Mental Health First Aid: Equipping Staff With Effective Training

This article examines Merseyside Fire and Rescue Service’s implementation of the Mental Health First Aid initiative.

Mental Health First Aid England (MHFA) works to ‘create a society where everyone’s mental health matters’. The initiative equips ‘people with the skills they need to support their own and others’ wellbeing’ [1].

With people spending a third of their time at work MHFA focus on transforming workplace mental health. This allows employees to not only support their mental health and their colleague’s wellbeing but enables them to take the skills back home to look after friends and family. The MHFA framework focuses on:

• Prevention: understanding factors that can influence mental health
• Early intervention: spotting signs of poor mental health, listening to and supporting colleagues, and knowing how to act in a crisis
• Signposting to support: accessing support, including counselling, therapy, peer support, self-help, medication, and getting emergency help in a crisis [1]

Merseyside Fire and Rescue Service are advocates for the MHFA initiative and have received several awards for their work championing mental health. They have ‘developed and embedded initiatives to reduce the stigma attached to mental ill-health, enabling staff to speak more openly and access help and support, as and when it is required’ [3].

We interviewed Kelly Patterson, Senior Occupational Health and Wellbeing Officer, and Mark Thomas, Prevention Manager, from the Merseyside Fire and Rescue Service [4]. The interview gave us an understanding of how Merseyside Fire and Rescue Service have utilised MHFA to make a difference to their staff and the wider community.

Why did your organisation choose to make MHFA training a priority?

MT: “It goes back to a specific incident in which we felt we couldn’t give an officer the support that we deemed appropriate. Now, after officers have been to an incident it’s very rudimentary.

Firstly, they will go back to their station and we will mobilise a diffusing officer to go back to that station with them. And we just have a conversation with them: how are you feeling, are you all right? It’s just a bit of time for us to find out if they’re okay and to gauge their emotional reactions.

If their emotional reactions are significant, we will then trigger the next stage of the process which is critical incident debriefing. These debriefings allow us to signpost officers to any further support they may need.

The firefighters become more resilient to incidents because they’re regularly sharing and talking through their feelings. It’s important to begin this process at the beginning of their careers. We can’t stop PTSD from happening but it’s about getting the support in place from the beginning to spot signs and symptoms of it early on, so we can get people to support early before it develops into a long-term situation.”

Indeed, Mind reported that ‘One in four emergency services workers has thought about ending their lives’ [2]. This statistic reinforces the importance of emergency services to be able to regularly discuss how they are feeling.

Why has the implementation of MFHA training been so effective?

KP: “When looking at other services we found that how they implemented mental health initiatives was very reflective in their effectiveness. In many cases where sickness from stress was high, we could see that mental health hadn’t necessarily been prioritised, it hadn’t been sold to the staff, or the staff very much felt like it was being used as a tick box exercise.

I think because we’ve sold the importance of mental health from the top, and the staff know that our chief officer is so passionate and so invested in it, everyone gets involved in some of the initiatives. You need that level of active leadership at every level, so yes we need the chief executive officer to be enthusiastic, but we also need this enthusiasm within the firefighters.”

Explain what the mental health first aid initiative means to you

MT: “The mental health first aid initiative is about giving our staff the tools to have conversations about mental health. It is about educating staff on mental health and reducing stigma and discrimination.

Our firefighters go to the doorstep of around about 50,000 properties every year. Many people in Merseyside live with mental health challenges, so it’s foreseeable that we might come across somebody who’s in crisis.

Our firefighters not only utilise the skills they learn from MHFA at work but within their family settings when they’re away from the workplace too.”

What has been done to reduce stigma around mental ill-health within the service?

KP: “The most effective thing we’ve done regarding stigma and discrimination over the years was the Mind Blue Light film. We had members of staff volunteer to sit on camera and talk about their own mental health experiences.

This allowed other staff to see their friends and colleagues, who they didn’t know had dealt with mental ill health, openly talking about their mental health and how the service helped them. The people that were on camera thought it was brilliant because they were getting approached, left, right and centre by their peers, saying ‘I’m glad you spoke, I’ve also struggled with my mental health, how did you get help?’.

In terms of an engagement and destigmatising tool, it’s been incredible.”

How are employees helped to maintain a work-life balance?

KP: “What’s really good to help with work-life balance is a flexible working approach. There are various shift patterns, so people can apply for the best shift pattern that works for them, as well as during that shift, having time allocated specifically for meal breaks and gym time.

For non-uniformed staff we do discourage people from working at their desk during their lunch break, we strongly suggest they move away from the desk to get outside.

Similarly, the firefighters have ‘Flexi Time’, so they can come and go anytime between 8 and 10 o’clock in the morning, they can have lunch breaks between 12 and 2 o’clock. So, you can have half an hour, or you can have two hours if you want. You can leave as early as three o’clock.

This flexible working approach seems to help a lot more with people’s work-life balance, especially people who have got children. So, we’ve got a very flexible work approach to help suit everyone’s individual needs.”

Moving forward, what are your aims, what would you like to see?

KP: “We are comfortable in sharing our work. We are working with the National Fire Chief Counsel, the guidance body that looks after how we deliver a service nationally. I feel as though people are starting to adopt the Prevention Agenda. If we can share our instructors, we can educate other services’ staff and similarly, they can have the same effects that we’ve had reducing discrimination. Rural counsellors, social workers and teachers working in the community can take the skills we teach them back into schools, to their clients and the people that they’re visiting around the community.

Another initiative we are following is introducing mental health checks during mandatory health screenings. Continuing to align mental health with physical health.

Finally, we want to see an improvement in multi-agency approaches. On a more frequent basis, our firefighters are at a mental health casualty before any other emergency services, so we need to continue providing our staff with the tools to understand how they can help and work with other services to provide support.”

Do you have any final comments?

MT: “Merseyside faces a lot of socio-economic challenges. It’s a dream to work in an organisation like this because you can make a difference. We know that if we have a mentally healthy workforce then we can make a difference in our community. Something that has already been emphasised through the work we’ve done is that if we invest in our people, they’ll be happier in the workplace, and work better.”

Key takeaways:

• Regularly defusing incidents supports staff when they need it. This helps prevent PTSD further down the line
• Mental health first aid empowers staff to have conversations about mental health; educating staff on mental health and, reducing stigma and discrimination
• Active leadership has been key to successfully implementing Mental Health First Aid training has been well received in the Merseyside Fire Service
• It is important to teach trainee firefighters that mental health is considered equal to physical health from the offset. This ensures a workplace culture that regards mental health as important as physical health.

Additional resource:

Sources:

[1] MHFAEngland.org. [online] [Accessed 14/04/21] 

[2] Mind. 2015. One in four emergency personal have thought about ending their life. [online] [Accessed 14/04/21] 

[3] Merseyfire.gov.uk [online] [Accessed 14/04/21] 

[4] MGC Interview with Kelly Patterson, Senior Occupational Health and Wellbeing Officer, and Mark Thomas, Prevention Manager, Merseyside Fire and Rescue Service, 20/08/21.