Mental Health First Aid is not the answer to tackling mental illness, but it's a big part of it

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Prince William and Kate Middleton attend an event hosted by Mind to mark World Mental Health Day on 10 October 2015. Last year, 13 local authorities spent nothing at all on preventing mental health problems (Getty Images)

Jay Watts raised a number of thought-provoking points in her article about Mental Health First Aid (MHFA).

When first developed in Australia in 2000, the premise of the MHFA model was simple – to see mental illness like any other illness and to provide an educational course which could skill people to assist those who are experiencing a mental health issue or crisis.

MHFA England started in 2007 as a small programme within the Department of Health under the then-Labour government. Now with 17 years of global experience and evidence base as its foundation, and 10 years of implementation in England with 194,00 people trained, I would suggest to term it “the new big thing in mental health”, as Dr. Watts does, is inaccurate.

MHFA is a global movement, the first of its kind to be translated across cultures and languages in 22 countries, including the education sector. The recently launched government-funded Youth MHFA in Schools programme builds on our work in schools which started seven years ago in 2010 – MHFA England has trained 25,000 school staff in more than 500 schools and colleges.

MHFA is in the process of commissioning a longitudinal evaluation to assess the impact our training has on those who are supported by MHFAiders. We very much welcome working collaboratively with the academic community and others to determine how best to develop a research paradigm to facilitate this. In the meantime, based on a large body of studies, both qualitative and quantitative, we are assured that MHFA is a positive influence when it comes to improving attitudes and help-seeking behaviour, because there is no evidence to suggest that MHFA is damaging anyone.

I’d also like to address Watts’s suggestion that MHFA is predicated on the idea that further help is readily available with adequate signposting. MHFA courses do not make the assertion or assumption that mental health services are readily available – instead our training provides delegates with access to a very large list of organisations, both government- and non-government-funded, which offer support across a range of mental health issues. I think it is very important to note that not everyone who has a mental health issue will require the support of mental health services, but that those who do very much deserve to be able to get the right support and treatment when they need it.

It’s also worth noting that delegates on our course certainly do not finish the course with a pair of rose-tinted glasses – the reality is that our ever-growing community of MHFAiders are very active and vocal around the need for better mental health provision. I very much agree with Watts that MHFA should not be considered a replacement to mental health services and yes, much more needs to be done by government to get this right. However, educating people, as we do on MHFA courses, to have a better understanding around mental health is surely part of the long-term solution.

I think it’s also important to clarify what MHFA is and what MHFA is not. On all our courses our instructors make it clear that we are not training people to be therapists, counsellors or psychiatrists. MHFA teaches people to have a greater awareness of their own and others’ mental health, to listen non-judgmentally and to detect early warning signs and symptoms. As a result, the need for complex mental health care later down the line is potentially reduced or is accessed earlier. I agree, however, that services are not always available and the knowledge to navigate the health system to access the right service may also be a challenge – an issue we surface and discuss on our courses.

At the heart of it, MHFA is a global movement which seeks to improve and increase mental health awareness across society and provide the skills necessary to have a non-judgmental conversation and encourage support – in doing so it aims to be exactly one of the many ways we can foster a mental health friendly society. We do not wish to see MHFA replace or indeed be positioned as replacing vital mental health services but we do believe we have a role to play in ensuring as many people as possible have access to good quality, well researched and positively evaluated mental health training course, delivered by an organisation which is committed to its social mission of raising mental health awareness and support skills

Poppy Jaman, chief executive, Mental Health First Aid England

London

BBC salaries

The director general of the BBC insists that the corporation needs to “be competitive, but not foolishly”, but it would be very interesting to see how many people actually watch sports programmes to see and hear the presenters and so-called experts, usually long retired from the sport (Alan Shearer earns £450,000 a year for BBC punditry and Match of the Day).

In fact, would people stop watching Match of the Day, for instance, if there was no presenter or punditry, and instead the highlights of each match simply followed one another, without the "expert" opinion? At least that would provide more football action, and the millions saved by the BBC could be spent on new programmes and new talent.

Bernie Evans
Liverpool

One has to admire BBC director general Tony Hall for deflecting the absolutely justified outrage at these crazy salaries, by bringing in the smokescreen of the gender gap, so that he can appear to be the knight on a white charger who rides to the rescue of the fairer sex.

No my dear DG, we do not need more women earning obscenely high amounts: we actually need fewer men earning more than the Prime Minister. And indeed come to think of it, every prime minister in my lifetime has been overpaid too.

And paying anyone a penny more than a hard-working London bus driver for the undemanding job of reading an autocue (like Fiona Bruce or Gary Lineker) is an outrageous waste of taxpayer funds. Indeed that tax on televisions – known as the BBC licence fee – must surely now soon join Nicolae Ceausescu's typewriter tax, in the dustbin of history.

Dai Woosnam
Grimsby

I’ve not had a TV since 1999, thankfully (despite being a finalist in the BBC 2004 national comedy-writing competition). However, other working-class licence payers and people of colour and people not resident in London dutifully pay the licence fee year in, year out.

So as well as informing the UK public that in 2017 only a third of top earners at the BBC are women, would Tony Hall also do a breakdown on how many non-white, non-privileged persons are in the top percentage of wage earners at the British Broadcasting Corporation?

Amanda Baker
Edinburgh

It’s democracy

Since there has been a significant response to my letter (Mark Thomas, Letters) on Brexit and democracy, might I be permitted to respond?

The referendum was advisory but Parliament took the hint and voted to enact the leaving process. It now becomes legally binding, surely? A majority, no matter how thin, is still a majority: that’s the way it should work in all elections unless it specifically states beforehand that there must be a minimum.

More of the electorate who voted voted out – if you don’t vote, you don’t have a say. In addition, we don’t count those who are ineligible to vote – the same as in any election. Should the electorate be widened to include 16-year-olds? I would agree but until then…

I agree that there should be a ratification vote at the end of the process but the referendum result cannot in the meantime be disregarded on the basis of some unquantified disquiet. If that approach was adopted we would be re-running general elections every week.

Mark Thomas
Cambridge

The Doctor’s first mission

Perhaps the new Doctor's first adventure should be fighting the internet trolls, who seem to have invaded Earth.

Peter Loschi
Oldham

Legalisation of drugs

Andrew Neilson of the Howard League for Penal Reform makes a well-reasoned case for reducing the prison population.

No one doubts that there are some prisoners, particularly those convicted of violent acts, who must be kept in prison both as a punishment and to protect the public. However, prisoners convicted of using or supplying drugs make up a sizeable portion of prison inmates. These prisoners tend to be non-violent and are in prison only because of our archaic and unenlightened drug laws.

By legalising all drugs, even the class A variety, enormous savings in police time, the courts' time and, of course, prison spaces could be made. Society would not fall apart. If the drugs were given away (much cheaper than the cost of enforcing current drug laws), crime associated with funding the drug habit would cease and the big-time dealers would be put out of business.

I know that some would argue that this could be interpreted as the state encouraging drug use, but this argument does not stand up to scrutiny. The current “war on drugs” has been going on for nearly 60 years and shows no sign of being won. As Neilson says in his article, drugs use is rampant in prison as inmates use them to ameliorate the boredom of inactivity brought on by having too many prisoners for a proper rehabilitation regime to be implemented.

I have never used illegal drugs in my life so I have no personal axe to grind but it seems to me to be a no-brainer. We cannot go on like this. Apart from the personal tragedy of prisoner suicide, damage caused during prison riots due to overcrowding cost millions to put right and it makes economic sense to ease the pressure by lessening the need to send so many people to prison.

Patrick Cleary
​Devon