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MHFA: Guidance not legislation

Thoughts on the 2019 House of Commons vote to introduce legislation on workplace Mental Health First Aid

On 17 January 2019, a backbench business debate took place in the House of Commons concerning workplace Mental Health First Aid (MHFA).

Following the debate, a majority of MPs from across the house backed a motion to introduce legislation to put mental and physical first aid on equal footing through First Aid regulations.

The proposal was not supported by Jackie Doyle-Price the Minister for Mental Health, Inequalities and Suicide Prevention, although she did commit to continuing the debate about workplace mental health.

Personally, I side with the Minister.

Current legislation already applies to both physical and mental health and safety.

Employers are simply not aware that their duty of care towards employee health includes their mental health.

This means it is not considered when first aid or workplace risk assessments are undertaken.

And Mental Health First Aid is not a silver bullet!

It is a programme that trains people to recognise the signs and symptoms of common mental health issues and feel confident to guide a person towards the right support, be that self-care and/or professional services.

Yet workplaces need more than Mental Health First Aid.

And focusing primarily on MHFA may lead to employers taking a piecemeal approach to employee mental health when what is needed is an integrated, whole organisation approach that enhances, protects and supports it.

More guidance not legislation

More explicit guidance is needed from the Health and Safety Executive (HSE), the regulator for workplace health and safety, about an employer’s duty to manage employee mental health.

Towards the end of last year (2018), the HSE began to update its webpages on stress, mental health and First Aid guidance to include on what employers might provide to meet employees’ mental health needs.

This is a good start and such changes echo recommendations made to the government in the Stevenson and Farmer Thriving at Work review.

But there is more still be done by the regulator.

Workplaces need more than Mental Health First Aid

Any guidance needs to be far wider than Mental Health First Aid which is, at best, a tertiary intervention.

Putting too much weight on this aspect encourages employers to focus in on dealing with issues that arise, rather than their duty to enhance, protect and support health in the first place.

Indeed, recent research undertaken by the HSE into the effectiveness of MHFA training in the work place found that MHFA has its benefits - raises awareness, helps reduce stigma and increases the form of mental health support available in workplaces.

However, there is no evidence that the introduction of MHFA training in workplaces has resulted in sustained actions in those trained, or that it has improved the wider management of mental ill-health.

Yet, almost weekly, I hear from CEOs, HR managers and Health and Safety reps that their organisations are training staff to be Mental Health First Aiders (MHFAs).

I know of one office that just trained 17 people in one go.

But when I ask how MHFA fits into a company’s mental health and/or wellbeing strategy (e.g. working conditions, stress risk assessments) or how these First Aiders fit with Health and Safety or are being supported/debriefed, I am met with blank faces.

When pressed about why this training is taking place, I am usually told “it seems like a good idea” or “staff asked to do it”.

MHFA is a good thing, I am a Mental Health First Aider myself but we can’t be the only action employers take in relation to employee mental health and there must be some process/procedure so that trends and issues are managed.

Applying MHFA in isolation of a wider strategy is like buying a hoover because you serve food with no plates (not one of my best analogies but you get the idea).

Prevent and respond

A successful health and safety initiative is proactive not reactive. And it is far more than first aid!

It consists of identifying hazards, assessing risk, putting in place control measures as well as monitoring, review and recovery processes.

In other words, there are two sides to the H&S coin, one side is prevention and protection whilst the other is response and recovery.

Mental Health First Aid is on the side of response.

If workplaces are serious about looking after employee mental health and they should be from a legal, moral and financial viewpoint then they need to be considering actions that prevent and respond.

Prevention is always the better solution and Matt Hancock MP’s Vision for Prevention champions this.

"Prevention is about helping people stay healthy, happy and independent for as long as possible. This means reducing the chances of problems from arising in the first place and, when they do, supporting people to manage them as effectively as possible."

Thankfully we don’t need to scratch our heads and scour the internet to find ways to look after employee mental health.

Lord Dennis Stevenson and Paul Farmer (Mind chief executive) have done the work for us.

Apply the Thriving at Work Core Standards

In 2017, an independent review was undertaken to consider how employers can better support individuals currently in employment including those with mental ill health or poor well-being to remain in and thrive through work. The result was the Thriving at Work Stevenson/Farmer review of mental health and employers.

As well as making recommendations to government about what might be done, it sets out a clear framework – termed core standards - which any organisation is capable of implementing.

Thriving at Work core standards

  1. Produce, implement and communicate a mental health at work plan

  2. Develop mental health awareness among employees

  3. Encourage open conversations about mental health and the support available when employees are struggling

  4. Provide employees with good working conditions and ensure they have a healthy work-life balance and opportunities for development

  5. Promote effective people management through line managers and supervisors;

  6. Routinely monitor employee mental health

Putting Mental Health First Aid to work

If all six core standards recommended in Thriving at Work review are put in place then a holistic, integrated plan for employee mental health would be established for a workplace.

Within such a framework Mental Health First Aid might usefully form part of the support available to those who are struggling (item 3).

This would ensure MHFA is embedded into a wider workplace mental health strategy and the first aiders themselves are supported.

What do you think?

If you are considering training your people to act as Mental Health First Aiders you might like to read my blog MHFA at work: good practice which outlines 11 things to consider when doing so.

Take care of you


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