Mental Health First Aid England is a social enterprise on a mission to teach mental health first-aid skills to 10 per cent of the population. Its CEO, Poppy Jaman, discusses the impact of mental illness on the economy and the ‘duty of care’ to employees that she urges all directors to embrace
There’s no shortage of statistics to highlight the impact of mental ill-health on the British economy. The OECD estimates the cost of lost productivity and benefits spending to be about 4.5 per cent of GDP. The latest NHS figures, meanwhile, have confirmed that nearly a third of fit notes issued by GPs are for psychiatric problems, making this the number-one reason for employees to take sick leave. Given that more than a third of sufferers don’t seek help, according to research by Business in the Community, mental illness has become a serious problem for employers.
“Would you expect 35 per cent of your employees with the flu to just suffer and come in to work because they didn’t want to talk about it?” asks Poppy Jaman, CEO of Mental Health First Aid England (MHFA England), the community-interest company committed to training 10 per cent of England’s population in mental health first-aid skills. “Business leaders are morally and socially responsible for looking after the wellbeing of their employees. It’s a duty of care that we must all take seriously.”
In 2007, while working at the Department of Health, Jaman – who had herself suffered postnatal depression at the age of 20 – was focused on improving the quality of mental healthcare throughout the country.
“There were lots of mental health training programmes in the public domain, but none that were properly regulated or had any infrastructure that would enable them to be implemented more widely,” she recalls. “Then we came across mental health first-aid training, which was being rolled out in Scotland.”
The programme had first been developed in Australia six years before, teaching participants how to identify, understand and treat people with mental health concerns. After attending the Scottish course, Jaman and her team realised that they could deliver it south of the border too. “I made the business case for setting it up as a community-interest company,” she says.
By the time MHFA England was registered as such in 2009, it had trained 17,000 people in the public and third sectors. It now also works with business, offering training to companies of all sizes. To date it has trained more than 200,000 people in mental health first-aid skills.
The decision to target the private sector was born of necessity and was not without risk, as Jaman explains: “At MHFA England I struggled with where the money was going to come from. Most of our customers originally were NHS trusts, local authorities and community organisations, but they were all making cutbacks because their funding had been slashed in the downturn. We didn’t have any business customers at all at that stage, while we had only two and a half employees and about 10 associates. If I didn’t change whom we were marketing to, we were going to die a death very quickly. I made the choice based on a bit of foresight, because the downturn meant that people were working harder and stress levels were increasing, so at this point businesses absolutely needed mental health first-aid training.”
A cultural issue
Although her decision would eventually pay off, tough times ensued and the company operated at a loss for two years. Part of the problem was a reluctance among employers to associate themselves with the subject, let alone encourage their staff to talk about it.
“I’d talk to employers and they would actually ask me: ‘Would you call it resilience training or confidence-building instead?’ They really weren’t comfortable with the term ‘mental health’ at all, because they felt they couldn’t relate to it,” Jaman says. “Mental health has now stopped being seen as such a negative term, because people have understood the difference between mental health and mental illness. A big shift is starting to take place.”
In June of this year the government pledged £200,000 in funding for MHFA England to deliver first-aid training in every secondary school in England over the next three years. “We’re the first country in the world to take a nationwide approach to mental health initiatives in schools – and that’s why it’s such a big deal,” Jaman says.
While this is clearly a significant breakthrough, she wants the government to go a step further and make mental health first-aiders in the workplace mandatory, as is the case with physical first-aiders. “That comes with implications for employers, often financial, so we need to be careful that we don’t increase the burden on firms that can’t afford it – particularly SMEs,” Jaman notes. “We have to develop a model that fits different organisations.”
Despite the clear business case for employers to look after the mental health of their workers in the same way they do their physical health, efforts to improve and maintain mental wellbeing are still falling short of the mark. Business in the Community’s Mental Health at Work Report 2016 found that, while 62 per cent of employees who’d suffered mental ill-health attributed this to work, only 11 per cent had discussed this with their line manager, while 30 per cent thought that their employer had failed to support colleagues who’d experienced mental health problems. The issue here, according to Jaman, is one of corporate culture.
“Don’t underestimate how much impact somebody with anxiety or depression can have on the rest of their team. Although it’s not contagious, the effect on their colleagues can be quite significant,” she says. “We often have conversations with the companies that we deliver training to about how, once people start disclosing their mental health problems, you as a line manager are going to handle the communication of this and its impact on your team. How do you ensure that the culture of the organisation will support an individual?”
As a basic starting point, Jaman suggests that firms run a health and wellbeing awareness campaign educating their staff on the importance of healthy habits with respect to sleep, exercise and diet to cultivate a safe culture in which employees feel secure and comfortable enough to talk about their mental health. MHFA England, for example, also offers its staff a one-week summer holiday and a one-week winter break in addition to their annual leave entitlement to focus on their wellbeing. “We try very hard to live and breathe what we’re preaching out there,” Jaman says.
Rising to the challenge
Jaman, who has a British-Bangladeshi background, hopes that the wider business community will also do more to tackle mental health issues in black, Asian and minority ethnic (Bame) communities. The Mental Health Foundation reports that Bame people in the UK are more likely to be diagnosed with mental health problems, experience poor outcomes from treatment and disengage from mainstream mental health services.
“If you live in an area where there is poor housing or a lack of jobs, there’s no doubt that your opportunities are not equal to those of other people,” she says. “Employers could benefit from reviewing the diversity of their staff and looking at how many people they are recruiting from diverse communities. What does that say about the pool of talent you’re missing out on and [your contribution to] levelling social inequality?”
While there’s clearly a long list of issues for MHFA England to tackle, it also faces its own internal challenge: how to manage its rapid expansion over the next few years.
“Right now we’re enormously challenged because we’re scaling up quite significantly,” Jaman says. “In the past six months we’ve doubled the number of employees and we’ve got a workforce development plan, which is set to bring about another 50 per cent of growth in the next six months.”
While the organisation is enjoying the benefits of expansion, her concern is that this could bring with it an element of depersonalisation, putting at risk the culture that MHFA England so values.
“Scaling up means efficiency savings, going digital, adopting modern ways of communication and so on, which can be impersonal,” she says. “When you’re dealing with a subject that’s as emotive as mental health, you need to be aware of some of those sensitivities.”
But, if the journey so far has proved anything, it’s surely that MHFA England is a resilient and forward-thinking organisation with plenty to be optimistic about.
“We supported the international mental health first-aid summit in Ireland in September and we’re launching our strategic toolkit guide to mental health strategy for employers on World Mental Health Day on 10 October,” Jaman says. “We also celebrate our 10th anniversary in November. This quarter is going to be busy, but it’s going to be really fun too.”
MHFA England: Vital info
Organisation Mental Health First Aid England
Founded 2007 by the Department of Health, and registered as a community-interest company in 2009
Staff 45, with 75 associates and 1,300 instructors
Key corporate clients Channel 4, EY, Royal Mail, PwC, Skanska and Unilever
The IoD’s mental health forum for SME directors, in partnership with MHFA England, takes place on 17 October. Visit iod.com/mhforum to book your free ticket
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