Early warning system

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

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

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

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

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

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