for support that is inaccessible or simply not available.
There is also a profound worry that Mental Health First Aid training will reinforce dominant ideas about mental illness as an illness, downplaying the social and broader understandings both of the factors that shape our mental health but also approaches to promoting better mental health across diverse communities.
The introduction of MHFA signals that prevention and early intervention in mental health are important, a theme currently being investigated by the University of Birmingham Mental Health Commission. The Mental Health First Aid programme is seen as an opportunity to increase and improve the dialogue about mental health, but we need to ensure that MHFA training robustly considers the social understanding of mental health and approaches to strengthening personal resilience.
In a University of Birmingham context, this means developing a good understanding of what impacts on the mental health of students and staff and how these factors can be addressed at both an organisational and personal level.
Mental Health First Aid is no magic bullet, but it can contribute to a comprehensive strategy for promoting and improving mental health, whether that is for students and staff at the University of Birmingham or elsewhere.