Mental Health First Aid (MHFA) started in Australia. A nurse called Betty Kitchener, who had mental health challenges herself, saw the need for mental health first aiders in every community.
She went on to design a training course for mental health first-aiders which is now being used in 24 countries worldwide.
St John of God Hospital CLG adapted her programme for use in Ireland in 2014 and set up Mental Health First Aid Ireland.
This service now delivers mental health first aid training courses to individuals, community groups and workplaces nationwide – both face-to-face and online. Almost 12,500 people in Ireland have now received this training.
“The aim of mental health first aid is for first aiders to spot people who are experiencing problems in their community or workplace early on and signpost them to services,” says Ber Mulcahy, director of nursing at Bon Secours Hospital in Cork and also an MHFA trainer.
“Early intervention is so important,” she says, “because the earlier the intervention the quicker the recovery and, more than likely, the longer the recovery (lasts), research has shown.”
Always interested in the topic of stress management she did the MHFA trainer training as part of her director of nursing role in order to pass these skills on to hospital staff and also, with general outreach in mind, to bring the MHFA approach out into the wider community.
She recently delivered her first in-the-community mental health first aid course to 17 members of IFA Cork Central branch following a request from IFA’s Farm Family and Social Affairs Committee chair Claire O’Keeffe.
Claire had seen a real need for this kind of training.“I had given a talk on mental health at a branch AGM and the response was staggering,” she says, “with many farmers talking about the stress they are under, in particular stress related to Bord Bia inspections and Department of Agriculture and Food correspondence. When I heard that Ber could provide this mental health first aid training I contacted her straight away.”
*Read Claire’s experience of the course below
A need for people on the ground
Ber Mulcahy, who trained as a psychiatric and general nurse, always had an interest in stress and mental health management. With a higher diploma in coaching, psychology and a master’s degree in mindfulness, she did the MHFA trainer training in order to help staff members deal with work stress.
“Hospital management wanted to obtain the Ibec KeepWell Mark, and one of its pillars is mental health so the decision was made to train mental health first aiders. That’s when we came across MHFA Ireland.
“Mental health first aiders are people on the ground who pick up the person who is not coping, who is experiencing anxiety or depression or who is out of control.
“We really do need people on the ground to be able to identify people in crisis or approaching crisis. We need mental health first aiders in society the same way as we need physical first aiders.”
Stigma still exists
She mentions that many people suffer in silence due to the stigma that still exists around mental ill health.
“They can be quick to tell us they are a diabetic but not so quick to tell us that they are depressed,” she adds.
What the course involves
Ber speaks highly of the training she did with MHFA and the course she delivers.
“It’s a very set curriculum, the teaching resources are phenomenal and every person who attends gets a really good manual to take away so they don’t have to take copious notes.”
The MHFA course involves two full days (four modules, three hours each) with sessions that use a mix of group work, video content, PowerPoint and group discussion to support the participants learning. Face-to-face courses are limited to 20 persons. Online courses are limited to 15. Participants receive an attendance cert to say they are now a Mental Health First Aider.
“Their training includes learning the signs and symptoms of mental health problems and what sort of help has been shown by research to be effective. They are also taught a framework for communication, how to offer and provide initial help and how to guide a person towards appropriate treatments and other supportive help.”
Aware of farming concerns
With a son in Macra na Feirme, Ber was very aware of the mental health challenges that farmers can face.
“We know that winter can be a difficult time for many farmers with many of them spending a lot of time on their own. Then there is seasonal affective disorder, dark evenings and dark mornings, and many are not as active at this time of year because cows are dried off, perhaps. It can be a lonely time. We hope that, by having first aiders trained in rural communities, people will be able to get support when they need it.”
What the course involves
Ber explains how course trainers use the mnemonic ALGE to remember the fundamental principles.
Approach the person and Assess the situation. After training, first-aiders will instinctively know in what situations they need support, when they need to call a GP or 999. The obvious crisis with depression is a person having suicidal thoughts and trainees learn to ask the person directly if they are considering taking their own life. Situations can vary from a person having an acute panic attack to an acute psychotic episode but trainees are told what to do in each situation. They do realise that getting help is crucial and they are, of course, trained to consider their own safety at all times.
Listen very carefully and non-judgmentally if the person is going through a crisis.
Give support and information eg provide emotional support and information on services available both locally and nationally. Encourage people to get the appropriate help. “People can be very resistant to getting professional help so we sometimes have to encourage it. We also train people not to take the response personally if it is negative at first.”
Encouraging other support. The family can’t support the person if they haven’t got support themselves so first aiders would seek to widen the support network around the patient.
She makes the point that there are boundaries, of course.
“We have to remember that we are a first aider, we are not a doctor, nor are we an emergency response team,” she says.
The approach is very factual, Ber says.
“The first aider mentions what they have noticed – eg ‘I’ve noticed that you’re not yourself lately’. It’s very simple, straightforward, letting someone know you want to help. Sometimes you have to make that approach a number of times as they may say, ‘I’m grand,’ or get defensive.”
Mental health first aiders are also advised to set up a support group for themselves, she says, and keep their knowledge of services available in their area updated regularly.
Many could benefit
“There isn’t a person in Ireland who wouldn’t benefit from attending the course,” Martin Gillick of MHFA says, “teachers, youth workers, line managers, customer service staff, gardaí, pharmacists, nurses, foster carers, social services, carers or parents.
The MHFA course has been shown to help people grow in confidence, learn new skills and even help their own mental health, all the while challenging stigma surrounding mental health in Ireland.
“Our vision is a supportive community in Ireland with a willingness to address mental health problems when they arise and enable recovery.”
*Saint John of God Hospital is a not-for-profit, independent provider of mental health services. The MHFA course is secular. MHFA Ireland has tutors embedded within organisations like a hospital eg Ber Mulcahy who is one of two staff members of Bon Secours Hospital Cork who has done the trainer training. There are also MHFA staff tutors.
MHFA Ireland also delivers courses for workplaces, either face-to-face or online.
Courses may or may not be free to individuals in a community. MHFA Ireland receives some HSE funding and training may be available to local communities courtesy of that, within limitations. Visit mhfaireland.ie for more information.
I found the MHFA course to be tough but very empowering. Mental health issues will touch us all at some stage in our lives, in one way or another, and in doing this course we have learned tools that will help us to recognise early signs of mental health issues and how to direct somebody towards the appropriate professional supports.
The course covered depression, anxiety, psychosis and substance abuse. These are very relevant issues that we are all coming across more and more in the community, particularly since the COVID-19 pandemic. I believe that the skills we have learned over the two days of the mental health first aid course will improve our own mental health, as well as giving us skills to help other people. The course was intense at times and it is important to keep in mind that it is first aid – we are not trained medics. Improving our knowledge of these issues will go a long way towards reducing the stigma attached to mental health illnesses.
We in Cork Central IFA plan to set up a mental health support group where members can contact any one of the certified Mental Health First Aiders, who will direct them towards the appropriate professional help. We hope, going forward, that more people will be trained in MHFA around the country, particularly young people, as I believe this is a very important area of their personal development.
Chair Cork Central IFA Farm Family & Social Affairs Committee
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