For many, first aid in the workplace has too often in the past been a green box that is kept in the corner and which, if we are lucky, is opened very occasionally when someone cuts a finger or scalds themselves when making a cup of tea. However, it is much more than that: not only can there be more serious physical illnesses to which we have to attend, such as a broken limb or a heart attack, but there are mental health challenges of which we need to be increasingly aware.
Very often, workplaces are highly stressful settings, which can accentuate mental health challenges. It is important that we put in place measures to reduce stress, to help pick up those first signs of mental illness and to ensure that people needing treatment and support receive it as quickly as possible. This is not only vital for those who are feeling unwell, but good for their employers.
I chair the all-party group on first aid, the secretariat for which is provided by St John Ambulance. I was on its management board in Suffolk before I came to this place. Mental health first aid training is increasingly being provided by St John Ambulance, which by the end of 2018 had provided 5,000 people with the skills to become mental health first aiders in their workplace, and this figure is due to rise to 10,000 this year. This is a good start, but it needs to be put in the context of 1 million physical first aiders in the workplace, requalifying on a three-year cycle. There is clearly a lot of work still to do.
I shall first highlight the research carried out by St John Ambulance, which shows clearly why we need to step up our game, and then I will move on to outline some cases that illustrate the benefits of embedding mental health support in the workplace. St John Ambulance carried out two surveys in 2018—one of 1,000 employees responsible for booking general first aid courses, and the other of 800 people who attended general first aid courses. The findings of the first survey prompted a variety of conclusions.
First, one in four people in work have left a job due to mental health problems. A further 43% of people considered leaving a job due to stress or mental ill health, yet fewer than one fifth of the organisations in which they worked had mental health policies in place. Conditions including depression and stress had caused nearly a quarter of respondents to miss work for a day or longer, and six out of 10 people asserted that their employer should do more to address mental health issues.
Individual responses from employees who took part in the research included a variety of comments:
“The company I work for are pretty archaic;”
“I believe my manager would mock me;”
“They recognise it as a valid condition but see it as an inconvenience.”
Nearly two thirds of people said that they would feel uncomfortable asking for a mental health sick day. On a more positive note, more than a third of people said that their employer recognised stress as a valid condition and worked to help, but more than a quarter said that bosses did little or nothing to help. In the second survey, more than half the respondents were unaware that employees have rights if treated unfairly by their bosses on mental health grounds, and nine out of 10 felt that organisations should have a mental health policy.
Both items of research indicate why the recent initiative by the Health and Safety Executive is so important. It has long been assumed that an employer’s responsibility for supporting mental health is covered by a standard risk assessment that takes into account all health and safety needs. In practice, however, due to the stigma attached to mental health, that simply has not been happening, and 44% of people do not feel able to tell their employer when they are feeling anxious or depressed at work, with most citing “embarrassment” as the main barrier.
There is overwhelming evidence of the need to embed a culture of mental health aid and support in the workplace. Last month St John Ambulance hosted a national conference with speakers and delegates drawn from such diverse sectors as construction, banking, retail, education, local government and the armed forces. Case studies included wellness programmes, a universal approach to mental health first-aid training, sleep training, talking groups for people as they tackled changing life circumstances, and the development of positive mental health champions. In one organisation, referrals to counselling by health professionals have fallen by 48% as a result of its initiatives, while another cited a 75% drop in absence due to work-related illness. The obvious impact on the bottom line has enabled senior leadership to buy into those programmes, which are now regarded as crucial to its success.
Having provided physical first-aid training for employers over many years, it is the experience of St John Ambulance that mandatory regulation will be necessary if every organisation is to give mental ill health the attention it deserves. It believes that further work is needed, especially among SMEs, to establish the right framework for such regulation. Extensive consultation will be required, and progress must be made in recognising the necessary impact on employees and employers. The Government must set out a firm timetable through which to consider proposals from experts, employees and employers, and they must consult on proposals for regulations to deliver parity of esteem, as called for by the Health and Social Care Act 2012, and implied by the Stevenson and Farmer report, “Thriving at Work”.