Mental Health First Aid – What, why and who?

Know your Why

At many board meetings across the world directors and HR personnel are discussing the introduction of mental health first aiders.  My question to you is why?  Why do you want to train mental health first aiders?  What problems are you trying to solve?  What do you see as the role of the mental health first aider?  What is the purpose for training people in these roles?  How will you deploy them?  What resources will you give your first aiders?  Once in post how will you support them either with mental overload or with ongoing professional support?  And possibly the most important question what do the people you wish to train see as their role? 

The Role of Mental Health First Aid

Mental health first aid is a bridge which we use to help people to get on the right side of psychological and psychosocial safety.  Workplace stressors can often be a catalyst for mental health overload and because of this, and the amount of time that we spend there, the workplace can be a great place to provide initial support. 

I described mental health first aid as bridge which we can use to support people simply by listening and providing opportunities to talk.  The first aiders have demonstrated a time commitment to develop personal and professional skills so that they will listen non-judgmentally to whatever their colleagues need to discuss.  Talking things through is often enough for a great deal of people.  However, for others mental health first aid might go further across the bridge and so mental health first aiders are trained to signpost the specialist support available and how their colleagues might go about accessing it.  Mental health first aid develops the skills of approach; how we can bridge the initial conversations around mental health when necessary.  How we can assess with a level of confidence whether our colleagues are in crisis, and how we provide assistance to those in need.  This is the role of first aider. 

The ability to listen non-judgmentally is fundamental to the role and I believe that one of the errors made by employers is to not fully grasp that some colleagues have rudimentary shortfalls when it comes to listening without judgment and bias.  Assessing listening skills prior to training, ensuring that those with overt bias are declined and selecting those candidates who display greater self-awareness are vital if you wish people to actually use your mental health first aiders.  Nobody will go to somebody who has a reputation for gossip or extreme opinions and if you do choose somebody like this it can harm the reputation of all the first aiders just by association.  I’ve seen this time and time again in companies and it leads to mistrust and withdrawal.

I’ll come on more to how we choose the right people in the next paragraph, but one further point is that nobody is there to “fix” another person.

Time and time again I hear people saying that they want to do just this and I’m afraid that this just demonstrates that they are currently not suitable to do the training.

The main reasons that I see mental health first aid failing in the workplace are as follows; a) the mental health first aiders have unrealistic expectations when it comes to the scope of the role, b) if you train people who believe that they can fix other people you will you will set them up to fail; they will offend, patronise and insult their colleagues albeit unitentionally, c) mental health first aid fails because there is no clear reason to have first aiders and d) there is ongoing support post training to continue to motivate and back up the trainers. 

The People

• How will you choose them?
• What will be the selection post process?
• What kind of people are you looking for?
• How will you let the people who you don’t select for training know that they haven’t been chosen?

As a Mindfulness trainer I am bound to interview everybody who wants to come on my Mindfulness courses.  It is not as a means of exclusion but as a way to ensure, as far as possible, that the participants are all well and they all are invested in developing a healthy mindset.  In short it means that no matter what they have experienced in life that they have come to a point where they have processed what has happened, are no longer triggered when events arise and are building rigorous self-awareness.  The companies who I work with also build in a selection process for mental health first aid training because choosing the right people can have a great impact on take up once training is completed. 

So, one of the tips that I give to companies is to provide a list of the course content ahead of a short interview process and check if the proposed candidates have personal lived experience of the subjects.  If the answer is yes, it won’t necessarily preclude them from taking part but an understanding of what they did to overcome the problems is important.  The main thing that you want to achieve here is to find out whether or not the candidate has successfully dealt with the experience.  I delivered a mental health first aid course and unknown to me three out of the eight people attending had experienced suicide through close family members.  When we unwittingly came to that part of the course the whole group were derailed.  It was not good for any of the people on the course.  As a therapist I made the decision to pause the training and spoke to each of the individuals initially, one decided not to continue.  Next, I spoke to the group and listened to their fears; the suicide module on any training is one of the most feared because people worry that they might not handle a real life incident well.  The upshot for me was that the trainees had not had even a basic assessment and at least, one of the three was not really in the best mindset to do the course.

Another flag for me are the people who take it to upon themselves to give personal advice because that is not the role of a mental health first aider, and it can indicate the wrong motivation to do the training.

People have different motivations for doing the training and it’s important to understand that motivation before booking them on the course. 

Am I saying that to be a mental health first aider you can never be triggered?  No not at all but we don’t want to escalate anxiety in the workplace in fact, we want to limit it as much as possible and we do that by ensuring the trainees are in the best mindset possible.  That’s point one.

Point two, is that people often want to become mental health first aiders because in their words “they want to fix other people.”  It’s an admirable sentiment but erroneous because nobody can “fix” another person.  As a therapist I don’t agree with the suggestion that people are broken, sometimes we get stuck but that’s it.  People who believe they can fix other people are probably not the best people to train as mental health first aiders so during the selection process check out their motivation.

Point three, I often hear people say I should be a first aider because I have anxiety and I know what it’s like.  No with all due respect you know what your anxiety is like.  Lived experience does not make you an expert in any other person’s anxiety but your own and only then if you successfully manage it.  Again if this comes up during the selection process it might not be the right time to allow this candidate onto training.

Consider whether any of the applicants are well known for having and expressing strong opinions?  If so they might not be the right fit for the training.

At the risk of sounding harsh experience tells me that when choosing mental health first aiders not everybody is a suitable candidate no matter how well meaning or good intentioned they are.  Ensure that you choose from a spread of people across departments.  Remove from your list anybody who is currently dealing with big issues – they will probably be great later on but not now.  Finally make sure that the people who you choose have the capacity to take time out of their day to help with any issues that come up. 

Once you have chosen your people it’s always a good idea to have some reserves in mind because things can change at the last minute and once seats are booked and paid for you may have to still pay for these seats.

My advice should you need to decline certain applications is to speak directly to these people.  Explain that whilst, you would encourage them to apply in future there were other applicants who were better placed at this time.  You don’t have to explain any selection criteria that you used but it’s good practice to tell them they were not successful.  I’ve seen several people harbour resentment because there was no follow up to their application.  Remember that we are building best practice for psychological and psychosocial wellbeing in the workplace and we don’t want to alienate any of our colleagues.

The Training Process

Do you want the training to be on site or online?  As a trainer I love face to face training but online can work just as well.  Both have pros and cons.  You could also check with your teams what they will prefer because the courses are quite lengthy, and they will have to sit through them.

The courses have many similarities but I have a license to train MHFA in England and a license to train in Wales and the courses and the course lengths are not the same.  It’s worth making sure that you are not comparing apples with pears when looking at the courses available to you.

Will you provide a hard copy of the First Aid manual for each person attending or will you expect them to use an online manual?  Again, people with different learning styles will get on better with one over the other.  Personally, I prefer a hard copy because I then have the option to use both but the hard copy does come with a cost which you need to factor in your budget.

The training can be intense in fact, I would say that this is the biggest feedback that we get.  We cover an awful lot of ground in a very short space of time.  That being acknowledged please can you provide a room, preferably with windows that open and which is away from the general workplace noise?  Please can you ensure that the rest of the team knows that their colleague is in depth training and that messages should only be sent when it’s urgent?   I’ve seen so many people attending courses pulled out to attend to minor issues that weren’t important but which did get in the way of learning.

Can you ensure that you have selected across a range of people, at a range of levels and a range of shifts if you do operate shift work?

The courses are very content heavy and you may decide that you don’t want training on Psychosis or Addiction in which case, perhaps you are looking at the wrong type of training.  If this is the case please ask me about the other training I offer.

The Instructor

I am qualified to deliver training on behalf of MHFA England and MHFA Wales but I also, create and deliver my own range of training.  Why is that important?  Well content is important but there is so much information about mental health available on the internet, on Amazon, my books included, and on You Tube that the expertise no longer comes from the content.

In my communication courses I stress that in effective communication content has a value of approximately 7%, that is the content of any mental health course.  Tone carries a value of around 38% and tone comes from knowledge, experience and supporting individuals in their mental health journey every day.  I do this through individual sessions, through my books and through my training sessions.  Finally, at 55% we have body language and in this example, I see body language as the ability to stand up on stage anywhere and discuss mental health and wellbeing as an expert and practitioner of all things mental health.  As in so many areas of life and work t’s not the content that differentiates courses but the experience and the wisdom, of the people who deliver those courses. 

You’re Qualified, What Next?

Many companies think that the training is the end of the journey in fact it’s just the start.  Some questions to think about?

How will you raise the profile of your Mental health first aiders?

Where will they chat to people?  How will people in need find them?

How will they record the conversations whilst maintaining confidentiality?

How will support the First Aiders?

I’ve noticed that often businesses believe that the training is the end point when in fact it’s the start.  It’s important that once you make first aiders available that you promote what they do and who they are there for.  When I go into companies to train mental health and resilience many people have no idea that they even have mental health first aiders on site.  Do you inform new starters at induction?  Do you explain their role?  How do you promote the idea of first aiders to a workforce who may be resistant to speaking about their mental health to their colleagues?

Because I’m a therapist as well as a trainer many of the companies who do their first aid training with me allow me to check in with the first aiders.  On a quarterly basis we have a group check-in.  The first aiders get to share experiences with each other, discuss whilst maintaining client anonymity the kinds of issues they have dealt with, ask each other for advice, we share best practice come up with ways to bring their team to a wider circulation in the workplace.  These catch-up sessions work brilliantly and mean that we don’t leave the helpers struggling.  The greater relationships we can build in our team of first aiders the better; they will be better advocates for communication, better role models and better able to provide great support to their colleagues. 

My teams all have my contact details because it is the building of strong relationships that makes mental health first aid so effective, and it starts with the people on the front line. 

In Conclusion

Mental health first aid is a great initiative when companies invest time in choosing the right people, providing experienced mental health professionals to train them, giving them time to build up a team bond as well as to build relationships with all of their colleagues.  It works even better we help the helpers by providing ongoing support, giving them opportunities to share best practice with each other and giving them ongoing access to their trainer.  If you would like to know how I can support your staff with mental health training, or for details of any of the courses that I run please get in touch.

Best Regards,

Carol