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Kylie Minogue, Fosters and Neighbours are just a sample of the Australian imports that have become part of our culture. In April this year, another one arrived when seven health care and social work professionals on Shetland became the first in the UK to be trained in mental health first aid.

The training teaches recognition of the symptoms of a mental health problem, how to provide initial help and when to refer people to appropriate professional treatment. Similar in principle to physical first aid, the training has one important difference: it aims to teach people to recognise indicators of a problem before a crisis occurs. Intended for the public, the course was devised by Betty Kitchener, project manager at the Australian National University's centre for mental health research, and 5,000 people in Australia have now completed it, including professionals from a range of disciplines. It is a two-day course, plus three days for those who want to become a trainer in mental health first aid.

The Scottish executive has followed up the Shetland experience by launching a first aid training pilot as part of its drive to improve mental health. With Scots taking 40 per cent more antidepressants than the English, a third of visits to GP surgeries linked to mental health problems and the Scottish suicide rate increasing by 250 per cent over 20 years, there is an urgent need to address the mental health problems that are experienced by so many.

Shetland health promotion worker Mari Todd, who discovered the Australian initiative and invited Kitchener to Lerwick to deliver the course, says: "I knew that people in the community were supporting friends and relatives suffering from mental health problems and I thought they could do with something to help them."

Todd completed the trainer's course and is now qualified to teach others. Having taken on the task of adapting the course materials to give relevant Scottish and, where possible, Shetland examples and statistics, she has already delivered the training to a range of participants including two care workers, a community worker and members of the islands' communities. The next course in November is full and will be attended mainly by professionals.

Shetland accident and emergency nursing sister Lynda Smith attended the course in April, and is sure of its relevance. "In our small island communities, GPs are very familiar with people and may be family friends," she says. "If you feel you can't approach your GP because of that, you may feel that being in A&E is a bit further afield. As a front line for hospital care for people who self-refer, we have to assess them as soon as they come through the door and it's what we do in that interim period that can be crucial."

The training has made her listen to people differently, she says. "People feeling emotional distress often say 'I'm such a bother, don't be worrying about me'. Before, I wouldn't have taken such pains perhaps to make that person know that they had every entitlement to be in A&E, just as much as if they had broken a leg. That builds trust so they realise you're not going to disappear off to something more 'urgent'."


Her colleague, Carol Colligan, senior A&E sister, also attended the course and is prioritising the training as part of her staff's professional development. "I started in A&E in 1986 and at that time it was absolutely taboo to talk about suicide, for instance. I think there's quite a taboo here on admitting mental health problems. Perhaps it's the culture of the men in harbour jobs, that saying you are depressed is seen as admitting a weakness."

Judd Brindley, co-ordinator of Shetland's Moving On employment project for disabled people, has also taken the trainer's course. He now feels better able to support his own team, which is often under considerable pressure from its work with clients, more than half of whom suffer enduring mental health problems.

His liaison work on behalf of clients includes advocating for greater awareness of mental illness in the local community. "In my work, which is with employers as well as with people moving into employment, everyone can understand a physical disability, but when it comes to mental ill health, the understanding may not be there," he says. "When we ran the course for the community, participants were shocked that 24 per cent of people will suffer a period of mental ill health - it brought home that it's a very common health problem and helped them to realise the ordinariness of it."

- For more information go to www.mhfa.com.au