'The explosion in anxiety, depression, self-harm and eating disorders among under-21s means every school should have a teacher trained in Mental Health First Aid'
In a previous column (in which I called for a Russell Brand-style revolution, except with less overthrowing of established political structures and more just looking after ourselves and each other a bit better), I mentioned "Mental Health First Aid" as an essential strand of the spectrum of solutions which can be implemented by schools. I thought I’d take this opportunity to expand upon what Mental Health First Aid actually is and why it’s crucial.
(FYI, I’m already getting a bit fed up with typing the words ‘Mental Health First Aid’ so I’m going to shorten it to MHFA henceforth. Hope you don’t mind too awfully).
At the end of last year I was invited by charity MHFA England to attend one of its training courses. Actually, that’s a lie. I went for a meeting with them upon which they handed me a stack of literature and I said, "Yeah….I talk about, write about and study mental health all day. I’m not going to ever get around to reading this, realistically. Can I come to one of your training courses instead?" Luckily the staff at MHFA England are some of the loveliest people in the British Isles and immediately acquiesced to my rather cheeky request.
The training was held at a hotel in central London. The room had been divided into sections representing a gigantic, three-dimensional grid of possible scenarios someone with a mental illness might find themselves in. For example, "diagnosis, in recovery", "no diagnosis but receiving treatment", "no diagnosis, not receiving treatment". We were asked to create four characters – young people between the ages of 10 and 25 – to imagine a set of life circumstances for them, as well as a mental health challenge. We wrote these on a large sheet of paper and placed our characters where they belonged within the 3D grid (by sticking them to the wall).
The genius thing about MHFA training is that we continued to refer back to our characters throughout the two days of training. So often mental health issues are presented as a one-off occurrence which, once fixed, will disappear into the ether, never to be experienced or referred to again. In reality, the challenges we face as we venture through life, or a change in circumstances, can trigger a relapse, or indeed symptoms of a different mental illness. The maintenance of good mental health requires constant effort for the majority of people, especially those who have experienced mental illness. We were asked, for example, what might happen if one of our young people started regularly smoking weed, or if their single parent started a new relationship and moved them to different places on the grid accordingly.
There is a misconception which still pervades most social and work environments that mental health must not be addressed by non-professionals. Many believe that to do so would be to run the risk of saying "the wrong thing" or that those with mental health issues are automatically unpredictable and dangerous and therefore best avoided. MHFA puts this myth to bed once and for all. Again and again the virtues of "non-judgmental listening" and of "asking open questions" were emphasised. We were taught that there is virtually nothing someone can say which cannot be responded to by simply asking them to elaborate and listening without freaking out.
These skills can prove crucial, in that they are designed to encourage those in a mental health crisis to "talk themselves down". The methods recommended are similar to those employed by the Samaritans (I sat in on some of their training a couple of years ago)m who, contrary to popular belief, do not allow their volunteers to give direct advice, but instead ask questions such as "what would happen if?" or "how does that make you feel?".
MHFA is designed to plug the gap between preventative measures and medical intervention. We were taught how to handle someone who is suicidal until professional help can be sought and provided, for example. The course was empowering, in that it drove home to us just how much active help can be provided by a community who have simply taken the time to educate themselves a little.
From a personal perspective, I found the section on psychosis, bipolar and schizophrenia the most interesting. As I am constantly reminded on social media (most commonly by users with black and white profile pictures depicting a middle-aged man in a suit, but far be it from me to suggest that their actions are motivated by sexism/inherent mistrust of anyone younger than them and not in a suit), I am not a doctor. Whilst I am confident in talking about the four most common mental health issues in under-21s (anxiety, depression, self-harm and eating disorders), having interacted with hundreds of people experiencing them, interviewed countless experts, read 4 jillion books and suffered from three of them myself, I’d always steered clear of addressing schizophrenia and bipolar, assuming I didn’t have the expertise. MHFA taught me that the basic principles of prevention and first-aid for bipolar and schizophrenia are the same as for any other mental illness. By introducing case studies in video footage, they reminded me that all mental illness happens within the context of an actual human being, even the most severe and complicated ones and from that point of view the course also goes a long way to reducing stigma.
From a school’s point of view, one of the main advantages of MHFA is that one member of staff can attend a trainer’s course and then deliver a standard MHFA course to the remaining workforce, which makes it cost-effective if you’re on a limited budget.
MHFA isn’t a substitute for high-quality PSHE or for Child and Adolescent Mental Health Services, but it provides a valuable bridge between the two. The methodologies and language used allow teaching professionals to feel less helpless around mental illness and more confident to play an active role. When I am Queen of Everything, it will be mandatory for all humans.
Until next time, TES readers.
Natasha Devon is the Department for Education’s mental health champion. She tweets at @natashadevonMBE