Mental Health First Aid England: is improving the mental health literacy of the population contributing to a public health priority?

Poppy Jaman - MHFA EnglandDr Paul Patterson - University of BirminghamDr Lesley Pearson - Coventry University

The Problem

- Mental illness accounts for 23% of the total burden of disease but receives only 13% of NHS health funding

- Among people under 65, nearly half of all ill health is mental illness (LSE 2012)

- 1 in 10 young people 5-16 years have a diagnosable mental disorder (Green et al, 2005)

- 400,000 adults of working age time off work with stress 10.8m working days lost (ONS 2011)

- 20% of University students report MH problems / 13% suicidal thoughts (NUS 2013)

- in a survey of over 18 000 adults in north-west England only 20.4% had high levels of well-being (Deacon et al., 2009)

It is estimated that British businesses could save up to £8 billion a year if mental health at work was managed more effectively (Sainsbury Centre for Mental Health 2003)

Mental Ill-Health is Everyone's Problem..

Prevalence studies suggest that we are all likely to know someone experiencing mental ill-health with thirty to fifty per-cent of the population meeting diagnostic criteria for a mental disorder at some point in their lives (WHO, 2000; Kessler et al., 2005).

Community surveys reveal that recognition of symptoms and awareness of helpful interventions or treatment options remains poor across the general population (Jorm et al., 2006)

Low mental health literacy associated with more stigmatising attitudes as well as increased delays in help-seeking and access to appropriate treatment.

Yet we appear to be reluctant to educate the public in methods to cope with mental ill-health..

Government Policy

More people will have good mental health

More people with mental health problems will recover

More people with mental health problems will have good physical health

More people will have a positive experience of care and support

Fewer people will suffer avoidable harm

Fewer people will experience stigma and discrimination

The Royal College of Psychiatry have led the call for action..

‘Mental illness is the single largest source of burdenof disease in the UK. No other health conditionmatches mental illness in the combined extent ofprevalence, persistence and breadth of impact’.

‘Mental illness is consistently associated withdeprivation, low income, unemployment, pooreducation, poorer physical health and increasedhealth-risk behaviour.’

‘Mental illness has not only a human and social cost, but also an economic one, with wider costs in England amounting to £105 billion a year’

‘Promoting mental health can save money in the short and long term. Evidence shows the cost-effectiveness of investing in mental health promotion, mental illness prevention and early intervention strategies’

Alongside many of England’s Leading Health Economists..

And Public Health England have taken up the cause..

1. Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol

2. Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency

3. Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics

4. Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme

5. Improving health in the workplace by encouraging employers

to support their staff, and those moving into and out of the workforce, to lead healthier lives

Priorities

So how are we currently addressing the problem of improving the nations mental health literacy?

Mental health in the media

‘Many depictions of mental illness

on TV are frightening

and misleading’

Department of Health, 2010

Luckily there are now some alternatives…

Mental Health First Aid being one of the only educational programmes for Mental Health Literacy that has a good evidence base

What is Mental Health First Aid?

Created as a response to the lack of training in mental health literacy by Tony Jorm & Betty Kitchener in Canberra Australia and described as "help provided to a person developing a mental health problem or in a mental health crisis. The first aid is given until appropriate professional treatment is received or until the crisis resolves".

‘Many people developing mental disorders do not get professional help or delay getting professional help. Someone in their social network who is informed about the options available for professional help can assist the person to get appropriate help or in a crisis can reduce the risk of the person coming to harm’

Betty Kitchener & Tony Jormoriginators of Mental Health First Aid

What is the evidence base?

Kitchener & Jorm, (2006) reported all trials of MHFA that employed (6 month) evaluation follow-ups:

- improved confidence in providing support to others - improved actual helping behaviour- improved concordance with health professionals views of appropriate treatments - reduced social distance / stigma from people with mental disorders.

- positive impact on trainees own mental health was found in the only trial that had tested for it (Kitchener &

Jorm, 2004)

Since 2006 more than 20 further evaluation studies have been published or are in progress, across many of the 21 countries promoting MHFA.

Betty Kitchener & Tony Jormoriginators of Mental Health First Aid

MHFA in England

MHFA England was developed and launched in 2006 in England by the Department of Health and since becoming a Community Interest Company in 2009 have had the social objective to increase the mental health literacy of the whole population, by training one in ten of the adult population in England.

over 650 instructors have been trained in England to date running courses for over 55,000 trainees

There are currently four training courses:MHFA Course* (2 days) – for anyone over 16Youth MHFA* – for those working or living with young people aged 11 - 18MHFA Lite – A 3 hour introductory courseMHFA for the Armed Forces Community (from 2013)

*(Instructor training accredited by The Royal Society for Public

Health)

Poppy Jaman - National Director of Mental Health First Aid England CIC

MHFA in England – What does Training Involve?

The major elements of the course provide a range of ‘self-help’ tools that allow a systematic approach to recognising and engaging with individuals experiencing emotional and mental health difficulties in a supportive and informed manner.Participants learn the symptoms of common mental disorders, possible risk factors, where and how to get help and evidenced-based effective help and receive a reference manual as part of the training. An acronym ‘ALGEE’ is employed to facilitate assimilation of systematic steps in response to a MH situation:

1. Assess risk of suicide or harm2. Listen non-judgementally3. Give reassurance and information4. Encourage person to get appropriate professional help5. Encourage self-help strategies

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

In what sectors are trainees employed (%)?

Third Sector: 39.8Statutory: 33.9Business: 6.5Independent: 2.0Education: 1.5Other: 4.3Not Stated: 13.0

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

A) Personal Confidence of how best to support others with a mental health problem

Delegates attending the MHFA Course demonstrated a significant improvement in their Confidence

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

A) Knowledge and Understanding

Delegates attending the MHFA Course demonstrated a significant improvement in their Knowledge & Understanding

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

A) Is improved knowledge correlated with confidenceof how to help others with MH problems?

Pre course confidence & Knowledge Correlation = .89Post course confidence & Knowledge Correlation = .81

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

A) How did you rate the course structure?

95% rated structure very good / good

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

A) How did you rate the course content?

96.5% rated content very good / good

MHFA in England – Does it Work?

MHFA England trainees October 2011 – December 2012Total Sample n=11502 Females 73.1% Males = 26.9%

A) How did you rate the course overall?

96.6% rated the training very good / good

MHFA England – meeting Public Health Priorities?

1. Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol

2. Reducing the burden of disease and disability in life by focusing on preventing and recovering from the conditions with the greatest impact, including dementia, anxiety, depression and drug dependency

3. Protecting the country from infectious diseases and environmental hazards, including the growing problem of infections that resist treatment with antibiotics

4. Supporting families to give children and young people the best start in life, through working with health visiting and school nursing, family nurse partnerships and the Troubled Families programme

5. Improving health in the workplace by encouraging employers to support their staff, and those moving into and out of the workforce, to lead healthier lives

We think so..info@mhfaengland.org