Mental health first aid

Could you recognise the signs of someone in acute mental health distress? The lack of recognition can seriously hamper the treatment of a sufferer. Craig Kenny looks at how Wales and Scotland are training staff to overcome this lack of knowledge

Failing to recognise the signs of acute mental distress and passing on necessary information to health and social care professionals is often the main barrier to the right mental health treatment. That is why in the UK, mental health first aid is being introduced to train staff in many frontline roles such as teachers and police to recognise and act upon the warning signs.

The Talk to Me scheme has been adopted in Wales as part of the country’s suicide prevention strategy following the spate of more than 20 suicides of young people in the Bridgend area over the past two years. In Scotland, mental health first aid has been introduced in prisons and the Assist scheme has been introduced.


In Wales each year, there are about 6,000 hospital treatments for self-harm and 300 suicides – a higher rate than England, but less than Scotland and Northern Ireland. However, the Welsh suicide rate has remained static over the past decade, and research suggests that three-quarters of suicides were by people who had made no contact with mental health services leading up to their death.

Talking therapy

Wales’ Talk to Me scheme aims to address this. Frontline staff in schools, job centres, police stations, prisons and healthcare settings will receive training in helping them to recognise the signs of mental distress and help the person to receive the right support.

Developed in Australia, mental health first aid has been adopted throughout Scotland, where more than 40,000 frontline professionals have received the 12-hour training course over the past three years.


Those delivering the training say it has given staff the confidence to give the right assistance and the skills to collect and pass on key information to mental health staff to help them prioritise the most urgent cases.

Staff fear

William Aitchison, who trains staff in mental health first aid at health helpline NHS 24, said that many people had been fearful of handling apparently suicidal callers.

“Someone may call NHS 24 with a medical problem, but then say they are thinking of suicide,” he says. “If someone says they are in so much pain and want to kill themselves, a lot of people are frightened about that. They don’t want to be the last person that the caller ever spoke to.”

Mental health feature p 29 (13 March issue)

He says the training enables professionals to deal with it and pass it onto the proper people.

On Halloween night, NHS 24 received a call from a man afraid his house was being haunted. “That person had schizophrenia and was being influenced by what was happening around the house,” said Aitchison.

“The person who took the call took it very seriously and realised that this person would be in a great deal of anxiety. They were able to get them sorted out that night and seen by a CPN.”

Prison life

Doris Williamson, the instructor at HMP Barlinnie in Glasgow, has trained prison officers, human resources staff, social workers, general nurses and some prisoners in mental health first aid.

“We have prison officers who are the first point of contact in working closely with some unwell or distressed people.”

“The benefit we have seen is that once someone completes their training, their referrals to the mental health nursing service are much more appropriate.

“Before, we might have been told that Mr Smith was acting oddly. Now the referral is more detailed because they know the signs and symptoms to look out for. That enables us to prioritise who to get help to. In some cases it’s stopped someone’s poor mental health deteriorating into mental illness,” adds Williamson.

A high risk factor for suicide is social isolation, and Williamson believes the training has made the prison service more sensitive to this type of case.

He says that Scottish prisons have been good at identifying people who are obviously unwell, “but we needed skills to care for people who are quietly unwell.

“Now we have been able to set up a stress service to deal with anxiety, stress and depression.”

Suicide prevention

Scotland has also introduced specific suicide prevention training. Since 2003, the two-day Assist course has been given to 14,000 professionals, many of them working in voluntary sector drug and alcohol services.

It is probably too early to tell what impact the approach has had in Scotland. In the three years between 2005-7, 13% fewer people took their own lives in Scotland compared to 2000-2. However, there was little change compared with 2003-5 figures.

Wales will be hoping for a quicker return on the £1.7m it is spending on the suicide prevention strategy. It will focus on the main risk factors for suicide and self-harm:

• Relationship problems

• Job loss

• Problems at work or school

• Being bullied/feeling isolated

• Drug or alcohol problems

• Serious mental illness

Wales’ health and social services secretary Edwina Hart says that outreach services targeting young people and rough sleepers are a vital part of their approach. “We need to change the culture around mental health problems so that the signs can be identified and support provided at an earlier stage in order to reduce the rate of suicide and the numbers of those who self-harm.”

Related articles from Community Care

Bridgend: suicide myth and reality

‘First aid’ to prevent suicide: practitioner Mark Drinkwater on the Assist programme in south of England

Recognising the warning signs of suicide

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