1. Mental Health First Aid Armed Forces Community Photo: Sam Spurgeon

2. _ Increase your understanding of mental health _ Increase your understanding of military culture _ Increase your personal resilience _ Spot the early signs of a mental health problem _ Feel confident helping someone experiencing a problem _ Provide help on a mental health first aid basis _ Help prevent someone from hurting themselves or others _ Help stop a mental health problem from getting worse _ Help someone recover faster _ Guide someone towards the appropriate support _ Reduce the stigma of mental health problems 2 MHFA for the Armed Forces will help you to:

3. MHFA International MHFA is international with a robust evidence base. _ MHFA is originally an Australian initiative, created by Betty Kitchener and Prof Antony Jorm at the Centre for Mental Health Research, University of Australia _ MHFA is an international initiative currently being delivered in 21 countries _ MHFA was introduced to England by the National Institute of Mental Health in England (NIMHE) in 2007 _ MHFA England became a Community Interest Company in September 2009 _ MHFA England, Royal British Legion and Combat Stress developed MHFA – Armed Forces in 2012 3

4. Course outline Section_01 _ Why mental health first aid for the Armed Forces community? _ Exploring your understanding of military culture _ What is mental health? _ Stigma and discrimination _ Mental health problems, violence and the criminal justice system _ ALGEE – the actions for mental health first aid 4

5. Course outline Section_02 _ Suicide _ Depression Section_03 _ Self harm _ Eating Disorders _ Psychosis Section_04 _ Anxiety Disorders _ Impact of Trauma _ Alcohol and substance misuse _ PTSD _ Recovery _ Action planning for using MHFA 5

6. Why Mental Health First Aid Armed Forces? _ Mental health problems are not uncommon in the serving and veteran community _ We can discriminate against people with mental health problems _ We are not well informed about mental health or mental health problems _ We may lack the insight to realise that we need help or that help is available _ There is a culture of resistance towards seeking professional help _ The majority of us do not know how to respond _ The majority of us do not fully understand military culture 6

7. Impact of mental health problems Mental health problems are common - exact estimates vary _ 1 person in 4 will experience some form of mental health problem in any year (Goldberg, 1991) _ At any given time 1 in 6 working age adults have symptoms associated with poor mental health (e.g. sleep problems, fatigue, etc) which do not meet the criteria for diagnosis _ In 2010, 164 personnel had to leave the armed forces because of a psychological condition.( NHS choices) _ In 2011/2012, 3970 serving personnel were assessed as having a mental disorder ( DASA, 2012 ) _ Total cost of poor mental health in England for 2009/10 was £105.2 billion ( Centre for Mental Health ) 7

8. Serving personnel presenting complaints CharacteristicAll patients seen Patients assessed as having a mental disorder All54043970 ServiceRoyal Navy610388 Royal Marines11876 Army34142570 RAF1262936 GenderMales44003184 Females1004786 RankOfficers491400 Other ranks49133570 Age<20289161 20-2415361054 25-291240913 30-34666519 35-39496391 40-44202165 45-4910384 50+872683 Source: UK Armed Forces mental health: Annual Summary & Trends Over Time, 2007/08 – 2011/12, DASA, MOD; 31st July 2012 8

9. Mental Health and the armed forces community Who is the armed forces community? “Serving and ex-service personnel (including reservists) and their families, friends and carers as well as those working in this community” What does the term ‘mental health’ mean to you? “Mental health influences how we think and feel about ourselves and others and how we interpret events. It affects our capacity to learn, to communicate and to form, sustain and end relationships. It also influences our ability to cope with change, transition and life events.” (Dr Lynne Friedli 2004) 9

10. Armed Forces mental health and stigma _ Stigma had been reported as an important deterrent for seeking help for mental health problems in the general population. It is likely that such deterrents are amplified in military culture where characteristics of strength, resilience, and self-sufficiency are selected for and prized. (The stigma of mental health problems and other barriers to care in the UK Armed Forces, King’s College 2011) _ 81% of veterans suffering from mental ill health revealed that they felt ashamed or embarrassed about their condition. _ The fear of stigma and discrimination means that more than 1 in 3 of those people didn’t feel able to tell their families about their problems (Combat Stress Stigma and veterans mental health survey 2011) 10

11. Armed Forces mental health and stigma 11 From an average sample size of 698 UK military personnel in service at the time of the 2003 Iraq War. The stigma of mental health problems and other barriers to care in the UK Armed Forces Kings College 2011

12. Person/ Family/Carer A L GE E Assess the risk of suicide or self harm Listen non-judgementally Give reassurance and information Encourage the person to get professional help Encourage self-help strategies Actions for Mental Health First Aid 12

13. Armed forces mental health and recovery “We don’t remain in the dark about many subjects which could affect our soldiers or ourselves, so why would we wish to remain in the dark on the subject of mental health? This course has given us the knowledge of how to assist our soldiers and signpost them to the most appropriate professional help. We now have more awareness and understanding about the importance of early intervention and how this can improve their recovery.” ARC Army Recovery Capability, April 2013 13