The idea of the general public being more aware of mental health problems is without question positive and “The Mental Health First Aid” project (MHFA) appears to be a step in the right direction.
Originally developed in Australia, it provides a short course of mental health education for members of the public and/employers. Since its birth a number of countries have taken it up, including the UK.
More recently our UK government has become more vocal in supporting the initiative, announcing funding of £200,000 to begin to establish the project in schools.
The idea behind mental health first aid is to train the public in some of the common features of mental health problems which will enable them to signpost people towards available mental health services.
More people knowing about mental health problem will always be useful in puncturing some of the myths.
But does the rhetoric of mental health first aid programmes match the reality on the ground?
The evidence which exists about MHFA seems almost entirely based on the perceptions of trainees who have taken the course, rather than people with mental health problems who might have been in contact with those trainees. This seems to be a major omission.
It also raises questions about the idea of signposting people to services, the question being whether those services “exist”.
There is a beds crisis in mental health care, a shortage of psychiatrists and nurses and in my area of CBT, a vast gap between the ‘supply’ of therapist and the ‘demand’ from people needing psychological therapy.
I also wonder about how far reaching the programme might be.
I am writing this in a café at Derby Station and when I look around me, I know that at least one quarter of the people I see may have or will develop a mental health problem.
How will MHFA reach these people and will the trainees be able to spot any signs or symptoms in good enough time before they reach a crisis?
This is an important question.
The build-up for mental health problems can take a long time. People can quietly cope through putting on a ‘mask’ for years.
Sufferers with OCD can suffer for up to 10 years before eventually coming into services.
Being aware of the early signs of mental health problems is important. The fact that the government is looking at developing this training in schools may go some way towards looking at these early signs.
What also appears to missing in the MHFA is any reference to the social, economic and political dimensions of mental health.
A mental health problem has many ingredients. They can be the consequence of work place problems. They can be influenced by poverty and a lack of employment. They can have roots in discrimination and social isolation.
These are social and political rather than mental health problems.
Kwame Mckenzie’ s work –“Social Capital and Mental Health”, looks at how far ‘good’ mental health is an aspect of community life.
The MHFA needs to have a greater appreciation of these social capital factors. Nevertheless, any increase in the level of mental health literacy is good and the fact that 185000 people have already been trained in this approach is positive.
This is a work in progress, and any progression would, I feel benefit from a greater awareness of this realities of mental health in this country.