Written by Jerome Monahan, the following article appeared in Education Guardian Children’s services on Tuesday 7 July 2009.
A new scheme trains adults in ‘first aid’ for young people who turn to them in a time of crisis
Lucy is explaining why she didn’t go to school today. “I just couldn’t get up. I wasn’t being lazy. I just felt as if every bit of me has been filled with weighted blocks of sadness.” She is at a point of crisis and has singled you out to tell about her mounting depression. What do you do?
This scenario is one of a number of filmed true accounts of young people’s struggles with emotional distress, their sadness, fear, shame and anger – which are a key ingredient in a training scheme being pioneered in Southampton. The idea is to make sure young people get support from the first person they confide in about their troubles.
In most cases, such people will not have specialist medical knowledge. Those who have taken the first Emotional First Aid (EFA) training have included teachers and teaching assistants, youth workers and student support officers.
“The course’s aim is not to create experts in adolescent mental health but to help people recognise that they have an invaluable role in assisting young people in need,” explains family therapist Dave Smith, one of EFA’s designers. “Sometimes their involvement will be enough, getting the young person back on track, but even if more specialist services have to be mobilised, then there’s a part for an EFA-trained adult to play in supporting the young person through the process.”
This is an aspect of the training that Paul Jetten particularly appreciates as an outreach worker with the national charity Fairbridge in Solent, his focus being young people whose lives are often already seriously troubled. “I have already seen the EFA training come good in my work with a teenager with anger-management problems. I was honest and explained that I didn’t have all the answers, but I was happy to work together with her trying to get them. She has really responded.”
Barbara Inkson, children and adolescent mental health manager for Southampton’s city primary care trust, says: “EFA needs to be seen in the context of a broader policy of trying to ‘roll-back’ help for young people so that they get the early interventions they often need to stop their problems developing into severe kinds of illness.”
The trust has championed a multi-agency scheme offering young people a short burst of specialist counselling – often all they need to turn their lives around. For seasoned campaigners such as Dr Andrew McCulloch, head of the Mental Health Foundation, the scheme is an exemplary means of alleviating some of the “referrals congestion” that besets most children and adolescent mental health services nationwide. Young people are saved the agony of long waits for appointments – crucial time lost, during which their mental health often deteriorates.
McCulloch is also impressed by EFA: “It is essential to help young people before they get stuck, and equipping those adults that young people might turn to first for help is a sensible step.”
His use of the word “stuck” is significant. “Among the most important lessons we teach,” says Stuart Gemmell, strategic lead for primary mental health in the town and one of the creators of the approach, “is that young people’s behaviour, however distressing, is often their solution to their problems. We also emphasise the notion of ‘stuckness’ – the fact that self-harm, not eating or drug-taking may offer temporary relief, and there is a danger that they come to dominate a young person’s life.”
For Linda Tanner, the special education needs co-ordinator at St George Catholic voluntary aided college in Southampton, this aspect of the EFA training has already borne fruit. “Thanks to that simple word ‘stuck’, I have been able to move a huge distance with a young boy who is very withdrawn,” she says. “The concept seemed to click with him and he started to open up to me. I don’t think I would have had the confidence to address this with him had I not had the EFA experience.”
Gemmel says there is a responsibility for institutions, too, to offer staff the kind of support workers in health services receive in the form of proper “supervision” – the chance to discuss their case load. “Without the proper structures in place, there’s a real danger people can be left exposed when it comes to the kinds of powerful two-way transference that can go on in any human interaction, but particularly so in a counselling situation.”
The EFA training devotes one of its six two-and-a-half hour sessions to addressing the importance of the adults looking after themselves.
“Among our next moves,” says Gemmell, “is to provide the EFA training to new audiences such as carers or those working with certain minorities.”
NHS Innovations South East is working to develop EFA into a national brand. Karen Underwood, a spokeswoman for the organisation, says a recent posting advertising the next round of EFA training brought 300 applicants in just a few hours: “We don’t see that level of enthusiasm for something new in the NHS every day.”