'Why every school should have a team of mental health first aiders'

With so little professional help available, teachers need to be knowledgeable and confident enough to deliver mental health support, writes one deputy head

Karen Megahey

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Like many schools, mine has been very aware of the publicity around the rising number of young people struggling with emotional and mental health problems – it's become very obvious that getting suitable treatment is difficult.

In 2014, the Health Select Committee concluded that “there are serious and deeply ingrained problems with the commissioning and provision of children’s and adolescents’ mental health services.” Sadly, the problem has not improved since then.

In many areas of the UK, the Child and Adolescent Mental Health Services (CAMHS) are under great pressure and early intervention is just not possible.  In most cases, only a crisis – for example, a suicide attempt – will trigger immediate help. The subsequent treatment is often very time-limited and can be disrupted frequently, owing to the volume of work.

Mental disorders often arise for the first time in adolescents or young adults. If they are recognised and treated early, this may increase the chances of a better long-term outcome. Many adults with lifetime mental health issues can trace the symptoms back to childhood. However, in practice, professional help is often not sought at all or only after a delay.

Early recognition and appropriate help-seeking will only occur if young people and their "supporters" (family, teachers, friends) know about the early changes brought about by mental disorders, the best types of help available, and how to access this help. It is also important that the supporters know how to provide appropriate first aid and ongoing help. Such knowledge and skills have been termed "mental health literacy.

At my school, we felt it was important to find a way to help the supporters of our young people gain this emotional literacy.  However, our staff were unsure and lacked confidence when it came to mental health issues. So, we decided to train two members of staff as mental health first aid instructors on the two-day Mental Health First Aid (MHFA) youth course, which is accredited by Royal Society for Public Health.

Profound effect

Developed in Australia in 2000 and now internationally recognised in 23 countries, the MHFA course teaches people how to recognise the signs and symptoms of common mental health issues, provide help on a first aid basis and guide someone towards the right support services. 

In under two years, over 50 of our staff and 80 sixth-form volunteers have been trained and can act as mental health first aiders. The effect is profound. Staff have been given strategies to respond to distress using the ‘ALGEE’ action plan:

A: Approach, assess, assist with any crisis

L: Listen and communicate non-judgementally

G: Give support and information

E: Encourage the young person to get appropriate professional help

E: Encourage other supports

Now, increasing numbers of staff and older students feel confident that they can respond appropriately to an emotional crisis, just as a well-trained physical first aider can be a first responder for a physical injury. Pastoral staff routinely make judgments about where a student is positioned on "The Mental Health Continuum" so that proactive and planned action can be taken before distress becomes unbearable.

Also, it has been noticed that the language used to describe emotional distress is far more factual and non-judgemental. There is also clear acceptance by the vast majority of students that feeling low or unhappy is nothing to be ashamed of and they can be helped.

Emotional needs

Staff continue to train on a rolling programme and the first cohort of parents have signed up for training.

Pupils can also drop in at any time to seek help and support in our new, dedicated wellbeing centre. The centre is deliberately sited in the heart of the school, where PSHE sessions take place as well as activities such as mindfulness, yoga, Pilates and aromatherapy. 

The school counsellors, also, are key to helping support students in distress. They work alongside the school nurses and doctors, and can usually provide the therapeutic help necessary for students to make the changes for better mental health. Students are now accessing counselling at a very early stage, often with the support of their tutors, and there is a trend of fewer sessions being needed.

Schools have the ability to reach the widest range of young people and it is vital that this is utilised. Mental health first aid should become a part of every teacher’s training, enabling them to actively support the emotional needs of young people and act on any concerns they might have. 

Karen Megahey is the deputy head and counselling and wellbeing lead at Felsted school.

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Karen Megahey

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