Mental health first aid in the workplace is about a culture of wellness

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BOSTON — For clients and HR officers, employees' mental health is often a top concern.

But how can you convert your workforce into a self-serving support system?

Tramaine El-Amin is an energetic advocate of mental health first aid, a relatively new system of providing employees with basic training on spotting signs of emotional distress and engaging with the troubled individual in what could be a potentially crucial intervention to help the person find treatment.

During a presentation at the recent International Foundation of Employee Benefit Plans conference, El-Amin drew an analogy to conventional first-aid training. That course will teach you CPR and how to check vital signs, but it will not teach you how to perform a tracheotomy or set a compound fracture, she said.

"Mental health first aid doesn't teach you how to be a psychiatrist," said El-Amin, assistant vice president of strategic partnerships at Mental Health First Aid USA, an initiative of the National Council for Behavioral Health. "But you will be able to support someone at that first aid level, that level of crisis, which does happen in our workplaces, right?"

Or if it is not an obvious crisis, maybe it's that situation "where someone just needs help to connect" with another support structure, such as a firm's employee assistance program or an in-house substance use or mental health program.

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"We help until the right help gets on to the scene," as El-Amin describes the role of mental health first aid.

Instructors certified through El-Amin's organization work all over the country to provide workplace training sessions. She emphasized the importance of getting buy-in from senior leadership and creating a culture where employees are attuned to signs of mental health problems and the stigma surrounding issues like addition or depression.

She described that transformation as an ongoing process demanding an enduring commitment from the organization to promote wellness and mental health — a culture where "it's okay to not be okay."

"That can't be done with one meeting — it can't be done with one training," El-Amin said. "When organizations decide to reframe what wellness looks like, and automatically include mental health as an expectation, we see that impact to utilization. We see that impact to how organizations increase the understanding around mental wellness inside of their organization."

To date, the more than 12,000 instructors have trained more than 1.5 million people on mental health first aid, a broad group that includes business leaders and employees, law enforcement, and college and university staff.

For businesses, instructors develop training sessions that are tailored to the contours of the organization, accounting for factors such as the age and demographic of the workforce, the industry and the settings in which employees typically interact.

In the training sessions, instructors explain warning signs of mental health issues, risk factors and treatment options. A role-playing component gives employees a chance to think about how they would approach a co-worker they might be concerned about.

Equally important is the emphasis on restraint. Much like someone administering physical first aid, mental health first aid trainees are encouraged to connect a struggling colleague with professional mental health, rather than trying to make a diagnosis on their own.

"We stay in our role by knowing who we are and who we're not," El-Amin said. "It's really about understanding that our role as mental health first aiders is mental health ambassadors, not necessarily diagnosticians."

But there is also an element to the training that encourages employees to be bold. El-Amin says that instructors commonly get pushback in their classes from participants who envision the awkward scenarios they are role-playing, such as asking a co-worker if they are thinking of suicide.

Trainees will say, "'We can't ask that question, because what if they're not considering suicide?'" El-Amin said. "But what if they are? I'd rather you be here and mad at me for asking the question than not be here."

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