Merseyside Fire and Rescue Service MH & Wellbeing Support Programmes

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 at Merseyside Fire and Rescue Service (MF&RS) and when they have retired.

It is with this in mind, we are committed to offering our staff just as much support for their mental health and wellbeing as we do for their physical health.

MF&RS has developed and embedded initiatives designed to help reduce the 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.

The Mission of Merseyside Fire & Rescue Service is to achieve:
‘Safer Stronger Communities - Safe Effective Firefighters’

Co-Production

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

Evaluation

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

Find out more

What We Did

Highly Commended in the 2016 MH and Emergency Services Award

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 at Merseyside Fire and Rescue Service (MF&RS) and when they have retired.

It is with this in mind, we are committed to offering our staff just as much support for their mental health and wellbeing as we do for their physical health.

Mind national blue light programme research states that ‘85% of Fire and Rescue respondents said they had experienced stress or poor mental health whilst working for a blue light service’.

MF&RS has developed and embedded initiatives designed to help reduce the 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.

 

The Mission of Merseyside Fire & Rescue Service is to achieve:

‘Safer Stronger Communities – Safe Effective Firefighters’

There are 1014 staff employed by Merseyside Fire and Rescue Authority at 25 Community Fire Stations, a Water Rescue station, the Training and Development Academy, our headquarters and operational workshops.

To enable us to achieve our Mission and Organisational aims, the Service is delivered through various functional departments managed at our central Headquarters site. People and Organisational Development overarch the HR function and our Occupational Health Team lead in terms of developing, maintaining and supporting a physically and mentally well and healthy workforce.

The benefits of a mentally healthier workforce are clear, and the success of our new programmes are demonstrated in the use and feedback regarding these services, reduction of sickness absence and our success in continuing to lead our regional MIND Blue Light network.

 

MIND Blue Light Programme

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

By working in collaboration with our colleagues from the national mental health charity MIND under phase 1 of the project, we were able to review our own best practice regarding mental health and wellbeing support and challenge and how any of our related programmes could be developed and improved.  Our initiatives were showcased at the Merseyside MIND Blue Light Conference in March 2016 attended by other Services from the North West. We were able to then gauge how significantly more mental health support and assistance was available within MF&RS than any other attending North West Blue Light Service.  Following the conference, 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. These include Greater Manchester Fire and Rescue Service and Merseyside Police and further afield Durham and Darlington Fire Service with, more recently Tyne and Wear and Leicestershire Police.

On completion of phase 1, legacy fund remained and local MIND charities were approached to bid for this funding. After meeting with Wirral MIND in March 2016 and explaining our procedures and processes we submitted a joint bid with Wirral MIND. The bid was successful and £100,000 was awarded to Merseyside Blue Light Services in April 2016 to continue with phase 2. The funding was utilised to further develop the network and ultimately support the positive mental health of Blue Light staff.  Kelly Patterson (MF&RS Senior Occupational Health Officer and Service mental health lead) and Mark Thomas (Uniformed Senior Officer), were instrumental in leading the bid for further funding and also throughout phase 2 with other blue light partners.  This programme has enabled MF&RS to lead the way with all other Merseyside Blue Light Services such as Police and Ambulance to challenge the stigma in the Organisations and encourage services to support the mental health of their staff as they do the physical health.

At the conclusion of phase 2 in March 2017, MF&RS mental health leads requested that Wirral Mind support our vision for the creation of a Merseyside 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, Kelly and Mark approached the film maker to create our own MF&RS 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 (can be provided at request).

The joint Merseyside blue light mental health film can be viewed here: https://www.youtube.com/watch?v=oSSst4JR19E

 

Critical Incident Stress Management (CISM)

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 24 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 four years since the process began, over 200 critical incidents have been declared with over 500 staff being defused (out of an operational cadre of 620). We have undertaken 20 Critical Incident Debriefs with over 100 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 Fire and Rescue Services such as 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.

 

Mental Health First Aid

 Mental ill 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. 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 local community teams such as the Knowsley Healthy Homes Team.  Merseyside Police have also requested MF&RS to provide there staff with Mental Health First Aid and due to the positive feedback received from the courses ran in the last financial year, the Police have requested further training from our Instructors in the financial year (in total MFRS MHFA Instructors have delivered the training to 85 Merseyside Police staff to date with a further 51 members of the Police already scheduled on future planned courses in this financial year).

To date, our internal trainers have trained over 18% of our workforce in Mental Health First Aid (>160 staff), 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 compulsory training element for all of our new Firefighter recruits on joining the Service.

The Service now has 8 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.

All employees are required to complete feedback forms following the course, with all respondents to date reporting that they now had more confidence, knowledge and understanding in in how best to support others with a mental health problem after attending the course. (Feedback evidence can be provided on request).

Starting 1st June 2017 all employees at all of our sites will complete a minimum of Mental Health First Aid Lite (3 hour awareness course).

A fit and healthy workforce is more productive and engaged and will deliver better performance. This will then lead to less sickness absence. If employees become unfit for their usual duties we will take whatever practical step is available to the Service to return our employees to full health and fitness.  This includes returning into the workplace to perform sedentary duties and maintaining line manager contact when an employee is long term absent.

All of our sites have fully serviced gyms and our staff are given 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.  Additionally we also have an Alcohol Pathway of Care for staff who are experiencing alcohol addiction issues.  This is a supportive approach designed to assist staff in recovering whilst continuing to work and undergo appropriate professional assistance.

 

Family Liaison

 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, last year 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 Kelly Patterson and Mark Thomas 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 Kelly Patterson manages the team of assessors and a wider group of Senior Officers to ensure the correct application and further support is made available.

 

Cheshire and Merseyside Suicide Reduction Board

 Merseyside Fire and Rescue Service are represented at board level at the Cheshire and Merseyside Suicide Reduction Partnership Group.  Mark Thomas is a Uniformed Senior Officer with the Service who attends quarterly. 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.

 

Employee Assistance Programme

 MF&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. Merseyside have assisted other Fire Services through extending our EAP to their staff, i.e. the Highlands and Islands Fire and Rescue Service who suffered a death in service. Discussions with Lancashire Fire and Rescue are also taking place regarding joining our Employee Assistance Programme.

 

Service Chaplain and Bridging Team

 The Chaplain Bill Sanders works closely with the mental health lead, he 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.

 

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, Kelly Patterson, has 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

 

 Wider Active Support

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 as well as local community teams such as the Knowsley Healthy Homes Team

 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.

As a result of the good practice in mental health support displayed by MF&RS at the Merseyside FS Blue Light Networking Event, Greater Manchester Fire Service requested to meet to discuss how MF&RS can help to develop their current working practices in the areas of mental wellbeing support.  This led to partnership working between MF&RS and GMFRS.

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, Durham and Darlington, Tyne and Wear and Leicestershire Police.

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.

Merseyside Fire and Rescue Service have been working in partnership with the Dementia Society.  Home Instead who an organisation that aims to help people who suffer with dementia remain independent in their own home have been delivering dementia training to the operational crews based in Sefton, with the aim that this training will help crews to recognise the signs and symptoms of the illness and how best to support someone within the community with dementia. This year’s Dementia Awareness Week (May 14-20 2017) our firefighters from Southport Community Fire Station visited people in the town with dementia to offer fire safety advice and check they have working smoke alarms. Watch Manager Steve Bousfield said: “Many members of our Watch are Dementia Friends and want to support those in Southport living with dementia by ensuring their homes are safe.”

 

 Co-production

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.

 

Looking back/ challenges faced

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.

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.

 

Sustainability

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.

 

 Evaluation (Peer or academic)

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 process of reviewing this again to ensure continued excellence towards mental health support is maintained. During evaluation the Service provided 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 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 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 and in 2016 won the Engage Award for Best Employee Health and Wellbeing Strategy.

 

Outcomes

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 video which will be used internally for staff education and to promote positive mental health and wellbeing. (This separate film is available on request).

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

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 compulsory 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 will complete a half day Mental Health First Aid Lite (3 hour) course, raising awareness, educating and tackling stigma and challenging discrimination across the entire Service.

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.

 

 Sharing

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 to assist their newly appointed wellbeing officer in relation to mental health support initiatives for their Service which are currently strained.  The Service and Merseyside Police now 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.

The Mental Health Lead, Kelly Patterson was previously seconded into Merseyside Police for one day a week for 3 months to assist setting up their health promotions and their original application for the workplace wellbeing charter.  This was initiated by the Police due to the positive work they felt MF&RS were undertaking.

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 CVS 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.

 

Is there any other information you would like to add?

Innovation in positive practice is demonstrated throughout the application. New initiatives unique to MF&RS are highlighted in for example, leading the Merseyside MIND Blue Light project and creating a film which uses our own employees to talk about their mental health; aiming to break down the barriers of people talking about mental health and challenge associated stigma.  Innovative programmes such as Peer support and Critical incident debriefing have been reflected by the levels of engagement from the work force and representative bodies.  The positive practice by MF&RS and their mental health leads is demonstrated by other emergency services in the country such as Manchester Fire Service and Leicestershire Police contacting the Service for advice and assistance in improving their own mental health support strategies.

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.

In doing so 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’.

(Deputy 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 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 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 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.

 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.

 The various mental health initiatives in MF&RS are designed to create a happier and healthier workforce where staff feel supported in both their physical and mental health.

As an emergency service, it is reasonably foreseeable that our staff (and particularly our operational staff) will face traumatic incidents regularly throughout their career.  With that in mind, our Critical Incident Stress Management programme is actively promoted throughout the Service to help support our staff’s wellbeing following attendance at potentially traumatic incidents.  Whilst this programme can mean we are proactive in ensuring our staff’s wellbeing is maintained, we can now potentially reduce the possibility of any staff member retiring, whilst experiencing mental ill health as a result of experiences they have had whilst in Service.

Peer Support programmes, Blue Light Champions and Mental Health First Aid training are amongst many wellbeing programmes designed to ensure colleagues are both educated in mental ill health and are aware of the support available at times when they many need it most.

The blue light mental health film that we helped to lead on the creation off has actively promoted positive mental health in the Service and opened the doorway for staff to recognise that any person can be affected by mental ill health and MF&RS are ready and willing to support any person affected.  The Service recognises that a happier and healthier workforce is a more productive workforce.

Feedback from staff has been very positive– largely due to the leads encouraging staff from various levels to be involved in the wellbeing programmes but also engaging staff in the creation of such initiatives.  This both helps to engage colleagues in the initiatives, but also helps gain feedback from staff as to how we can continue to improve these programmes to meet the wants and needs of our staff.

Our proactive initiatives are aimed at accessing support for our colleagues earlier on before their mental health deteriorates to the point sickness absence occurs.  By implementing these programmes and supporting staff mental health and wellbeing we have managed to reduce our long term sickness figures (those with mental ill health tended to stay off long term once booking sick) by over 50% since 2014/15, successfully halving long term sickness figures since embedding and enhancing our positive practice in mental health programmes.

 

 

 

 

 

 

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