Merseyside Fire and Rescue Service MH & Wellbeing Support Programmes

The Mission of Merseyside Fire and Rescue Service (MF&RS) is to achieve ‘Safer Stronger Communities - Safe Effective Firefighters’. To achieve our mission, the Service invests in its people and over several years has developed mental health initiatives which are now embedded as ‘normal’ business for our workforce. We recognise the need to create a mentally resilient workforce which in turn will lead us to a happier, healthier and more production workforce.

Co-Production

  • From start: Yes
  • During process: Yes
  • In evaluation: Yes

Evaluation

  • Peer: Yes
  • Academic: Yes
  • PP Collaborative: Yes

Find out more

 

Please briefly describe your project, group, team or service, outlining  what you do and  why it makes a difference

 The Mission of Merseyside Fire and Rescue Service (MF&RS) is to achieve ‘Safer Stronger Communities – Safe Effective Firefighters’.  To achieve our mission, the Service invests in its people and over several years has developed mental health initiatives which are now embedded as ‘normal’ business for our workforce.

We recognise the need to create a mentally resilient workforce which in turn will lead us to a happier, healthier and more production workforce.

There are approximately 1000 staff employed by MF&RS at 24 Community Fire stations, a Water Rescue station, the Training and Development Academy, our Headquarters and operational workshops.

The Service mental health and wellbeing lead works within the Occupational Health Team and is complemented by input from all of our representative bodies who embrace these initiatives and work very effectively towards tackling the stigma attached to mental ill health.

To achieve our aims we provide education, training and support to each member of the Service and we work in partnership with many stakeholders both internally and externally to benchmark our progress and ensure we continue to be proactive leaders in staff mental health and wellbeing support

 

What makes your service stand out from others? Please provide an example of this.

MF&RS mental health leads have developed and embedded initiativesdesigned to help reduce stigma attached to mental ill health within the Service and to enable our staff to both speak more openly and access help and support as and when required.  We remain committed to offering our staff just as much support for their mental health and wellbeing as we do for their physical health hence each year we continue to build and improve on our current psychological wellbeing initiatives, for example:

Trauma Support Conference

On the last National Stress Awareness Day, (1st November 2017), the MF&RS mental health leads in partnership with Wirral Mind hosted a very successful ‘Trauma Support in the Emergency Services’ conferenceattended by over 70 representatives from across North West emergency services.

As an emergency service, it is reasonably foreseeable that our staff (and particularly our operational staff) will face traumatic incidents regularly throughout their career.  We maintain a legal and moral duty to ensure that we support our employees’ mental health and wellbeing throughout their careers, so that they may live happy, healthy lives both during their time in service and when they have retired.

The aim of the day was to educate staff around the importance of supporting colleagues psychological wellbeing, with key note speakers on the day such as Dr Anne Eyres ‘Putting People at the Heart of Emergency Management’ and Dr Dave Sloggett ‘The Forgotten Victims, The Wider Implications of Terrorism’.  Demonstrating leadership in trauma support for staff, Merseyside Fire Service’s Deputy Chief and Chair of the Authority both committed their time to participate in the conference and deliver presentations from both a personal and professional perspective as to why they so strongly believe that psychological support for staff should be at the heart of everything that we do.

 

Trauma Support for Staff

Following the mental health leads undertaking an 18 month research/scoping programme and assessment of other Fire and Rescue Services, MF&RS created and introduced Critical Incident Stress Management in July 2013. The Critical Incident Stress Management (CISM) Team was developed using only our own staff, ensuring the fullest possible engagement with the workforce. The team is committed to supporting staff who have attended or experienced a traumatic incident either in or out of the workplace.

Our team consists of two coordinators, Kelly Patterson (Senior Occupational Health Officer/Mental Health Lead) and Mark Thomas (Uniformed Senior Officer). Kelly and Mark have also attended external training courses, enabling them to upskill as internal CISM trainers, again allowing the fullest possible engagement from others.

Our Defusing officers are 24 Flexible duty Senior Officers at Station Manager Level who offer defusing post incident. The defuser role is very transactional in the immediate aftermath of an attendance at a traumatic incident – defusing officers will be deployed back to the home station of each team in their own environment to discuss the incident and raise any immediate welfare concerns. Utilising officers in this manner we can ensure that all individuals are accessed as and when the requirement arises.

We have now developed a team of 17 Debriefers who offer post-incident debrief support to crews and teams following the more serious or unusual incidents which may provoke a more unpleasant emotional response. This team consists of individuals from varying departments and roles allowing selection of the most appropriate individuals to undertake a Critical Incident debrief.

In the five years since the process began, over 221 critical incidents have been declared with over 550 staff being defused (out of an operational cadre of 620). We have undertaken 22 Critical Incident Debriefs with over 110 attendees and feedback from each session has been positive.

All those involved in the Critical Incident Stress Management Team have participated in full training courses in their specific area of work within the team and all are also Mental Health First Aid trained.

The success of this programme has resulted in other Services such as Liverpool John Lennon Airport Fire Service and Merseyside Police approaching the coordinators of the CISM Programme for assistance in implementing Critical Incident Stress Management in to their service.  In 2017 the MF&RS CISM Leads helping to co deliver debrief training to Merseyside Police staff.

National Fire Chief’s Council (NFCC)

MF&RS are recognised locally, regionally and nationally as an employer who prioritises the mental health and wellbeing of their workforce.  Other emergency services across the UK have approached our staff to explore our successes and to improve their own.  Subsequently, the mental health leads have volunteered to contribute nationally for the Fire and Rescue Service at the NFCC Mental Health Sub- Committee.  This sub-committee sits underneath the Prevention Coordination Committee and deals with the broader mental health challenges within the communities of the UK, joining up Fire and Rescue and Public Health England at a strategic level to ensure a consistency in Service delivery in relation to mental health in the community; whilst also recognising the needs in terms of positive mental health for Fire and Rescue staff.

Alcohol Pathway of Care

Alcohol dependency is a problem that affects all occupations, the effects of which can have a disastrous consequences for the individual, colleagues, and families and in certain circumstances members of the general public.

The Service, by the very nature of its risk critical work, recognises the importance of being proactive as opposed to be reactive, and that early identification intervention is vital in relation to issues staff may have with alcohol dependency.  MF&RS therefore seek to address this issue when possible in a caring, positive and constructive manner.

MF&RS have adopted an ‘Alcohol Pathway of Care’, which provides the Service and the employee with a clear methodology for dealing with problems arising from the employee’s use of alcohol should an employee acknowledge that they have developed an alcohol dependency.

Essential for the success of the pathway of care is that the employee recognises their problem and that they fully co-operate with their treatment programme.

The aim of the pathway of care is to provide support for the employee with a view to assisting them to a full recovery, thereby allowing a return to a normal life enabling them to function and continue with their career safely without risk to themselves or others.

In order to help promote alcohol awareness, MF&RS host a programme of health promotion initiatives, which will ensure that employees are made aware of the effects, implications and risks associated with alcohol abuse, the signs and symptoms of abuse, and the method of seeking confidential treatment, guidance and advice. This is achieved by promotional information and health promotion initiatives as well as advice given during medical/health screenings and on request by the Occupational Health team.

Mind Blue Light Programme and MF&RS mental health film

Merseyside Fire and Rescue Service have pledged to tackle mental health stigma and discrimination by signing the Time to Change MIND blue light pledge.

MF&RS continue to work in close collaboration with our colleagues from the national mental health charity Mind so that we can review our own best practice regarding mental health and wellbeing support and challenge how our programmes could be developed and improved.  Our initiatives have been showcased at several events such as the Merseyside MIND Blue Light Conference in March 2016 attended by other Services from the North West and more recently in 2017 presented at the Positive Practice in Mental Health SIG Group for Staff Wellbeing.

Following our conference presentations, other emergency services have continued to contact MF&RS asking for guidance and assistance to develop and improve their own mental health and wellbeing services such as Cumbria Fire and Rescue Service, Alder Hey’s Children’s Hospital and North West Ambulance Service.

As part of the blue light collaboration with Mind we previously created aMerseyside blue light mental health film. Volunteer staff who have experienced mental ill health previously created the concept and we were able to deliver in collaboration with Police, Ambulance and Search and Rescue teams under the auspices of the Merseyside Blue light network. The project has increased awareness of Mental Health in the emergency services on a regional and national scale with media interest locally and several thousand views via social media within the first ten days of publishing. Due to the amount of incredibly powerful film material that was filmed using our staff, MF&RS have now created our own bespoke film of our staff talking about their mental ill health experiences, which will be used internally for staff education and to promote positive mental health and wellbeing.

The Merseyside Fire and Rescue Service mental health film is available on hard copy from the bid submission team if required.

 

Blue Light Champions and Mental Health First Aid

Mental ill health conditions have emerged as the single biggest cause of long term absence from the workplace.

Mind’s blue light programme research conducted in Phase 1 of the national project stated that ‘85% of Fire and Rescue respondents said they had experienced stress or poor mental health whilst working for a blue light service’.

The Service has recognised this and been proactive in our approach of educating staff around mental health.  We have been running Mental Health First Aid courses since 2009, these courses train employees to spot the early signs/symptoms of mental ill health among their colleagues and signpost them to the relevant support agencies. This course has proved one of the most popular initiatives that we have run to date, with MF&RS having more employees trained in this area than any other health related training programme that we have ever previously run.

The success of this training programme has attracted participants on the course from other Fire Services in the country as well as Merseyside Police and local community teams such as the Knowsley Council.

To date, our internal trainers have trained over 18% of our workforce in Mental Health First Aid (>160 staff), a 2 day course, enabling employees to be able to spot the early signs and symptoms of mental ill health among their colleagues, make emergency interventions and signpost them to the relevant agencies for professional help and support.

We recognise that our staff are more likely to meet someone with a mental health condition than they are to meet someone requiring physical first aid, so MF&RS have made Mental Health First Aid a mandatory training element for all of our new Firefighter recruits on joining the Service.

The Service now has 6 employees fully qualified to deliver Mental Health First Aid training, enabling the Service to deliver the training to more employees cost effectively and by people who can engage the audience.

In June 2017, the Service MHFA Instructors began the huge task (in addition to their full time roles) in training all employees at all MF&RS sites to a minimum of Mental Health First Aid Lite (3 hour awareness course).  This rolling programme has been an enormous success, with over 221 operational staff so far being trained in mental health awareness (in addition to the 160 staff already trained in full Mental Health First Aid).  The delivery of the Mental Health First Aid Lite has resulted in the Service now having 34 Blue Light Champions across the Service.  The Champions are volunteer employees who are ready and willing to help promote mental health conversations across the Service, are willing to share their own personal experiences with their peers and are available to help support staff in to seeking psychological support. All of our vulnerable persons’ advocates who work within the community of Merseyside have also received this training.

 

Cheshire and Merseyside Suicide Reduction Board

 A Senior Officer from MF&RS represents the Service at board level at the Cheshire and Merseyside Suicide Reduction Partnership Group. Directors of public health have identified Suicide reduction as a priority. This Board is one of nine national groups commissioned by Local Authority Public Health to produce and deliver a local Suicide Reduction Action Plan (SRAP) with the aim to reduce suicide numbers within both the Cheshire and Merseyside areas.

The Cheshire and Merseyside Reduction Network was established in 2008 to seek greater coordination of responses to and understanding patterns of suicide and to ensure suicide reduction activity does not get overlooked or slip off the agenda during the reshaping of the public sector.

As a result of the ongoing work within the Board and MF&RS’s commitment to mental health awareness and education, in May 2018, the Health, Safety and Welfare Committee, chaired by a member of our Strategic Management Team and attended by all Union Representatives agreed to the roll out of suicide awareness training to all Service Staff.  As the Service responds to suicide threats within the community (as well as MF&RS having a number of retired Firefighters over the years complete suicide) MF&RS believe that making staff suicide aware could help to make a difference to the numbers of suicide within Merseyside.

Peer Support Programme

The Service recognise that not everyone will wish to access support through the usual, formal channels. Because of this, the Service mental health lead introduced and developed a more informal peer support network within the Service.

The Peer Support Network is available to help support colleagues in times when their health and wellbeing may be affected due to various life difficulties. The Network is made up of volunteer staff who are passionate about supporting their colleague’s health and wellbeing.  They will provide confidential support in which colleagues may find more comfortable that accessing through more formal means.  Peer support is designed to be used in conjunction with existing welfare systems, with Peer Supporters referring staff they support to OH Services such as counselling and the EAP – Supporters giving their colleagues the prompting and confidence to seek further assistance.

As well as providing one to one support to colleagues, Peer Supporters will seek to promote the Network and positive mental health.  For many staff, the comfort in knowing that support is within easy reach is enough to create a more relaxed and healthier environment; in which staff know that they have their colleagues looking out for their best interests.

Peer Supporters will also promote positive mental health and wellbeing, working towards removing the stigma attached to mental ill health.

The Aim of the Peer Support Network is:

-Promote positive mental health and wellbeing across the Service

-Provide support to colleagues whose wellbeing may be affected by life issues such as financial difficulties, relationship breakdowns, mental and/or physical illnesses, caring responsibilities etc.

-Actively work to reduce the stigma attached to mental ill health

-Develop a trusting and non-judgemental relationship with those that they support

-To identify colleagues needs and help them to recognise what support they may need and signpost to supporting resources both inside and outside of the Service

 

Family Liaison Officers

The Service has identified that if a death in service was to occur, then the bereaved family in the community would require both emotional and practical support.  Family Liaison officers were appointed and trained in 2015; so should the unfortunate event of the death of a colleague occur whilst on duty, appropriate support is available by the Fire Service for the bereaved family within the community.  Chaplaincy support is also readily available for the families (available to those of faith or not) should they request it.

The Service has trained 15 family liaison officers to deal with these eventualities (CPD is undertaken annually). All of these individuals are staff volunteers from every department of the Service and each has made a commitment to support their colleagues.

The Family Liaison Officers have been utilised with additional duties since the training; for example, in 2016 one of our staff members was unfortunately involved in a road traffic collision whilst on duty, which resulted in the fatality of a motorcyclist.  This employee had little to no support at home, living alone and struggling already with serious health issues and financial difficulties.  The Family Liaison Officer used their knowledge, skills and training to offer both emotional and practical support during the emotionally difficult time for the individual. Prior to the introduction of the FLO process this support would not have been available to our employee. The Critical Incident Coordinators oversee the Family Liaison Team.

 

Stress Risk Assessments

The Service utilises its own team of staff from different departments who are trained to undertake Stress Risk Assessments (around the identification and management of the symptoms and effects of stress).  This is aimed at being proactive rather than reactive regarding stress in the workplace, with assessors working with personnel to identify perceived stressors and put in place actions that can help to reduce these feelings prior to them becoming detrimental to the persons health to the point they become absent from work due to it.

Working closely with employees and line managers; we are committed to providing intervention and support to our staff as necessary. The Senior Occupational Health Officer/mental health lead manages the team of assessors and a wider group of Senior Officers to ensure the correct application and further support is made available.

 

 Employee Assistance ProgrammeMF&RS has recognised that the health of our staff is affected by the wellbeing of their family and where practicable, offers services for the families of our staff.  MF&RS offers all employees a full Employee Assistance Programme (EAP) that also provides life management services encompassing issues such as childcare, eldercare, finance and debt advice.  Running 24 hours/365 days a year, this service is extended to provide some support for the employees’ family living at the same address. The Service reviewed the provision of the EAP in 2016 to ensure that the offer to our staff is the most appropriate and timely and meets their needs.

Mental health and wellbeing is an area we are developing to keep employees healthy and in work. Our EAP offers life management support that allows our employees and their immediate family to utilise the services available. The EAP provides counselling, via a 24 hour helpline and face to face counselling for our staff.

The MF&RS mental health lead receives quarterly usage reports from the EAP, which indicates what issues the EAP are most commonly being contacted about within that 3 month period alongside, which district areas are utilising the services most.  This report helps the mental health lead personalise health promotion materials to specific areas of the Service that are most relevant to what is most commonly being enquired about during that period.

 

Service Chaplain and Bridging Team

The Service Chaplain works closely with the mental health lead and is embedded in the Service to such an extent that he has completed the firefighter recruitment training programme.  He has built and developed relationships with staff and provides pastoral care and support to those of faith or not.  He officiates at weddings and funerals of our staff and attends operational incidents to provide support following difficult operational incidents.

A Bridging Team also works alongside the Chaplain.  The bridging team is a group of voluntary MFRS staff who offer peer support to other colleagues in times of emotional need and distress.  All this work contributes towards our goal of ensuring a healthy workforce as we recognise the importance of mental and spiritual wellbeing.

All of our sites have fully serviced gyms and our staff are allocated time in their working day to enable them to undertake personal and group fitness activity – our staff understand the inextricable link between physical and mental fitness.

MF&RS again this year continue to show commitment to the Charter for Employers who are Positive about Mental Health, by renewing its Mindful Employer membership early in 2018.

 

How do you ensure an effective, safe, compassionate and sustainable workforce?

Through proactive involvement and championing work streams, Senior Leadership have encouraged and supported the mental health initiatives from the onset.  With this level of support in place, combined with a collaborative and inclusive approach from all interested representative bodies, the Service has developed a network of champions at every level ensuring continuity should individuals move from their current roles or indeed the Organisation.

The mental health lead, has embedded all mental health and wellbeing support and initiatives in to the Service, with each strand having a supportive team dedicated to that particular work stream. As an example, the Critical Incident Stress Management process whereby additional coordinators are trained to offer resilience to the process, the coordinators, and the lead.

The mental health champions involved in all of our initiatives are embedded at every level in and around the workforce, keeping a momentum of mental health support ongoing. This results in a dedicated and trained group of staff throughout the Service who maintain the work as opposed to an individual retaining responsibility.

Occupational Health has a dedicated budget line for the mental health support for Service personnel.  At the beginning of each financial year planned mental health training for staff, mental health initiatives and related work are planned, ensuring that work can be arranged and initiatives can be resourced.  This aids resilience should the lead individual not be available, as the strategic plan can be picked up and continued by the replacing mental health lead and/or current existing supporting team members.

Service Instructions and policies such as the ‘Positive Mental Health and Wellbeing’ policy and ‘Critical Incident Stress Management’ policy (which can be provided if requested) are currently published internally regarding mental health and wellbeing support for staff.  The Service is then bound to maintain the policy requirements, such as post incident welfare support and alcohol support pathway of care.  Resilience for all mental health work is important to ensure all policy standards are met and continue to be met should the lead not be available.

 

Staff Leadership has helped to embed the initiatives within the Service, with full support from Authority members and principle officer buy in,

‘We want to promote an environment where discussion about mental health feels as natural as the discussions we have about our physical wellbeing and any associated stigma is removed.

It is important that we allow all of our staff easy access to the support that they may require, at a time when they most need it’.

(MF&RS Chief Fire Officer Phil Garrigan)

By encouraging all of our staff to be involved in wellbeing initiatives such as Peer Supporting and Critical Incident Debriefing, encourages them to take more ownership and responsibility for the mental wellbeing of their workforce.  Education and support around psychological wellbeing for all staff has engaged colleagues in feeling both comfortable in seeking help and starting supporting conversations with each other- when prior to these initiatives, culture around mental health was largely to keep quiet, ‘suffer in silence’ or utilise black humour as a coping mechanism.  These initiatives have changed Fire Service culture in relation to mental health, creating a more empathic and compassionate culture within the Service- upskilling staff to have the knowledge and skills to deal with a mental health issue proactively, as they would a physical health issue.

The Service now has over 160 trained Mental Health First Aiders and 34 Blue Light Champions embedded in and around the Service.  The Champions are volunteers who are willing to openly talk about their mental ill health experiences to staff, with the aim that this will continue to embed the change that staff can talk openly and honestly about mental ill health, without fear of being discriminated or stigmatised.  The Service continue to support these staff and are actively encouraging more staff to become Blue Light Champions.

With all of the mental health and wellbeing initiatives that MF&RS undertake, a level of supervision is required to ensure that those delivering support to their colleagues are receiving adequate support themselves. The Mental Health Leads oversee the supervision, so for example, Critical Incident Debriefers will be debriefed themselves within 48 hours of them working with a crew and specific teams who attend more potentially traumatic incidents than others will receive Clinical Supervision in addition to debriefs.

Regular CPD is imperative to ensure that all staff involved in the programmes remain skilled enough to undertake the initiatives.  All Service staff involved in the mental wellbeing programmes will be offered a minimum of yearly CPD with additional opportunities to be part of new and upcoming initiatives in the future.

Merseyside Fire and Rescue Service have pledged to tackle mental health stigma and discrimination by signing the Time to Change MIND blue light pledge and again this year continue to show commitment to the Charter for Employers who are Positive about Mental Health, by renewing its Mindful Employer membership early in 2018.  Both the Pledge and Charter are effective tools that give the mental health leads the opportunity to reflect and review what is currently being undertaken and how we can continue to improve our support programmes.

As part of our continuing commitment to maintain high levels of engagement and communication with staff across the organisation, MF&RS will be carrying out a third staff survey between the 11th June and the 16th July this year.  The support from Senior Leadership this year will now see for the first time health and wellbeing questions being included in the organisation staff survey. This will not only give the Service a general view of the health and wellbeing of its staff, but will also give employees the opportunities to feedback ideas/voice their opinions about how initiatives such as the mental health and wellbeing programmes can be improved.

 

The Mental Health Lead Kelly Patterson is part of (and supported by) the Occupational Health team and alongside Group Manager Mark Thomas are dedicated to leading these initiatives, with Kelly previously training and qualifying as a counsellor/psychotherapist in her own time to increase her knowledge and skills in the area- the Service part funding this course to demonstrate their commitment to her role.  Mark volunteering his time for the initiatives and being supported to do so by principal officers shows dedication to improving the mental health and wellbeing of staff by encouraging leadership from a senior officer level.

MF&RS encourage colleagues (both operational and admin support) to be part of these mental health and wellbeing initiatives, such as our staff being critical incident Debriefers, family liaison officers and Peer Supporters.  Our own staff are encouraged to lead in these so that optimum staff engagement can be sought and representatives from all levels of the organisation are showing commitment to improving the mental wellbeing of our staff and reducing the associated stigma and discrimination.

 

               

How do you work with the wider system?

The Service focuses on proactive health messages, pushing health agenda issues, and signposting staff to healthy living. We have partnerships with Merseyside local authorities (Public Health) being Liverpool, Knowsley, St Helens, Sefton and Wirral.

MF&RS will continue to develop and broaden the understanding and knowledge of health inequalities and health improvement both within the workforce and within the community.  In doing so, the Royal Society of Public Health courses were run at our Service Headquarters by Sefton Council (Public Health) staff.  The course was aimed to qualify all of our Community Advocates in Level 2, however, the course proved popular and several employees from other sections including Occupational Health, HR and Health and Safety also participated in the course and qualified.

Mental health conditions have emerged as the single most widespread cause of long term absence from the workplace.  The Service has recognised this and been proactive in our approach of educating staff around mental health.  We have been running Mental Health First Aid courses since 2009, these courses train employees to spot the early signs/symptoms of mental ill health among their colleagues and signpost them to the relevant support agencies.  In collaboration with Sefton Council (Public Health) we initially joint funded the training for employees, enabling the courses to run with a wider range of participants who were all able to offer different experiences and opinions.  This course has proved one of the most popular initiatives that we have run to date, with MF&RS having more employees trained in this area than any other health related training programme that we have ever previously run.  The success of this training programme has attracted participants on the course from other Emergency Services in the country such as Merseyside Police, as well as local community teams such as the Knowsley Healthy Homes Team and Knowsley Council (Public Health).

 

The current Stress Risk Assessment process which MF&RS use to help identify and support staff with stress related issues is being reviewed.  The mental health lead for the Service is currently working in collaboration with Knowsley Council (Public Health) to develop a new and improved stress risk assessment process, which aims to create a more holistic view of the person; looking at their overall wellbeing and how lifestyle aspects can also affect mental health issues as well as incorporating the HSE stress management standards.

We have worked collaboratively with Wirral Mind, North West Ambulance Service, Merseyside Police and RNLI to create a Mental Health Strategy for Merseyside Blue Light Services. The strategy was written by our mental health lead Kelly Patterson for all Merseyside blue light Services to adopt as best practice (this can be provided as evidence if required). The MIND Blue Light Programme saw Merseyside Fire and Rescue Service sign the Time to Change Blue Light Pledge and also host one of the Networking Events in which Blue Light Services across the North attended, more recently hosting a joint conference with Wirral Mind on the recent National Stress Awareness Day entitled ‘Trauma Support in the Emergency Services’.

The success of the CISM programme has resulted in Liverpool John Lennon Airport Fire Service approaching the coordinators of the CISM programme for assistance in implementing Critical Incident Stress Management in to their service; other Fire Services have contacted MFRS for their assistance and advice in setting up their wellbeing initiatives such as Critical incident Debriefing.  Some of the Fire Services MF&RS have recently assisted in this area are East Sussex and Durham and Darlington and additionally Leicestershire Police and Alder Hey’s Children Hospital.

 

British Red Cross volunteers help people across Merseyside cope after a fire or emergency, providing practical help, advice and comfort.

Known as the FESS, trained volunteers are on call 365 days a year, seven nights a week.  When called upon, they attend incidents in a specially adapted camper van which provides emergency shelter for those who have been involved in domestic fires, floods or other emergency incidents. Each volunteer is trained in working in tandem with the fire service at the scene of an incident.    The Red Cross FESS will be utilising our Fire Station community rooms.

MF&RS have also recently been invited to the British Red Cross Training and Development days to conduct a training event for the Critical Incident Stress Management Process.  This event received positive feedback, with Senior Officer attendees responding that this is an area they would like to pursue further for their own employees. MF&RS intend to undertake further training with the British Red Cross.

The Service how now recruited a Volunteer’s team.  Volunteering can improve people’s social connections and is positively associated with improved mental health and wellbeing.   A positive impact on mental health is more likely when people take part voluntarily, rather than when mandated to do so. Moreover, some research suggests that those taking part voluntarily contribute more time than those required to volunteer.

The quality of relationships formed while volunteering should also be considered when evaluating volunteering programmes. Research points to the importance of developing a connection with beneficiaries as important in improving mental wellbeing.

MFRS began the recruitment of volunteers in October 2016 with the first cohort starting in the role in March 2017. 14 volunteers were recruited with a further 10 volunteers joining the programme in September 2017. The total currently (June 2018) is 36 and we look to expand.

To date our volunteers have supported a broad range of activity within Community Risk Management including:

-Arson Reduction campaigns pan Merseyside assisting MFRS staff in completion of Home Fire Safety Checks (HFSCs) and reassuring the public on arson reduction/crime within the communities

-Events utilising the climbing wall engaging with members of the public including events for the Homeless Games (May 2017) and the 50th birthday celebration of the Training and Development Academy

-Water Safety Week at the Pier Head working with Marine Fire team to engage with school children to advise on water safety

-Community clean up events with key Local Authority partners in Wirral prior to the opening of the Hive Youth Centre

-Health and Wellbeing events where the volunteers have engaged with elderly members of the community about the services MFRS offer and the importance of working smoke alarms

-High Rise Campaigns pan Merseyside following the Grenfell Tower fire in London. Volunteers assisted Advocates and MF&RS employees in completion of HFSCs

-Family fun days during school summer holidays engaging with members of the public, handing out leaflets and giving advice on home fire safety

-Bag packing event in Knowsley for “Mission Walk” with North West Air Ambulance charity

-Southport Air Show weekend at which volunteers assisted staff at the MFRS Heritage Centre utilising the water shoot game to engage with youngsters

This activity equated to 140 volunteers assisting with the above activities/events/campaigns and a total of over 400 hours in volunteering clearly contributing to improved health and mental wellbeing of our volunteers in MF&RS and their communities.

Do you use co-production approaches? If so, please illustrate how you involve individuals, families and carers to drive improvement and deliver services?

All of our initiatives have been developed in conjunction with our representative bodies, these being the Fire Brigades Union (FBU) and Fire Officer’s Association (FOA). Our Organisation utilises a Health, Safety and Welfare committee formed from all the representative bodies and managers alike. The committee is inclusive and is attended by an Authority member who champions against the Mental Health strand. Agenda items include the Occupational Health Managers’ report which includes mental health and wellbeing updates, at which time feedback may be relayed for action. To date there have been no negative responses that have been raised in this forum. Relationships between managers and rep bodies are positive; promoting openness and honesty in driving the culture we would like to see embedded. Feedback from this forum is actioned and recorded through minutes.

We utilise an external consultant to assist in delivery of some of our initiatives from a London Based company called LivewellWorkwell. This company assists us in measuring and evaluating the success of our initiatives, enabling us to respond where change or development is required. The Director of the company is available for the Service at short notice to offer support and advice. He also attends the Service at regular frequencies to visit our teams and engage in professional development activities.

A range of MFRS staff (from admin to operational) at various ranks/roles within the organisation make up many of our mental health and wellbeing initiatives. For example – Critical incident stress management Debriefers are all volunteers who have expressed an interest in supporting the mental health and wellbeing of their colleagues post incident. Similarly, the Family Liaison Officer, Bridging and Peer support teams all consist of voluntary staff and all have been trained to fulfil these roles. All these volunteers who work within the Service communicate staff feedback regularly to the mental health lead  Kelly Patterson so that staff may express their opinions and initiatives may be adapted as necessary to reflect the needs and wants of the staff and the organisation.

We do not accept complacency and we encourage staff involvement in challenging our response and our procedures so that we may alter our delivery as the need requires.

As part of the Service’s continuing commitment to maintaining high levels of engagement and communication with staff across the organisation, MF&RS will be carrying out a third staff surveybetween the 11th June and the 16th July this year.

The unprecedented challenges faced by the Authority have necessitated significant change to the structure of the organisation and the way in which the Service operates.  These challenges are set to continue for the foreseeable future and will continue to have an impact on each and every one of us.

It is vitally important that our staff are able to voice their opinions on changes, how they are being managed, and their experience of working for the Service at this moment in time and if there have been any changes since the last survey in 2016.

The Service is striving to be the best employer it can be, with employees that feel valued and listened to as well as offering a first class service to the people of Merseyside. This is an opportunity for staff to continue to contribute to improving the organisation.

 

Do you share your work with others? If so, please tell us how.

The Service continues to work with other organisations to share our good practice.

We share our working with local Public Health Teams.  We continue our joint working with Wirral CVS and Wirral MIND following continuation of the MIND Blue Light Programme.  We are sharing both experience and knowledge of the emergency services to help Wirral MIND lead on the programme, as following our presentation at the regional blue light event, it became apparent that MF&RS is advanced in terms of our support services and initiatives.  Our work has enabled collaboration and leadership in working with other blue light services.  Our Senior Occupational Health Officer has a close working relationship with Merseyside Police and their Wellbeing Manager, in which they meet regularly to share support and advice in relation to best practice.  Merseyside Police also access our Mental Health First Aid courses; we train their staff in the most vulnerable working roles as well as their Management.

In February 2016, following our presentation at the MIND Blue Light regional event, Greater Manchester Fire Service requested that we meet with their wellbeing team to showcase our work as they felt we could help support and improve their current support systems in place.  We remain committed to share further work together.

Kelly is currently working with Knowsley Council (Public Health) undertaking a joint review of the stress risk assessment processes.  Both are able to share good practice and experience in creating and updating an improved approach.

We have been approached by Durham and Darlington Fire Service, Sussex Fire Service, Tyne and Wear Fire Service and Leicestershire Police who had heard about MF&RSs approach to post incident support.  The mental health leads have been able to share good practice and their extensive research portfolio to help them in finding an appropriate support mechanism for their Service.

Liverpool Airport Fire Service have also been in contact; with MF&RS wanting advice and support on their post trauma support for staff; requesting that we offer Defuser training and MHFA training to their staff as currently they have no post incident welfare support in place.

The mental health leads also have a portal page on the internal Service intranet dedicated to the mental health and wellbeing initiatives available to MF&RS staff. This then ensures that staff can access support materials and publications 24/7.  Online resources are made readily to staff on this site, so that they can easily access up to date and relevant information as well as information regarding the support mechanisms available and contact numbers to use should they need to speak to someone.

In April 2017 the Service piloted ‘Safe and Well’ visits using our staff to integrate in to the community of Merseyside and help to promote positive health and wellbeing.  A safe & well visit is advice and person centered.  It is built on the traditional Home Fire Safety Check which has always covered fire safety advice such as closing doors, night-time routine (turning appliances off etc.) having an escape plan, how to call for help and the importance of working smoke alarms.

In addition to this the visits the residents received from MF&RS advocates included information about other health/age conditions that may impact or increase a risk of fire or escape.  Dementia, mobility, drowsy medication, sensory impairment and oxygen use.  Specific information relating to any risk would have been given.

In support of the local health needs of Merseyside, and when appropriate occupiers will have been asked if they have completed and returned their bowel cancer screening kit.  Dependent on the responses MFRS will discuss the benefits of the screening program and will ask if the occupier would like a kit sent out to be completed.

If the occupier smokes, MF&RS will utilise a Making Every Contact Count (MECC) conversation.  This is a short structured health recognised intervention designed to make a positive change to a person’s behaviour.  At the end of this, staff have the ability to directly refer the occupier into the local smoking cessation group if required.

We will also discuss alcohol consumption and we use the recognised public health AUDIT-C- tool.  It is 3 simple questions and dependent on the score we will then give brief advice (again a recognised structured health conversation) around the health benefits of reducing alcohol intake with the ability to refer directly into local authority services if required.

We complete a falls assessment using FRAT (Falls Risk Assessment Tool).  It is 5 questions and again dependent on the answers the occupier will be offered an onward referral to the Local Authority Falls Team.  An advice leaflet will be left with the resident covering all of the fire and health information.

Finally we undertake blood pressure testing and if results fall within certain parameters we will refer the individual; to their GP or other specialist for further advice, guidance and treatment.

‘Safe and Well’ is now currently awaiting independent academic evaluation, but is has been received well within the communities of Merseyside and is supported by local public health partners. Outcomes include improved mental health and wellbeing for our community members.

 

What outcome measures are collected, how do you use them and how do they demonstrate improvement?

We have created a staff mental health awareness film that we were able to deliver in collaboration with Police, Ambulance and Search and Rescue teams under the auspices of the Merseyside Blue light network. The project has increased awareness of Mental Health in the emergency services on a regional and national scale with media interest locally and several thousand views via social media within the first ten days of publishing in April 2017. From the onset, the concept was to create a film which enabled us to actively promote our Service challenging the current stigma and misunderstanding about mental health and encourage other Services to support the mental health and wellbeing of their staff, just as they support the physical health. This has been delivered successfully.

Due to the amount of incredibly powerful film material that was filmed using our staff, Kelly and Mark approached the film maker to create our own bespoke short film (in addition to the joint Service film) which will be used internally for staff education and to promote positive mental health and wellbeing.

The multi-agency blue light film can be viewed here: https://www.youtube.com/watch?v=oSSst4JR19E

The Merseyside Fire and Rescue Service film can be viewed on DVD provided by the MH lead on request.

To further improve the collaborative approach whilst working towards a common aim, we have created and shared a joint mental health strategy which has been accepted by the Merseyside Blue light network partners to promote a strategic vision to positive mental health and demonstrate active leadership and commitment to supporting these associated initiatives.

Whilst the CISM process will remain anonymised, the Service requests and receives feedback forms from all staff who attend a CI debrief. To date all feedback has been positive with all staff attending indicating that they found the process beneficial in terms of understanding their role in the incident, enabling them to further understand the story and process the event in a safer manner. Other feedback received from other Fire and Rescue Services regionally and nationally would suggest that the Merseyside CISM model is one of best practice and we continue to share this with others across various local, regional and national groups.

Regarding Family Liaison Officers, one of our staff members was involved in a road traffic collision whilst on duty, resulting in the fatality of another road user.  This employee had little to no support at home, living alone and struggling already with serious health issues and financial difficulties.  The Family Liaison Officer used their knowledge, skills and training to offer both emotional and practical support during the emotionally difficult time for the individual. Prior to the introduction of the FLO process this support would not have been available to our employee.

The Cheshire and Merseyside Suicide Reduction Partnership Network is regarded as a national example of good practice, with the MF&RS representative, Mark Thomas being at the forefront of initiating the Zero Suicide campaign. Working collaboratively the Service now welcomes suicide support groups onto fire stations and tackles sensitive issues both with our own staff and within the more vulnerable members of our communities.

The mental health leads have successfully integrated Mental Health First Aid as a mandatory training element for all of our new Firefighter recruits on joining the Service and starting June 2017 all existing employees at all of our sites have started being trained in a minimum of Mental Health First Aid Lite. Reports from the feedback forms are created after each training event to demonstrate the effectiveness of the courses and give staff the opportunity to offer opinions and constructive criticism. Staff on the feedback forms answer questions regarding how much their confidence has improved regarding having mental health conversations as well as how much their knowledge has improved around mental health following the training.  These reports help to indicate to the trainers how effective the training has been and highlight that our Service is helping to diminish any barriers there may be in talking about psychological health and wellbeing.

Sickness statistics in MFRS have always highlighted that those who book sick due to mental health illness will likely remain off work long term.  Hence the reason much of the work in this area has been proactive in assisting people to spot signs/symptoms of mental ill health earlier on and to reduce stigma and discrimination to enable colleagues to feel more comfortable in talking about mental health and seek assistance prior to it getting to the point of booking sick.

Due to this proactive approach with the introduction of such effective mental health and wellbeing initiatives, we have been successful in reducing our long term sickness absence rates by over 50% since 2014/15.  In 2014/15 total shift loses were 6986.87 and we have dramatically reduced this to 3116 shifts lost in the last financial year 2016/17.

As part of the Service’s continuing commitment to maintaining high levels of engagement and communication with staff across the organisation, MF&RS will be carrying out a third staff surveybetween the 11th June and the 16th July this year.

The unprecedented challenges faced by the Authority have necessitated significant change to the structure of the organisation and the way in which the Service operates.  These challenges are set to continue for the foreseeable future and will continue to have an impact on each and every one of us.

It is vitally important that our staff are able to voice their opinions on changes, how they are being managed, and their experience of working for the Service at this moment in time and if there have been any changes since the last survey in 2016.

The Service is striving to be the best employer it can be, with employees that feel valued and listened to as well as offering a first class service to the people of Merseyside. This is an opportunity for staff to continue to contribute to improving the organisation.

 

 

 Has your service been evaluated (by peer or academic review)?

 

In order to ensure that the Service’s mental health work is having a positive effect on the workforce and is delivered effectively; the Service welcomes the opportunity to evaluate its ongoing mental health support/initiative programmes.

The Services’ Health, Safety and Welfare committee places Mental Health as a standard agenda item each meeting.  This meeting is chaired by a Senior Officer, with representatives from all representative bodies present.  This gives the opportunity for all representatives to recognise, question and challenge the mental health support programmes and initiatives, ensuring that recognised best practice is maintained and that all work streams remain relevant and fit for purpose.

Over the last few years the mental health and wellbeing programmes have been evaluated both externally and internally.

The work was assessed by Liverpool’s Health@Work Team for the Workplace Wellbeing Charter Award both in 2011 and 2014. We are now in the final stages of reviewing this again to ensure continued excellence towards mental health support is maintained. During evaluation the Service provides information and evidence regarding the support measures in place for staff wellbeing, with evidence to include how these measures would be evaluated to ensure they were making a positive difference.  The evidence previously provided resulted in the Service being awarded ‘Excellent’ in all categories for employee wellbeing, categories evaluated were mental health support, absence management, health and safety, leadership, smoking and tobacco, physical activity, healthy eating and alcohol and substance misuse.

As a Service involved in the national MIND Blue Light Programme, evaluation was needed against the mental health programmes currently in place in order to sign up to the Blue Light Time to Change Pledge.  This afforded the opportunity for future initiatives to be considered and improvements to current programmes to be realised.  After providing evidence and an accompanying action plan describing our intentions to maintain, develop and embed initiatives (as well as providing evidence as to how the success will be monitored) the Service was awarded the nationally recognised Time to Change Blue Light Pledge.

The Service has worked with Sefton CVS, being awarded a Royal Society of Public Health (RSPH) Health and Community Wellbeing Organisation and Partnership Award.  This application included lengthy evidence based submissions detailing the work undertaken to ensure the ongoing mental wellbeing of our staff.  Following evidence submission, RSPH representatives required a presentation from both Sefton and MFRS as well as a panel interview; the Service was evaluated and assessed on the work we undertake, how we undertake it, why we undertake it and how we know that the work is positively supporting the wellbeing of our staff.

The Critical Incident Stress Management programme is continually evaluated by an external consultant employed by the Service.  Post debrief questionnaires (immediately after debrief, 3 month and six months later) are sent to each attendee to establish how useful or otherwise, they found the process. This evaluation is important to the Service as it enables a change of approach should the need arise. To date evaluation and feedback has been positive indicating that the current ways of working are effective.  All Debriefers adhere to a designated code of professional practice to ensure their continued work is effective, ethical and best practice.

The Service also peer reviews and benchmarks against other local and regional blue light services to ensure gaps are identified and good practice is shared.

 

 

How will you ensure that your service continues to deliver good mental health care?

Through proactive involvement and championing work streams, Senior Leadership have encouraged and supported the mental health initiatives from the onset.  With this level of support in place, combined with a collaborative and inclusive approach from all interested representative bodies, the Service has developed a network of champions at every level ensuring continuity should individuals move from their current roles or indeed the Organisation.

The mental health lead, has embedded all mental health and wellbeing support and initiatives in to the Service, with each strand having a supportive team dedicated to that particular work stream. As an example, the Critical Incident Stress Management process whereby additional coordinators are trained to offer resilience to the process, the coordinators, and the lead.

The mental health champions involved in all of our initiatives are embedded at every level in and around the workforce, keeping a momentum and mental health support ongoing. This results in a dedicated and trained group of staff throughout the Service who maintain the work as opposed to an individual retaining responsibility.

Occupational Health has a dedicated budget line for the mental health support for Service personnel.  At the beginning of each financial year planned mental health training for staff, mental health initiatives and related work are planned, ensuring that work can be arranged and initiatives can be resourced.  This aids resilience should the lead individual not be available, as the strategic plan can be picked up and continued by the replacing mental health lead and/or current existing supporting team members.

Service Instructions and policies such as the ‘Positive Mental Health and Wellbeing’ policy and ‘Critical Incident Stress Management’ policy (which can be provided if requested) are currently published internally regarding mental health and wellbeing support for staff.  The Service is then bound to maintain the policy requirements, such as post incident welfare support and alcohol support pathway of care.  Resilience for all Mental Health work is important to ensure all policy standards are met and continue to be met should the lead not be available.

 

Staff Leadership has helped to embed the initiatives within the Service, with full support from Authority members and principle officer buy in,

‘We are extremely proud of the work that our staff do on a daily basis, under some challenging and traumatic circumstances, so it is right that we should do everything that we can to support their mental health and wellbeing’.

(MF&RS Chief Fire Officer Phil Garrigan)

 

The Mental Health Lead Kelly Patterson and Senior Officer Mark Thomas are dedicated to leading these initiatives, with Kelly training and qualifying as a counsellor/psychotherapist in her own timeto increase her knowledge and skills in the area- the Service part funding this course to demonstrate their commitment to her role.  Mark volunteering his time for the initiatives and being supported to do so by principle officers shows dedication to improving the mental health and wellbeing of staff by encouraging leadership from a senior officer level.

MF&RS encourage colleagues (both operational and admin support) to be part of these mental health and wellbeing initiatives, such as our staff being critical incident Debriefers, family liaison officers and Peer Supporters.  Our own staff are encouraged to lead in these so that optimum staff engagementcan be sought and representatives from all levels of the organisation are showing commitment to improving the mental wellbeing of our staff and reducing the associated stigma and discrimination.

  

What aspects of your service would you share with people who want to learn from you?

MF&RS have been demonstrating the desire to share initiatives and learning experiences with other Services, by show casing MF&RS mental health and wellbeing work at several events over the past 12 months such as the Positive Practice in Mental Health SIG group for Staff Wellbeing and the ‘Trauma Support in the Emergency Services’ conference held at our Headquarters and attended by over 70 people from across the North West in late 2017.  MF&RS seek to continue sharing initiatives and learning experiences (what has gone right and just as importantly, what has gone wrong) with other Service’s in order to maintain transparency, authenticity and a genuine desire to ‘do the right thing’ in all that we deliver within MF&RS.

Since the start of these mental health and wellbeing initiatives the aim has been to involve all service staff and union representatives so that all employees can have their say and their opinions heard. Also so that employees are engaged with principles and practicalities around our working practices.

As the projects have developed, so have our knowledge and skills – any aspects which we feel could have or should have been improved have been and we will continue to ensure best practice and ongoing improvement in services and support are available to staff.

Historically, operational Firefighters have been predominantly males. With this in mind, one of the main challenges we have faced as an Organisation is trying to challenge and change the culture; that it is ok for men to talk about mental ill health; that it is not a sign of weakness or for something to be embarrassed talking about.  We are trying to nurture and embed a cultural change; this is something we continue to work hard to achieve, challenging ourselves and our workforce through a joined up approach.  We felt the first approach to do this was to begin by educating our workforce.  Educating staff, not just about signs and symptoms of mental health but about how we all have it; how is can be positive and negative and change fluidly throughout people’s lives.  This education (via MHFA) challenged perceptions on the stigma and discrimination attached the mental ill health and as the courses gained momentum,  more and more participants began to talk openly and honestly on the courses with their colleagues about their own struggles with mental ill health.  This of course then continued after the courses and with over 160 staff trained in MHFA this is starting to break down that barrier; we will continue to do so as we embark on training all of our staff to a minimum of Mental Health First Aid Lite, with so far an additional 221 staff trained in this also.

Regarding our Critical Incident Stress Management procedure, our scoping document captured much research and prior to implementation, the Organisation was offered two alternatives to proceed – the Trauma Risk Management (TRiM) process or the CISM process.  As one of our main goals was to break down the barrier of men not talking to each other and reduce that stigma, CISM was identified as definitely the best option for MFRS as the TRiM approach was predominantly perceived as a ‘quick box ticking’ paper exercise. CISM enabled us to adopt a proactive approach as opposed to TRiM which is inherently reactive.

The CISM process is now embedded and has been live for four years. The original scoping group still come together on a regular basis to ensure that the process is working as it should. Any challenges are addressed and any relevant adjustments are made. As our operational documents are fluid we review and amend accordingly every 12 months to ensure that process is not lagging.

With recent decreases in budgets, financial cuts have presented challenges in implementing supportive health and wellbeing initiatives.  Therefore the mental health and wellbeing team has had to work hard to continue the dedicated working towards the mental health and wellbeing initiatives with limited financial resources.  From this challenge has come a positive however, new partnerships have been formed and sharing of services and good practice have helped to keep the momentum going.  In areas where we were bringing in external trainers, such as Mental Health First Aid trainers or Defuser/Debriefer Trainers, appropriate personnel were selected to undertake Train the Trainer courses so that in the longer term, costs can be saved, more staff can be trained and the workforce will feel the benefit. Whilst we are improving the knowledge, skills and understanding of our own staff and we can also offer the services to our working partners.

Multi agency work is highlighted through the work with Wirral MIND and the Merseyside Blue Light Services, Merseyside Police, North West Ambulance Service and the RNLI– which has seen a Merseyside Blue Light Mental Health strategy created by the MF&RS Lead that demonstrates a collaborative approach by the Services to support the psychological health and wellbeing of their employees.  Kelly has been working with various other agencies, such as Knowsley CVS and the review and improvement of the stress risk assessments, Sefton Council and the health awareness training courses and Mark represents MF&RS at the Cheshire and Merseyside Suicide Reduction Partnership Group.

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