Mental Health First Aid for all

Today is World Mental Health Day, which means that around the globe people will be sharing their experiences and stories. In celebration of this year’s theme ‘Psychological and mental health for all’ we hear from a Mental Health First Aider about the difference the training has made to her work and life.

Pamela Hewitt is a Welfare Benefits Officer at Together Housing Association (THA) in Blackburn, Lancashire. This large social landlord organisation is a member of the Together Housing Group which manages over 37,000 properties across the North of England, providing services to over 50,000 people in the region.

Day to day, Pamela and her 1,300 colleagues at The Together Housing Association provide social housing and the Welfare Benefit Officers support customers with their housing needs, helping them to correctly comply with housing benefit requirements and in creating action plans with people who are struggling to afford their rent.

Pamela said: “The point where I get involved is when a person is potentially getting evicted through non-payment of their rent. At that point they will be in an extremely stressful life situation which can have a huge impact on their mental health.”

At the same time, Pamela has observed that mental ill health can be a factor in a person’s housing situation deteriorating in the first place. She added: “I see time and time again that when a person has got into arrears with rent it is often linked to a period of mental ill health. A lot of the tenants are not lucky enough to come from supportive circumstances.

“If someone is struggling with their mental health, they may not have the coping resources to keep on top of things. The housing benefits system can be overwhelming to a person who is struggling with their mental or physical health, so they lose contact with the system, and find their benefits stopped.

“When they finally get an eviction notice, this is often the catalyst for them to reach out for help – perhaps for the first time. And of course on the surface we are here to help with their housing situation, but that comes hand in hand with supporting them to get appropriate help for their mental health too.”

Operating within such frontline roles, Pamela and her colleagues regularly deal with customers who are in the midst of a mental health crisis, including needing to respond to people who are expressing suicidal feelings.

“It is distressing,” said Pamela. “We had a process to deal with these incidents when customers told us they were suicidal, but we were not at all confident that it was the best way to help them. We wanted our response to be more personal.”

This is where THA decided to reach out for help themselves. To address an increasing concern around safeguarding, Pamela’s employer decided to give the team the practical skills to handle these conversations with customers effectively while protecting their own mental wellbeing.

Several groups of staff from THA attended the Adult Mental Health First Aid (MHFA) training, a two-day course designed to teach the skills and confidence to spot the signs of common mental health issues and guide a person towards support.

Pamela added: “The training was very helpful. It was a really meaningful two days. It wasn’t just about how to help our tenants, but about our own resilience. We felt safe to talk about ourselves, and I opened up to my colleagues about my own experience of mental ill health for the first time. It was daunting – but it turned out that I was not at all the only one who had been through this.”

The team were able to immediately apply the skills they learnt on the MHFA course to their work with tenants. “One of the most illuminating things we learned was the Mental Health Continuum. I now understand how people can have a significant diagnosed mental health issue but with the right coping resources they can be in good mental health and managing daily life.”

Now, since becoming Mental Health First Aiders, she and her colleagues are better equipped for those difficult conversations with tenants. “Before, if a customer told us they were struggling with their mental health, our procedure was to call their GP or call the police if they were in immediate danger. This would often turn out to be too heavy-handed and would alienate the person.

“Now, our response is centred around them as a person. We have a full conversation to understand their issues and signpost them accordingly. Where possible, we support the person to seek help themselves which is more empowering than seeking it for them.”

In parallel to THA’s approach to housing, they are helping tenants to take control of their own mental health, not taking control of it for them. She added: “Sometimes, all they need is to have their feelings acknowledged with a caring response and to be given some information and encouragement to seek help for themselves.”

And when a tenant is in crisis, the team are now able to recognise the signs a lot more efficiently, and crucially, know how to respond. One such situation happened when one of Pamela’s tenants with a long term illness had his benefits stopped after being found ‘fit for work’.

“We arranged a hardship appeal but he was sure that he would be assessed as fit and well.  His response was to say: I might as well kill myself, they’ll believe me then.’

“In the past this would have gone straight to the police. Instead, I used my MHFA skills to ask if he was feeling suicidal. This instantly opened up a conversation about his mental health, and he shared that he was feeling very depressed and having trouble sleeping. Before my training I would never have known if it was safe to start that conversation, or how to begin.

“I gave him the number for the local crisis team and he was able to access that service by himself. We also gave him the number of a local “chill and chat” session which he goes to every week. His housing situation is now stabilised, he is in recovery and now volunteers at the chill and chat sessions, helping other people. The whole approach was a lot more empowering than just introducing another perceived threat to someone who is already struggling and feeling alienated.”

As well as helping them deal with customers, the team at THA has noticed a change in office culture since taking the course.

“It’s as though the safe space created during the MHFA training has come back with us into the office. We now feel able to be more open with each other about our mental health and to support each other when we are stressed,” she added.

Having experienced a period of mental ill health 15 years ago Pamela feels passionately about being a positive example for recovery. “When I became ill with hypomania I had a supportive family and a stable home life which gave me the tools to recover. A lot of our tenants don’t have that and I feel proud that we are able to provide some of that encouragement for them.”

As Pamela concludes, “We all have mental health, so we should all have access to Mental Health First Aid.”