There’s no doubt that mental health awareness is all around us. High profile supporters such as the Duke of Cambridge do make us sit up and take notice, but what is being done practically and specifically for organisations to support their workforce?
Mental Health First Aid appears to be the latest thing. Or is it? Scotland’s Mental Health First Aid (SMHFA) was introduced in 2003 and is supported and funded by NHS Scotland, there’s is a similar version in England. It’s not a new concept. Are corporate organisations only now feeling pressure to do something about mental health? Is Mental Health First Aid the answer?
The Health and Safety Executive (HSE) are not yet convinced. They say “Based on the published research, it is not possible to state whether MHFA training is effective in a workplace setting to improve the organisational management of mental‐ill health. There is a lack of published occupationally‐based studies, and the studies that have been conducted are limited in quality.” The full report can be found here
I can’t speak for every version of the course but I recently did a two day SMHFA training and my response would be no, it’s not the answer. Having spent 25 years in the corporate world before training as a psychotherapist I can say this with insight and first hand experience.
Here is why:
1. Gaps in content
The course did not cover stress. It is widely documented that stress is the major cause of work-related absence in the UK. In order to understand other forms of mental illness, we need to understand how our body and minds react to stress.
2. Practical application
The training did not cover practical application in a corporate context. The training is aimed at anyone and everyone, in a positive sense it’s very inclusive but to really be of benefit to organisations, it needs to be specific and practical about how the role of “first aider” can be applied. Importantly organisations need to demonstrate a return on investment.
3. Mental illness is NOT the same as physical illness
There are many comparisons made to physical first aid in this course. I believe we need to move away from this mindset. Many physical injuries are treated similarly in first aid. The most serious of which may require immediate medical attention, readily available in the form of an ambulance or a GP. Access to Mental health supprt is completely different and not accessible in the same way. Difficulties cannot be viewed in the same way. Every person and every issue is different. Difficulties could be brought on by circumstances at work or it could be something at home. It can be one situation or many. The same illness could present with different symptoms for different people. Many people don’t even know they are having mental health difficulties. It’s just not the same as physical triage, it requires an individual approach to each individual instance.
4. Ethics, confidentiality and boundaries
While the MHFA role is definitely not pitched as counselling training, who is ensuring that the boundaries are in place to protect the individual, the first aider, and the company? Who is the best person for the role? Are management picking people randomly or those who volunteer? How many first aiders are required per organisation? How are they ensuring confidentiality? What if someone has an issue with a co-worker causing distress but doesn’t want to say to their line manager? There is no practical guidance given.
5. Mental Health First Aiders are not insured
MHFAs are potentially expected to give advice and support. I have not come across a situation where they are insured professionally to provide advice. Employer liability may cover it, but is this being considered? Aligning individuals from the business to a role in which they are expected to provide support normally given by insured professionals is risky for any organisation.
6. Lack of experience
Most mental health professionals (psychotherapists, counsellors, psychologists etc) normally undertake several years training and are accredited by a professional body. Giving an individual 12 hours of information on a range of mental health conditions does not qualify them to discuss any depth of problem with a colleague. The course did not highlight the potential for issues arising and how to tackle them.
7. Supervision
Fully trained and accredited mental health professionals undertake supervision, it’s counselling for counsellors. Supervision is support for the counsellor to explore the issues they have faced with clients and is a crucial element of talking therapy. The course provides no guidance on how the MHFA could be individually supported in the role.
8. Will employees take up the chance to use the first aid model?
Many people I have spoken to do not consider it appropriate to have a colleague put in a position of pseudo counsellor. Many organisations also have employee assistance programmes (EAPs). How does this interact with the role of the MHFA? One person said “there’s no way I would confide in someone I work with when I could phone up my health provider and get counselling through that”.
9. There is no one size fits all
All businesses are different. Demographics, size, industry all play a role in the risks to mental health of employees. Any course focussed on supporting mental health in the workplace needs to address what is applicable and importantly not applicable for individual organisations.
10. Fear of professional suicide
Still the most important aspect for me is that many individuals simply will not give their employer a hint of mental health problems because they fear their career will be impacted. I have spoken to Counsellors who absolutely agree and have clients who express this frequently. A recent statistic in research by Deloitte Centre for Health Solutions showed that according to data from Mind, 94% of employees who have taken off time due to stress named another reason.
Despite raising these concerns over the applicability of MHFA training in corporate organisations, I can whole heartedly say that I support any and all positive mental health awareness. It’s the perception of applicability in the corporate environment I oppose and raise these concerns about.
Kirsty Ritchie, FCCA MNCS Accred
Originally written 2019
