Mental Health First Aiders

[JaneBoleyn]

There are a couple of points regarding the role that I feel uneasy about and I'd appreciate any MHFA educating me or responding.

I understand that their role is to provide initial support and guidance.

Other than 5 day course, what qualifies them to do this? Do they interview for it? Who is doing the interviewing?

What is the remit on confidentiality, especially if asked by a manager to talk to them?

Promoting MH awareness and reducing stigma. How, exactly? Is this part of the "Bring your whole self to work day"? I don't want to hear about Maddie in accounts experience with anxiety, largely because I don't know what to do with that information (plus it feels extraordinarily invasive).

So they have clinical supervision from a clinician? My bet is an emphatic "No". So there is the potential for poor practice, oversharing and vicarious trauma.

Signposting I get. But the internet tells me that their role is to support without judgement and offer immediate assistance to those in distress. What do they actually do with that information, other than signposting?

It all feels very virtue signalling to me, but please do change my mind.

Isn’t it similar to a physical first aider ie no clinical supervision and in reality not called upon very often in a standard office? They can help with immediate needs eg recognise a panic attack and help with calming techniques, but just like a physical first aider would not be expected to offer ongoing therapy-adjacent conversations? Maybe some additional responsibilities around education eg signs of stress, signs of depression, here’s som websites and who you can contact.

Can I just check what you mean by clinical supervision? The use is very specific in clinical terms and does not mean someone checking your work.

I think PP's analogy is quite clear. There will be a dedicated first aider in the workplace, they receive no clinical supervision of any sorts. The only thing they have to do is to regularly refresh their training. Same for MH first aider. Their role is to provide first aid, i.e. to stabilise the person in distress and contact relevant support i.e. counselling, ambulance in severe cases etc. They are not required to provide ongoing therapy and, therefore, no clinical supervision is needed.
In terms of data protection, they are bound by the same laws as everyone else in the workplace.

They don’t have clinical supervision because they aren’t counsellors or expected to counsel. They’re simply there to provide first line support if somebody is struggling, and to and signpost and encourage towards suitable services which can help. In terms of confidentiality, it’s no different to any other colleague telling their manager or colleague about something sensitive: it’s covered under data protection and workplace conduct.

I did MHFA recently.It was a 2 day course as part of my job.

I see it like this:

Without a MH first aider
Maddie in accounts is having a panic attack. Everyone stands around awkwardly while Gemma fetches Maddie a glass of water. Maddie's manager sends her home for the rest of the day.

With a MH first aider
Maddie in accounts is having a panic attack. Gemma fetches Anne, who's a MH first aider. Anne calms Maddie down and after a quick walk, Maddie is ready to get back to work. Anne writes "panic attack" in the first aid book and sends Maddie an email with the contact details for the company's private health insurance provider and a summary of the mental health support they offer.

Thanks everyone for your thoughts.

I particularly bring up supervision because, although they may not counsel, it's reasonable to think that they might hear distressing stories or perhaps those that are a bit close to home. The MHFA might deal with suicide/attempting suicide after contact and in my opinion, they need a safe place to discuss that.

@ComtesseDeSpair , please could you unpack the data protection issue as I didn't understand? AFAIK, GDPR doesn't cover this eventuality and I wonder how the MHFA would handle a disclosure of suicidal intent with a plan.

@PrincessHoneysuckle , tell me about your thoughts on the course.

Did a doctor diagnose the panic attack?
Can anything else be confused with a panic attack?

I am a MHFA.

I did a 2-day course, same as a 'normal' FA. I got a certificate, same as a 'normal' FA. I am trained to provide an immediate help for the person until then can get long-term support, same as a 'normal' FA. I have no clinical supervision, as it is just that - a first-instance support, same as a 'normal' FA. I need to do regular 'refreshers', same as a 'normal' FA.

Unsure what is so confusing?

I've done the training too. This post just feels a bit goady.

@TallulahBetty I think MHFA have the potential to carry a lot of responsibility.

First point of contact is not to be trifled with or minimised as just "a first instance support".

And I think you deserve a space to discuss, learn and receive support yourself.

I did not say it was 'just' a first instance support to minimise it.

My point was that I do not need clinical supervision, as it is the same concept as a 'normal' FA. Your post seems to suggest it is a different thing?

I am DO have space/time to receive support myself if needed.

I'm a MHFA and my employer provides post incident support if needed. We also have access to a 24 hour helpline and unlimited counseling.

I think it carries more responsibility.

If someone breaks their leg at work, you provide immediate first aid and call an ambulance.

MH is not quite as straightforward as you are working with fewer professional resources.

I'm glad you have space to reflect and learn and receive support. I also think that your workplace has a duty of care towards you in your scope as a MHFA.

@Lilimoon that's great news to hear and I'm glad they do that.

I've done the training previously though it's long since lapsed. I don't really understand the issue, OP.

MHFAs obviously aren't mental health professionals and they don't purport to be, any more than the average office first aider would fancy themselves to be qualified doctor or nurse etc.

They are present to provide a first line of support and to help people access more specialist support as required. They are not there to overstep the limits of their own competence. Surely it is a good thing for organisations to have people with at least some understanding of mental health than none at all? What's your objection to this, exactly?

Re the GDPR issues, that should be covered by your own internal policies. In every place I've ever worked, a MHFA would absolutely respect individual confidentiality in most circumstances, but as always, safeguarding takes precedence so they might have to breach that confidentiality if the individual or other people are thought to be at risk.

I don't have an immediate objection. If you read the thread you would see that I did not say that.

What I do have are questions about how it works. As I said in my first post, I am seeking education on the point.

I do feel very strongly about clinical supervision as otherwise the MHFA is potentially vulnerable to the associated stress.

A PP described what her workplace has to support MHFAs and that sounded great.

I also think that there should be a specific policy in place supporting* *MHFA and times when confidentiality may be breached.

Could you tell me what you meant by helping staff to obtain "more specialist " support please?

it is not the MHFAs job to diagnose, counsel or treat the mental illness. They are there for immediate first aid - recognise the signs of an issue, and either signpost to further support or if an immediate danger to contact emergency services / GP etc to take over the support.

It is exactly the same as a first aider - yes they may come across a horrific car crash but realistically they are looking at cuts and deciding if a plaster if fine and advice to keep an eye on it or if it needs a trip to A&E. They don't diagnose the injury or write a prescription.

Not everyone will be cut out to be a MHFA and it sounds like that is you. Which is fine. Some people wouldn't want to be a normal first aider because they don't like the sight of blood.

I did the MHFA training. Amongst other things, we practised asking people on the course whether they felt suicidal now. I hope I never have to ask in real life but was useful to have the confidence to ask that question

You seem to feel strongly about how MHFA should be approached but without much understanding of how it is approached. Why don’t you join a course, even if you don’t intend to be a MHFAer, if you’d like additional information or assurance of how MHFAers can get support for themselves, and the guidance the training and organisation provides around when it’s appropriate to listen and when it’s more appropriate to encourage towards more suitable services; confidentiality guidance; how workplaces should approach MHFA etc.

@ComtesseDeSpair that is exactly why I asked to be educated more on the topic. Post number 1.

I'm not sure how the challenges you are describing differ from that of a first aider. I volunteered as a first aider in my last job - same as above, two day training plus the odd refresher - and I listened to extremely difficult disclosures including abuse, neglect, rape, and abortion to name a few. It's the job of the FA / MHFA to appropriately log the incident along with any safeguarding concerns. It is the job of the organisation to ensure there is support available for the FA / MHFA, following such an incident.

@SneakAttackDamage I wholeheartedly agree.

Which is why one of my questions was about the support available from the workplace to the MHFA.

I'm a MHFA. as everyone has said, there is no clinical supervision as it's not a clinical role. @JaneBoleyn - why the concerns? Was your experience of your works MHFA not what you wanted or hoped for?

I think that MHFA are a dreadful idea. I also think that therapists (of any mode/training) operating without prior personal therapy and ongoing clinical supervision is a dreadful idea.

If the limit of what a MHFA did was to provide signposting to services, that would be great idea, but it isn't and in any case would people with a few day's training actually be that boundaried?
I think it's unsafe for the person in crisis - They have to continue to exist in the workplace alongside their MHFA after their moment of crisis and vulnerability. How many MHFA work outside of the limits of their training through the best of intentions? Where is the line between empathetic co-worker / friend / therapist? It's a very muddled frame. The MHFA is bestowed an artificial position of expertise, with extremely limited training and no personal therapy, how can they not operate from their own personal experience and biases?

It's also harmful for the MHFA. What do they do with what they're told? How does it affect them? How do they establish limits on the care they provide? This isn't a physical injury they're treating, they're dealing with a person's emotions and private thoughts. A relationship will be formed in that moment of crisis, what happens next? Again no prior personal therapy and ongoing clinical supervision leaves them in a very vulnerable situation.