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.

It’s not, materially, much different to any manager who might sometimes have someone they manage open up to them because they have a lot going on in their personal life, are in crisis, or raise stress or health issues they’re struggling with. Most workplaces who operate a MHFA scheme will offer the same sort of training as they would to managers in that. MHFA provides colleagues with the added training to actively listen, to sensitively but clearly ask if a colleague has been considering harming themselves, to assess when it’s appropriate to contact emergency services, to know about a range of services they could access for support. It’s about knowing there is someone in your workplace who you wouldn’t be “bothering” with a problem, because they’ve actively volunteered for that role. Many workplaces have employee assistance lines, which would be available to MHFAers and regular FAers; Aiders can also speak with each other if they feel they need to debrief; and they can contact the MHFA organisation for guidance.

A broken leg is comparatively straight forward, but what if it's having to do CPR or deal with traumatic blood loss or something?

Similarly, MH might be dealing with a panic attack, but it could be someone on the roof of a building threatening to jump off or something.

I'm a first aider at work, and have been for years. One of the things that has changed over the years is the training organisations recognise that dealing with an incident can be traumatic and they now offer a support line for first aiders, as do some employers, either directly or through their EAP provider. 30 years ago, it was more the case, you weren't the one injured, so you must be fine.

Mental health is now also referred to in the FAAW training, even though it's not for mental health first aid - again, there's a recognition that it can be something that causes a need for physical first aid, plus not all workplaces have MHFAs.

We're all covered by normal data protection. I might have to fill in an incident form, and talk to someone's manager or HR, and I might tell my colleagues, sorry I missed the meeting, I was dealing with a first aid thing. But I'm not going to say, "OMG, you won't believe what happened to Dave in the networks team today!" whether Dave in networks and a physical accident or a mental health incident. The most I might say is, "he's had to go home early."

But workplaces are also full of gossips, and people make friends, so things tend to get out - it just doesn't have to come from the first aider, whichever type.

As a first aider, you can't sew up a wound, prescribe medication or even diagnose (you describe symptoms.) Your job is to stop them dying, keep them safe until professionals can take over. I can advise someone to see their GP, go to A&E, etc, but if they're conscious and able to consent, I can't force them. Same with MHFA - you can tell them about relevant support services, maybe get them to a room where they can call and ensure no interruptions, that sort of thing.

We have counselling services available through our EAP, as well as various options available to anyone with a phone etc. I'm willing to bet that though we have posters up, people are told about it in induction, and we have info sessions a few times a year, many of my colleagues aren't really aware it's available to them.

All of your concerns are covered as content within the MHFA course.
The limits and boundaries of an MHFA are covered in depth.
It is perfectly acceptable to form an going supportive relationship as long as it doesn’t stray into the realms of dependency, at which point there are actions the MHFA can take to mitigate.
Most workplaces will have multiple MHFAs as they do FAs and they will work as a team to cover situations as needed. There will usually be a co-ordinating MHFA and a support group in place for debriefing etc.
As an MHFA you are aware that you may not always be in a position to help, particularly if you are having a tough time yourself. Self-awareness is a big part of the role.

If you are first aid trained (physical or mental health), your skills are valuable anywhere, not just in work. Amongst everything else, it provides you with much more understanding of the signs of crisis and helps to reduce stigma surrounding mental health conditions.

I think it will vary.

In our case, it might include signposting towards our Employee Assistance Programme or statutory services, including self-referral for NHS talking therapies. It might include signposting or referral to various voluntary sector services available in the local area, or helping someone to identify appropriate services or support groups on the local social prescribing platform. It might involve encouraging someone to see their GP or seek crisis support. It might involve referring the client to suicide prevention services etc. Or escalating to crisis services as appropriate.

We do have clear policies and procedures in place for our MHFAs and support/debriefing opportunities for them as required.

I have been a trained first aider since my Girl Guide days. 99% of treatment I have given has been plasters and such, But I can confidently say that there are three people walking around now that would otherwise be dead. I can also say that one woman died despite my best efforts, she was too badly injured after being hit by a car to survive. By your argument I should never have been trained just in case something bad happened. I completely disagree. Yes, I had one bad experience, but I'm sure the people that are alive because of the help I was able to give are grateful. It's the same as Mental Health First Aid. The benefits will undoubtedly outweigh any potential negatives.

As an actual therapist, the MHFA seems to be to be a bit of a meaningless but potentially dangerous tick box that appeals to employers. They can claim to be a 'mental health friendly workplace/employer'. The role even being called 'first aider' is an attempt to draw equivalence between physical and mental health that just doesn't work in practice. Putting a plaster on a cut is unlikely to go horribly wrong. Untrained/unqualified people speaking to colleagues (who they then have to work alongside) who may be in a crisis, with no real supervision and very little training, could be disastrous.

In a previous workplace before completing my training I saw the downsides, the type of people attracted to the role tended to be quite nosy do-gooders unfortunately, who really relished a justification for being nosy about their co-workers. I heard some real horror stories like the MHFA saying things like 'suicide is a selfish act, think of your children'. If someone is in such a state they require assistance they deserve to get that from a suitably trained and qualified person.

There's a reason therapists go through hundreds of hours of supervised clinical work, need to pass post-grad level training, have ongoing clinical supervision and stringent accreditation requirements (the qualified ones, anyway. Sadly it's not a protected title). Even Samaritans go through a lot of training to learn how to speak to somebody who is suicidal.

I just think there's very little benefit and a whole lot of harm.

I totally agree that it is a tick box exercise.

Despite the fact that my workplace has trained mental health first aiders, I had a crisis/ panic attack during a customer call.

I didn't get a jot of help and there were no procedures to remove me from the situation.

It just gives an organisation the ability to pat itself on the back without actually addressing procedures to improve/ assist with employee mental health issues in the moment.

100% similar to physical first aid and calling for an ambulance for a broken leg.

If someone is distressed, with a plan for suicide they call an ambulance.

If someone just needs a tissue and a chat they make a brew.

Anything in-between and they signpost to the support available - EAP, Samaritans, AA, etc whatever is appropriate for that person.

At my workplace we have a manager (of the MHFA process) that organises quarterly check-ins for the MHFA to discuss themes to help make awareness campaigns relevant. No names or personal details are shared just generalisation such as lots of discussions around grief this quarter, or a few cases of self harm, or a few people worried about money.

We have an EAP that all employees can use and MHFA are encouraged to call it after every interaction as MHFA as a self check-in.

MHFA are trained to listen and signpost. They should not be offering advice, suggestions on therapy or treatment, or talking about their own MH experience.

Some MHFA are too keen to help and potentially overstep what they are trained to do (with best intentions).

@BlueMum16 - in regards to your final paragraph, this is exactly what I've seen. I didn't mention is earlier as I was trying to be neutral and information gather rather than running along with an ill informed knowledge base.

@CBTTherapist222 , that was my perception too.

@taratill I'm so sorry that happened to you. I how you feel better now

The thread itself has been valuable but shocking in terms of insight of the potential impact - for both MHFA and the person receiving the support - and the lack of support for the MHFA.

Thank you all for your input.

Na it’s a load of bollocks IMO.

Mostly do-gooders who think they’re empaths and want to be the one who people reach out to.

And genuinely, would anyone really feel comfortable talking to one of their colleagues not knowing whether it would get back to anyone else? Not a chance.

As someone said above, it’s a box ticking exercise with a smattering of virtue signalling thrown in for good measure.

I did the training through work, I told them that I absolutely do not feel comfortable doing this kind of work on a 2 day 'course'.

In my workplace it is people who are trained outside of our employee that overstep.

They might have done a psychology degree, might volunteer for Andy's Man Club or the Samaritans. But in the workplace they are only trained and insured to signpost.

We do provide supervision and check-ins and reminders of boundaries but obviously no one is listening on their every interaction.

Good for you @InLoveWithAI . I hope they were supportive about that? It sounds like you took the role very seriously and didn't dismiss it.

I work in a college in one of the top universities (not a brag, it's relevant re. how high-achieving and pressured the environment is). Kids are comitting suicide or having breakdowns all over the country. Mental health first aiders are literal life-savers, every bit as much as paramedics are here.

You seem to be talking as though, without the MHFA training, no-one will run into mental health issues or incidents - these will still happen and harmful do-gooders will exist anyway so surely providing training will make people better equipped to deal with what will occur anyway? Someone doesn't just decide to be suicidal because there's a MHFA'er around. How do you envisage other people around will deal with the panic attack/suicide attempt etc without any training? The person with poor mental health is just told "Sorry, we can't deal with you. You'll have to wait until the police/ambulance are called"?

Given your own example, are you really saying that a 2 day course is appropriate?

I really did think it was at least five.

A 5-day course would be great, but that would be so much less affordable and many fewer people would be able/willing to attend so how effective would that be? Same as physical first aid, a longer course would be amazing but mean far far less people with basic life-saving skills, which is the whole point of any first aid.

The label and the idea that they've been trained can give the person in crisis and the MHFA a (false) sense of them being an expert. The label lends weight to any advice /judgement they offer

The course addresses some misconceptions, appropriate use of language, some indications that you might not know to look for, questions you can and should ask and how you can be present - unlike a lot of people - without actually making things worse.

The general outcome for me is that I get a second, comfortable chair in my office and when assorted people are seen sitting in there, nobody interrupts or asks me/them what the hell they are doing in there rather than getting on with their work. Most start off asking practical things, some then go on to discuss deeper issues. They all know that I'm not going to tell them that they're crazy, stupid or ridiculous and that, whatever happens, if they disclose something that comes under safeguarding, I'm going to report it. I maintain confidentiality, I don't counsel, I don't keep secrets.

It's fine. Half the time they're not entirely sure why they're there but they need to talk to somebody. Which is fine.

It sounds more like she missed the point about what the role actually is.

They do have the space to decompress, discuss and talk.

A physical health first aider could potentially have to give CPR or apply a lifesaving tourniquet; that also carries responsibility and could also be distressing.

Plus official MFHAs generally volunteer for the role, like a first aider or a fire marshal. They’ve chosen the role because they think they’re up to it and are aware of what it might entail.

Also, nobody is obliged to contact them if they’re not comfortable with it.

If a company was unwilling to spend money on a superior course, it could be argued that they should not be sending staff to a "Here's two days, have a certificate and a label" in the first place.

I think there is tremendous scope for harm to both parties- this very thread has highlighted frequent lack of supervision.

I have a first aid qualification - I don’t expect Anne from account to talk to me about her diabetes, but I will patch her up if she falls and cuts herself.
equally I’ve done the MHFA and I don’t expect people to talk to me about their ongoing anxiety but if it all gets too much and they get overwhelmed I can recognise that and give a calm response.
so far it’s been extremely useful when the a local mentally unwell man was standing in the middle of a busy road and I felt confident enough in my approach to him.
I had had experience before I trained of a terrible MHFA who leapt towards me and my son who was having a mental health crisis and started shouting about how her job was to keep everyone safe while trying to redirect traffic away from us (the wrong way round a car park) and causing absolute chaos.