It is election season in the U.K. So we should not be surprised that political parties are making promises to solve every problem under the sun. My attention was caught by the announcement this morning that one of the Conservative proposals for better mental health care was “mental health first aiders” in schools.
As I read, my heart sank. As a current counsellor and former teacher, I am used to people misunderstanding my job, but this seemed to miss the mark so widely that it was exceptionally worrying.
What is first aid? Anyone who has undertaken first aid training will know the “three Ps.” Preservation of life, protect the casualty from further harm, and promotion of recovery. Basic first aid training will also hammer home the need to do nothing which might make things worse. Indeed before the three Ps are used, there is the most important principle. Contact those with the requisite skills and training, then do your best. The role of first aid to is to minimize harm until the trained professionals arrive.
Inevitably, when it comes to physical injuries, a certain amount of triage is involved. Should you go to A&E with a cut finger? It depends on the depth of the cut, and one of the secondary principles of first aid is never assume, and get a professional opinion if there is any doubt.
Now, imagine you are a teacher in a primary school. A child is crying at break time, you instantly need to assess. Has there been an injury? Is this about bullying? Or is this a pattern? You know how triage, and most of the time it is nothing more than a scraped knee. However, sometimes it is about far more complex issues than a scraped knee, and then the systems of safeguarding and reporting take over.
To assume that teachers are unaware of their student’s distress is not only arrogant, but a huge misunderstanding of how our current education system works. Teachers do triage, all the time. They are hugely experienced at spotting the difference between minor issues and problems that require interventions. The problem is not teacher’s skills. The system of referral and safeguarding is creaking under the weight of underfunding. Ask any parent how long a referral to Child and Adolescent Mental Health Services (CAMHS) takes. Look at the loss of school counsellors, the reliance on (excellent) charities like Place 2 Be to fill the gap in services for our most vulnerable children. The problem is not a lack of referrals, but a lack of trained professionals to act on those referrals.
We are constantly told “it’s good to talk” and that stigma around mental ill health must be tackled. Both are true, but they are a beginning, not an ending. It is no good to talk if the person you are talking too does not know how to listen or how to respond. It is also wrong to expect non professionals to be able to carry the burden of other people’s sorrows. Consider for a moment how you would react to a 5-year-old confessing they were crying because their mum’s boyfriend came into their bed at night, or a 50-year-old revealing they were a victim of domestic violence and felt suicidal? People need better than first aid. They need trained, qualified professionals who can work with them. Yes, triage to direct them to those professionals matters, but just like first aid is the emergency response, before professionals arrive, so it should be for mental health.
I fear we are caught up in a “tea and sympathy” culture, which ignores reality. That just as a biscuit and brew will not fix a broken leg, it will not fix a broken soul. Perhaps it is a fear of mental ill health which causes people to downplay it, perhaps it is simply ignorance, and education certainly helps with both. However all the mental health awareness in the world will do nothing until there is funding for people when they want to talk. It is actually cruel to be encouraging people to speak if our only response is a cursory “first aid” of a sticking plaster over a gaping wound. It may even be dangerous, as the wrong reaction to someone in crisis can be the very thing which pushes them into the darkness they hoped speaking out might avoid.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.