1. Mental Health First Aid England:
is improving the mental health literacy of
the population contributing to a public
health priority?
Poppy Jaman - MHFA England
Dr Paul Patterson - University of Birmingham
Dr Lesley Pearson - Coventry University

2. 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)

3. 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..

4. 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

5. The Royal College of Psychiatry have led the call for
action..
‘Mental illness is the single largest source of burden
of disease in the UK. No other health condition
matches mental illness in the combined extent of
prevalence, persistence and breadth of impact’.
‘Mental illness is consistently associated with
deprivation, low income, unemployment, poor
education, poorer physical health and increased
health-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’

6. Alongside many of England’s Leading
Health Economists..

7. 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

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

9. Mental health in the media
‘Many depictions of mental illness
on TV are frightening
and misleading’
Department of Health, 2010

10. 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

11. 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 Jorm
originators of Mental Health First Aid

12. 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 Jorm
originators of Mental Health First Aid

13. 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 16
Youth MHFA* – for those working or living with
young people aged 11 - 18
MHFA Lite – A 3 hour introductory course
MHFA 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

14. 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 harm
2. Listen non-judgementally
3. Give reassurance and information
4. Encourage person to get appropriate professional
help
5. Encourage self-help strategies

15. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total Sample n=11502
Females 73.1% Males = 26.9%
In what sectors are trainees employed (%)?
Third Sector: 39.8
Statutory: 33.9
Business: 6.5
Independent: 2.0
Education: 1.5
Other: 4.3
Not Stated: 13.0

16. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total 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

17. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total 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

18. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total Sample n=11502
Females 73.1% Males = 26.9%
A) Is improved knowledge correlated with confidence
of how to help others with MH problems?
Pre course confidence & Knowledge Correlation = .89
Post course confidence & Knowledge Correlation = .81

19. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total Sample n=11502
Females 73.1% Males = 26.9%
A) How did you rate the course structure?
95% rated structure very good / good

20. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total Sample n=11502
Females 73.1% Males = 26.9%
A) How did you rate the course content?
96.5% rated content very good / good

21. MHFA in England – Does it Work?
MHFA England trainees October 2011 – December 2012
Total 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

22. 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