Mental Health First Aid in the Workplace

I beg to move,

That this House notes that the UK is facing a mental health crisis; further notes that, according to the Independent Review into Mental Health in the Workplace 2017 commissioned by the Prime Minister, each year 300,000 people with long-term mental health conditions lose their job; recognises that Centre for Mental Health research shows presenteeism from mental health is estimated to cost the economy £15.1 billion per annum; acknowledges this same research shows it costs the economy £8.4 billion per annum for mental health absenteeism; considers that a recent poll by OnePoll found that 38 per cent of people reported being stressed about work; observes that the Health and Safety Act 1974 made it a legal necessity for workplaces to train someone in medical first aid; and calls on the Government to change this law via secondary legislation to provide clarity that an employer’s first aid responsibilities cover both physical and mental health and to add a requirement for workplaces to train mental health first aiders.

It really is a pleasure to speak in support of this motion, alongside its co-sponsors the right hon. Member for North Norfolk (Norman Lamb) and the hon. Member for Plymouth, Moor View (Johnny Mercer). The application for this debate was supported by more 60 Members from all parts of the House, and we are very grateful to the Backbench Business Committee for allocating time for our discussion today.

Following the particularly challenging moments that this House has experienced over the last few days, today’s debate is a salutary reminder that the work of this Parliament goes on, and that we are capable of debating in a constructive and collegiate fashion. Our motion addresses a real and pressing need to support people affected by mental ill health. Our argument is simple. The Health and Safety at Work etc. Act 1974 ensured that every large workplace has someone trained in medical first aid, and that is now an accepted and established part of every office, factory, warehouse, hotel and anywhere else that people work; so why not a trained mental health first aider in every workplace? We want to change the Health and Safety Act via secondary legislation so that an employer’s responsibility explicitly covers the mental health as well as the physical health of their employees. This debate is a true cross-party initiative, calling on the Government to make a small change to the law that would constitute a step towards establishing parity of esteem—real equality between physical and mental health.

This is an excellent motion. Does the hon. Lady agree that when workplace training on first aid—including mental health first aid—takes place outside the workplace, the employer should be required to give the employee time off during working hours to attend?

There are many different ways in which this could be implemented. I myself have attended mental health first aid training at the workplace, but I certainly would not be averse to employers giving their staff time off for such training. I will later come to many examples showing that this is already the case with a number of employers, particularly large employers, across the country.

This debate was born out of the “Where’s Your Head At?” campaign, which was launched by campaigner Natasha Devon and supported by Mental Health First Aid England and Bauer Media, which have together collected over 200,000 names on a petition that a number of us delivered to No. 10 Downing Street. I commend those organisations for all their hard work, and pay tribute to their commitment and determination to see this positive change introduced. It really is admirable. Bauer Media—an organisation with radio stations and a number of magazines, such as Grazia—has really taken the idea forward, paying for billboards across the country to promote the campaign. I commend its social action on a matter that, as an employer, it knows would make a difference in its own workplaces.

This really would be a simple shift, but one with a huge beneficial impact on the lives of millions of British workers. No one can seriously contend that there is not a need for such a measure. Hon. Members only have to look at some of the statistics. NHS Digital suggests that one in six adults experience mental ill health, including depression, anxiety and stress-related illnesses. There are around 28 million people in work in our country, so it is not unreasonable to assume that 5 million people in work today are affected. In a recent poll, 38% of people reported being stressed about work. It is a tragedy that, according to the Stevenson-Farmer “Thriving at Work” report—a review commissioned by the Government and published just over a year ago—some 300,000 people with a long-term mental health condition are losing their jobs every single year.

I congratulate my hon. Friend on securing this debate. She is making a powerful case and is describing an epidemic of mental ill health that has many different sources. The Environmental Audit Committee is looking into this as part of our planetary health inquiry. When I met my local Wakefield UK Youth Parliament, I was struck by how concerned the young people were about mental health in schools, and I discovered that South West Yorkshire Partnership NHS Foundation Trust has provided mental health first aid training in schools for teachers. Does my hon. Friend agree that that needs to be rolled out across all schools so that teachers or trusted adults in schools can deal with young people and children in crisis?

I thank my hon. Friend for her important intervention. Of course, today we are talking about what happens in the workplace, but what happens with young people in places of education is equally critical. I sit on the Health and Social Care Committee, and we have interrogated the Government’s plans for the next generation and young people. There are plans in place to have a designated mental health senior lead in every school, and we should ensure that at least one person has that training. We could be doing better than that, but at least it is a start. I support the idea, and it is great to hear what is happening in my hon. Friend’s constituency.

Let me be very clear that we are talking about a huge number of people affected in our country every single day—our friends, colleagues and workmates who surround us. There is, of course, a huge economic cost as well as a very significant human cost. The Centre for Mental Health estimates that people with mental health conditions staying at work longer than they should costs our economy over £15 billion every single year, and that people being absent from work because of mental ill health costs our economy £8 billion a year. These are not insignificant sums. I reiterate that 300,000 people with a long-term mental health condition are losing their jobs every single year because they find themselves in an acute state, have to leave work, are not supported and get to a critical state, rather than having experienced early intervention or prevention, which might have helped them in the first place.

The Health and Safety Executive says that 15.4 million working days were lost in the last year alone because of stress, depression and anxiety, and the British Association for Counselling and Psychotherapy—I declare an interest, as I was recently appointed one of its vice-presidents— has calculated that stress is costing British businesses £1,000 per employee per year in sick pay and associated costs. That is very significant for the national economy, and for individual organisations and businesses. I do not think I need to set out any more statistics to evidence the fact that there is a clear need. Mental illness is having a significant impact on millions of workers across the country and costing our economy billions of pounds.

My hon. Friend is making an excellent speech. As we have all heard in our constituency surgeries, one of the real costs is that people who suffer from mental illness find it very difficult to get back into employment because of the stigma, and I have to say that the public sector is among the worst at having a bias against people with mental health problems. Does she accept that?

I thank my hon. Friend for making that important point. I am going to move on to talk about tackling the stigma and discrimination that we know still exist in our country. We have made some progress in the national conversation about tackling mental ill health, particularly with the younger generations, but in too many workplaces and too many communities, there is still the discrimination and taboo connected with mental ill health. As a constituency MP, I see that almost weekly. Men of an older generation feel that they are able to talk to me because I campaign on this issue and am very open about it, but they are perhaps unable to speak to their work colleagues—sometimes not even to their close family—because of the discrimination that they feel still exists. We are certainly on a journey as a country.

One objection to this proposal might be that mental health requires highly specialist medical intervention, not someone in the workplace with only a few days’ training—and of course that is absolutely true. Mental health conditions do require specialist diagnosis and treatment. That is why many of us, on both sides of the House, have been calling for more investment in this area to ensure that we have the clinicians within our NHS to address the mental health crisis in this country. But let us be very clear that this motion, with this specific initiative, is not seeking to substitute mental professionals with mental health first aiders. Mental health first aid training gives people the knowledge, the skills and the confidence to intervene early if someone is struggling with their mental health. It is not in any way intended to be a replacement for trained mental health professionals, either in the NHS or in our workplaces; rather it offers an early warning system and an opportunity for employee support. It is also, in response to the point made by my hon. Friend the Member for Stroud (Dr Drew), aimed at tackling the taboo that we often see. Raising awareness of mental ill health and placing it on an equal footing with physical ill health tackles some of the stigma and discrimination that we still have to break down.

I pay tribute to the hon. Member for Liverpool, Wavertree (Luciana Berger). She is right that it is wonderful to be in this place today with the noise dialled down, so that we can work on and think carefully about one of the most important issues in this country. Mental health is the No. 1 challenge for millions of people in this country every day. If we can meet that challenge in some way by working in the collaborative way that she talked about, that is wonderful. I am really pleased that she has secured this debate and that the Minister is here to listen to it. I also pay tribute to the right hon. Member for North Norfolk (Norman Lamb). The three of us have worked together on a number of issues. Like in any team, there are those who lead from the front and do all the heavy lifting and hard work, and that is definitely not me. I want to say a massive thanks to them for their efforts in getting us here today.

When I came into this place in 2015, I talked about how I wanted to end in this Parliament the stigma around mental health. I have found since then that there is still this—it is hard to understand—air around suicide that people do not want to talk about or address, but it remains the biggest killer of men under 44 in this country. Unless we talk about it, we will not come up with ways that interdict and meet the challenge.

I thank the hon. Gentleman for giving way and congratulate my hon. Friend the Member for Liverpool, Wavertree on securing the debate. Does he agree that we need not only to encourage people to talk through industry schemes such as Mates in Mind; we also need to listen? That is why the move towards mental health first aid workers is so important.

The hon. Lady is right. There is no point in getting people to come forward and talk about mental health, which can be very difficult, if we do not have the services or access to them to help them, after they have made themselves vulnerable in that way. That is why I am so keen to keep our foot to the gas and ensure that we start delivering on this. We have made progress—that is undeniable—but clearly there is a long way to go, and I will come on to that.

I want to address the point about legislation. As someone who does a lot of work in the armed forces community and on the armed forces covenant, I know that people will say, “Why legislate?” I have learnt in this place that we can have a number of good ideas and initiatives that we can encourage people to do but, ultimately, this is too big a challenge to be left to personalities involved in companies at different times. Sometimes we have to legislate for it. This is not a problem for the companies that already do this, but sometimes the most vulnerable people in our communities deserve the Government legislating and letting them know that we are on side.

I am sorry that I was not here for the beginning of the speech by the hon. Member for Liverpool, Wavertree (Luciana Berger). I was having my own health and wellbeing check with our excellent service here. The practice nurse was particularly keen to know about my stress levels, given the experience we have all had in the last week, but I am good for another few years.

My hon. Friend may know that I am the co-chair of the all-party parliamentary group on mindfulness, which is a simple way of looking after employees’ mental health. Before Christmas, we held a seminar here involving military figures. He knows, from his experience, the high level of mental health issues among that group. I am glad to say that the Army is now seriously looking at how this measure can be introduced, and why wouldn’t it? This is a win-win situation: if an employer looks after its employees and its workforce, they tend to do a better job, and they look after the company or Army unit better as well.

I thank my hon. Friend for his intervention. He is right; the military has come a long way. It gets a hard time, but the Army in particular has come a long way on the importance of mindfulness and how much easier it is to keep a healthy mind than get better from a mental illness. I thank him for all the work he does on that. We all come to this place for different reasons, but there is no doubt that the mental health challenge of a decade and a half of combat operations has ripped apart the circle of friends that I grew up with, so I have a real passion for getting this right.

As the hon. Member for Liverpool, Wavertree says, we need to look at this in a slightly different way in this country. We are very good in this place at talking from the Front Bench about what we are putting into services in terms of money and priority, and that is extremely important, but we need to turn the telescope around and ask what it actually feels like to be in the community waiting for access to child and adolescent mental health services or mental health treatment. That is the true metric of what we do in this place. I strongly encourage the Government to look at that approach.

Why am I so interested in this? As everybody now knows, I have had OCD for a long time. Obviously, I like to pretend that it is some sort of distant memory, but my close friends and family know that it is not. It is much better, but there is no doubt that, if there had been mental health first aid when I was a boy, growing up and going into the military, my life would have been completely changed. We cannot underestimate how important it is to intervene early, when someone is so much more likely to get better. I will never forget the Saturday afternoon when I ended up in the Maudsley, thinking, “How did I end up here? How did this all start?” If policies like this had been talked about 20 years ago, millions of lives would have been very different.

I talk about this because it sends a powerful message: you can get better. People think that they are managing their mental health for the rest of their life, they reach their zenith and that is it. I cannot over-emphasise how wrong that is. Clearly managing a mental health challenge is a difficulty, but it can absolutely be done, and the chances of doing that are exponentially increased by early intervention. If we can get into workplaces and say to people, “We take mental health as seriously as physical health,” we will affect millions of lives, which is ultimately what we come to this place every week to do.

I pay tribute again to the hon. Member for Liverpool, Wavertree and the right hon. Member for North Norfolk, who have done a lot of the heavy lifting on this. There are not many people here today, but in some ways, that does not matter. There will be people following this intensely because they have a mental health challenge. They may be 15, 16 or 17-year-old young boys, like I was, who never talk about it and who learn about what is going on through their phone but do not even talk to their parents. When I spoke about my OCD in the Evening Standard, I had loads of phone calls the next day, but the best one was from a 16-year-old boy who said he had never spoken to his parents or anyone about it.

It is good to see the subject of mental health in the workplace being discussed this afternoon, and I obviously congratulate colleagues from all parties who have secured the debate. To echo the point made in both speeches so far, given the recent discussions here, it is good that Members can come together and discuss subjects of national significance in a spirit of fraternity.

It seems to me that there are two basic elements to today’s debate: first, how to implore employers to accept their responsibilities to do more; and, secondly, to take the opportunity to showcase good practice in our communities, where employers are stepping up to the challenges in offering mental health first aid.

As we know, the backdrop is that we are increasingly aware of the scale of the mental health challenges we face. For example, one in four of us will experience a mental health issue at some point in our lives, according to the World Health Organisation. As has been mentioned, the report by Lord Dennis Stevenson and Paul Farmer, “Thriving at work”, has highlighted the costs of poor mental health provisions in the workplace. They suggest that some 300,000 people with long-term mental health issues lose their jobs every year, that poor mental health costs employers billions of pounds each year and that the economy in turn loses billions per year as a result.

The numbers are staggering and quite extraordinary, but the subject of our discussion is not really a question of overall economic utility; it is the suffering of our fellow citizens, and what a good society and what good employers should be doing about these profound challenges. We should think of it this way: a Business in the Community publication, “Mental Health at Work”, has found that 15% of employees face dismissal, demotion or disciplinary action after disclosing a mental health issue at work, which could mean that this reality applies to some 1.2 million people of working age in the UK. It has also told us that just 11% of employees felt able to disclose mental health issues to their line manager. These figures are appalling, so things have to change. That is why employers must do more to address these issues.

On the other hand, as I said, we should use this debate to highlight new initiatives where employers are stepping up to meet their responsibilities. I therefore want to reference the workplace mental health work of a company at the heart of my constituency—the Ford Motor Company.

Throughout last year, many Members may have seen or caught sight of the “Elephant in the Transit” film, which the Ford Motor Company put out, which was aired in TV ad breaks, in cinemas and, more generally, across social media in order to raise awareness of mental health issues. It is a short film—I would guess of only 30 seconds—and contains a pretty simple but very smart message. Basically, there are two young, working class lads in a Transit, and between them sits this massive elephant as the lads chat about their plans for the weekend. One clocks that his mate is not quite right—he has learned to see the signs—so he pulls over the truck to talk to him about it all. It is spot-on, and it really is aimed at a key demographic in this area—young, working-class males. In this instance, Ford has teamed up with Time to Change. It has sought to cut through the stigma, especially among young, working-class males, so that we can more openly discuss mental health issues.

I congratulate the hon. Member for Liverpool, Wavertree (Luciana Berger), the right hon. Member for North Norfolk (Norman Lamb) and my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer) on securing this debate, and the Backbench Business Committee on granting it.

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.