Thematic Analysis of Interview Findings

Introduction

The chapter aims to provide a clarified and detailed description of the findings and analysis in relation to the theoretical aspects explained in the literature review. The execution of thematic analysis by framing themes and sub-themes based on the available data contributes to explore objectives of the research while serving to develop answers for the raised research question (Terry et al., 2017). In this chapter, five key themes are formed within which the gathered data from the interview is analysed and explained. The analysis is based on making critical contrast between theoretical knowledge gained in the literature review and findings from the interview. In the interview, few dimensions are raised that were absent in the literature review due to which supportive facts for the information could not be provided in some cases. In the themes, quotes from the interviewees are used to present real data under themes. The name and identity of the interviewees were not mentioned and instead numbers are used to present their thoughts to ensure confidentiality.

Theme 1: Perception regarding presence of mental health first aiders at the workplace

The first interviewee who did not have any training in mental health first aid (MHFA) mentioned that presence of MHFA in the workplace is perceived as an effective way of getting the message out that mental health support is available for all and the employees who feel mentally ill can access the services.

“I know of a few people with mental health issues where I work, and I think it will reduce the numbers who are off sick. I think we need to do more to educate people and the individual needs need to be looked at, ….”

The MHFA presence is perceived in the workplace as a boon that allows educating all regarding mental health, taking active approach in addressing stigma and providing required mental support for individuals and line managers returning to the workplace after facing mental health issues. The second interviewee who had training regarding MHFA mentioned the perception that MHFA though is required in the workplace for promoting mental health but are they are not consistently supported through advertisement. Thus, it is highlighted that increased work is required to effectively institutionalise MHFA in the workplace. However, the third interviewee without prior MHFA training in support to first interviewee informed that the person perceives MHFA presence in workplace is needed as it provides support regarding mental health issues. The fourth interviewee mentioned the perception that MHFA in the workplace is needed to include managers in the training for making them develop perception regarding the way mental health issues of the employees are to be managed. This is because they are ones that closely connects with the colleagues and identify who are struggling with mental crisis to help them have effective assistance to overcome the issue. The fifth and ninth interviewee who were trained in MHFA mentioned the perception that MHFA is not been proactively managed in the workplace. They mentioned that more robust system regarding MHFA is to be developed at the workplace for its effective impact and benefit on the mental crisis of the employees.

Fifth interviewee: “ I think as an organisation we are trying to promote it I am not convince how well its hitting home …..we are not promoting the service proactively and again that just comes down to capacity.”

Seventh interviewee: “I don’t believe people are using their skills to the fullest because nobody know who they are there is no robust system for contacting mhfa, …..”

However, the seventh interviewee, who was trained MHFA, along with the eighth and tenth interviewee who are untrained MHFA provided no effective perceptions in explaining MHFA’s presence in the workplace.

Theme 2: Benefit of presence of mental health first aiders at the workplace for employee well-being

According to second and third specialist perception, the benefit of presence of mental health first aiders (MHFA) at the workplace is that it creates opportunity for the employees to safely consult their problem without the fear of losing confidentiality. The response is also supported by the first MHFA interviewee who provides similar judgement of the benefit of MHFA in the workplace.

“It will provide the organisation with a sound understanding of what Mental Health is and it will help remove some of the stigmas that surround MH. It will also provide people a route and signposting to go and speak to folk confidentially if they need to.”

The third MHFA interviewee informed that presence of MHFA in the workplace is beneficial as it creates a presence of repository knowledge in the organisation that supports making talks regarding mental health acceptable and ensures basic assistance is presence in some employees needs MHFA services. The fourth MHA interviewee informs that services regarding MHFA are beneficial for employee well-being because it provides opportunity to the mentally-ill employees to speak with trained professionals first. They avoid getting freaked while interacting with the MHFA and share their reason of stress along with stressful incidents for accessing relief to avail well-being. This response is in support of the specialist interviewee and the third MHFA interviewee. This has been proved from the responses of sixth and ninth MHFA interviewee too.

Ninth interviewee: “The benefit will be a support mechanism for staff, experiencing mental health issues at the moment there isn’t any face to face support so it would be a face to face support for that.”

Sixth interviewee: “I would like to think it would be an exercise to identify the problem before it becomes a big problem I … if you feeling a bit down you can seek support before it becomes a major problem, as I say I think it’s a society change.”

Theme 3: Nature of training, its impact and importance for the role of the mental health first aiders at the workplace

The second MHFA interviewee mentioned the person received only two day training in 2016 prior to their job. The impact of the training on use was found to be generic by the MHFA for executing their role. The person mentioned the training did not help them to support to any great extent in executing their duties of MHFA in the workplace and they experienced skill gap in performing their duties.

The fifth MHFA interviewee reported that they received only half-day awareness session as training to execute the job. In the training, the following discussion was made:

“what was mental health, what was stress and couple pointers how to address the issues and focus was also on being aware of your own mental health”.

The seventh MHFA interviewee reported that the person experienced three-day MHFA training course before executing their role and duties. Moreover, when interviewed regarding anything missed in the training, the person replied:

“No nothing I can think of right now”

This indicates that the person was somewhat satisfied with the training compared to the other MHFA professionals who involved and used training programs for executing their role. The ninth MHFA interviewee used training received previously and mentioned as similar to the seventh interview that the person has nothing to report regarding its impact on their performance. The first and fourth interviewee mentioned that MHFA training could have helped them in managing their role and duties.

First Interviewee: “Yes I do think it would of help, therefore the issue at the moment is since having the training, I haven’t had to use it so I think like everything else you don’t use you tend to forget…”

Fourth Interviewee: “Definitely, they have given us a pack of stuff in my drawer of all the different places to get information so like helplines websites, CDs so all that stuff was good to have handy you not necessarily know how to find it all before than googling it so yea it definitely helps…”

Theme 4: Challenges faced by the mental first aiders within the workplace

The second MHFA interviewee mentioned that lack of awareness regarding the MHFA services has led them to experience insufficient supportive resources to deal with the mental health issues of the people. Moreover, it has led them to face lack of protective services to avoid getting influenced by the mental health crisis of the people. The fifth MHFA interviewee mentioned that lack of support to balance a wider team as a line manager led to create challenge of delivering effective service support to the individuals. However, the seventh MHFA interviewee explained that they face the challenge of lack of confidence to work effectively in delivering mental health support to the required individuals at the workplace.

“We have very little training and people problem are serious, it’s hard to feel confident enough to ask people to open up, however what the training does do is help…”

The ninth interview expressed that the person face managing confidentiality of the patient as the key challenge while providing them care. The interviewee mentioned that:

“Confidentiality is a big thing for individuals they may be reluctant to come forward if they didn’t know the service would be totally confidential and individuals needing support whether its peer support or corporate support after you have intervened or helped someone..”

Theme 5: Strategies to resolve the challenges faced by mental health first aiders in performing their duties

The second interviewee mentioned that to cope with the challenges of emotional outburst regarding service users, the person communicate the facts with her husband. However, the fifth interviewee mentioned that they cope the challenge faced in their work personally without anyone’s assistance. The person tries to personally manage the emotion and workload by remaining patient and confident of being able to play their role. The ninth interviewee mentioned that they cope with the challenge of confidentiality by working closely with the supportive manager and colleagues. They collaboratively determine the way to store information and consult with one another regarding any problem to avoid any data regarding the patients to be revealed to any individuals or professional.

Discussion

According to the literature, the MHFA England (2018) reports that presence of MHFA in the workplace is perceived as an effective association that imparts detailed knowledge regarding mental health to all, decreases stigma, lowers discrimination and support people with mental health issues (MHFA England, 2018). Thus, it leads to prove the perception that MHFA is needed in the workplace as they resolve inappropriate stigma and enhanced mental health education along with acceptance in the workplace. The study by Bond et al. (2019) mentions that MHFA at the workplace are effective to help employees overcome mental health crisis and reduce stigma, discrimination and others regarding mental health problems with involvement of effective management. Therefore, positive perception regarding presence of MHFA in the workplace is true as it ensures better health of the employees and creates presence of positive working environment where mental health is not considered as taboo or stigma. The presence of MHFA in the workplace is mentioned to be beneficial by most of the interviewees and specialist. According to them, the employee with the presence of MHFA feels they are being effectively listened and signposted correctly to access care for overcoming the mental health issue. This is evident from the study of Haggerty et al. (2019) as MHFA has enhanced training about the nature of intervention to be made immediately in helping people cope mental crisis. They are found to act without judgement and compassionately with the employees which make the people feel being listened and ensure the MHFA is essential for the workplace. This is because often the mental crisis leads the people to get inappropriately judged and discriminated in the workplace which with the intervention of MHFA is avoided.

According to Clement (2017), the lack of presence of MHFA in the workplace makes the employees trying to seek counselling for mental illness differently seen and perceived at the workplace. This creates barriers for them to seek the counselling out of fear of discrimination. Therefore, repository knowledge delivery with the presence of MHFA makes it truly beneficial in this case as it avoids the discrimination to be faced as barrier by the mentally-ill employees, in turn, ensuring well-being of the people. As mentioned by Silverman, (2016), effective psychological well-being of the employees leads to work with increased productivity out of lack of stress. Therefore, the MHFA presence is effectively beneficial for employee's well-being as it resolves the stress, in turn, orienting them to work with enhanced productivity that brings in profit for the organisation as well as employees as appreciation. The MHFA England mentions that in the workplace the MHFA professionals act as support system for the employees (MHFA England, 2018). Thus, it ensures MHFA to be beneficial at the workplace as it creates a supportive mental health environment for the employees where no more fear of being misjudged by others. In accordance to CIPD, the learning and development is important as it allows people to adopt new capabilities and skills in performing the work with enhanced motivation (CIPD, 2015). The leaning if positively undertaken with appropriate approach and use of resources, it helps to build a skilled workforce who deliver productive results and perform skilful actions at work (Kim, 2017). However, gap in training is explained to be present by the MHFA interviewee. In relation to the literature, this gap has been created due to lack of positive learning and development environment and resources for MHFA, in turn, making them suffer to deliver appropriate care to the employees at the workplace.

The issues which are to be mainly death with by the MHFA in the workplace are mostly tackling stress and anxiety among the employees. This is because often employees experience extensive workload, discrimination, lack of work-life balance and others that mainly affects their mind to develop stress and anxiety as primary mental issues (Chowdhary et al., 2019). Thus, it indicates that the training received by fifth MHFA focussed on identification and management of stress and anxiety in employees is useful in helping the person to develop skills in tackling the common mental health issues in the workplace. However, the duration of the training reported by all the MHFA who used it is very limited. The training for limited time does not provide adequate information regarding by the MHFA to proficiently perform their roles, in turn, making them face knowledge gap while practicing their duties (Morgan et al., 2018). Thus, the mentioned knowledge gaps are crated in performing role of MHFA in the workplace because of limited and improper training availability and use. The difficulty that leads to hindered training of the MHFA can be explained from the perspective of Berger (2008). The study by Berge (2008) mentions that workplace training are done in some cases for wrong reasons and the managers are seen to place more emphasis on performing rather than learning. Therefore, it can be deduced that access and use of MHFA training in performing role by the mental health first aiders is useful. This is because it provides them to develop enhanced skills performing their duties as well as makes them aware of the way common mental health problem for the employees are to be supported at the workplace. The study by Terry (2011) informed that effective supportive network, clinical supervision; quality assurance and others are required for effective MHFA at workplace. The presence of enhanced system and supportive quality assurance would help people to successfully implement the MHFA program throughout each level at work. Thus, the mentioned requirements for effective MHFA working at the workplace are required to be established. In accordance with the study by El-Den et al. (2018), presence of effective awareness regarding any healthcare service or program is required. This is because it leads the program or service to be effectively used by the service users out of knowledge of its existence. Moreover, awareness of any health program leads to draw attention of potential governmental or public authorities in investing in the progress of the program and ensure adequate resources are present in successful delivery of the program (Jorm and Ross, 2018). Thus, the lack of awareness regarding MHFA does act as potential reason for raising the challenge of resources shortage and hindered role play by the MHFA to proficiently provide care to the needy service users. However, the actions taken by MHFA of discussing the facts with the family member is not an effective solution to the challenge. This is because sharing facts regarding patients beyond the professional field with the family leads to create breach in confidentiality of the patients (Jorm and Ross, 2018). The advertisement of health programs through media with proper mention of facts and evidence helps to draw attention of service users and government authorities in participating and investing in the program (Jorm and Ross, 2018). This is because the advertisement aware people and government or non-profit organisational official about the importance of the new health program in turn making them get interest in investing for the public we’ll-being and health.

The interview mentioned that confidentiality was another challenge faced by the MHFA in delivering services. The confidentiality for mentally-ill individual is vital as without privacy and confidentiality they fear of facing abuse or harm in the society out of stigma and discrimination regarding the disease (Jorm and Ross, 2018). However, with collaborative actions from professionals in discussing and maintaining patient’s information within their manager and colleagues acts to avoid patients information to be released in the public (Jorm and Ross, 2018). This is because it allows the health information of the patient to be shared within individuals who are actually involved in imparting care to the service users, in turn, avoiding intrusion of any outside individuals who may pose threat to breach the confidentiality. Therefore, the MHFA though faced confidentiality issue as challenge in delivering care but their collaborative actions of maintaining the patient’s information within their manager and colleagues ensured the challenge to be resolved and pave way for delivering appropriate confidential care.

Conclusion and Recommendations

The conclusion is developed with the intension to assist the reader understand the reason of the research and its importance. The conclusion is mainly synthesis of key points of the research not merely the summarisation of the facts presented in the study. In this study, the conclusion is going to include key points regarding role of mental health first aiders (MHFA) in the workplace. Moreover, the research topic is to be re-stated and the importance of the topic is to be highlighted. The key points identified from the literature review and findings are to be presented.

Conclusion

The Mental health First Aid in the workplace is referred as a program where mental health first aiders (MHFAs) are recruited as go-to-person for any individuals in the work to report and access help for their mental health issue or crisis. The MHFAs works to develop initial communication with the employees or colleagues at the workplace to guide the individual in distress and avail required help according to their need. The rationale of the study mentions that mental health issues or crisis are common for people in the workplace. This is because workers often under work pressure and complications become stressed and anxious in turn leading them suffer hindered emotional condition. In this relation, the key aim of the study was formed that includes critically analysing the perceived effectiveness and development of mental health first aiders in the workplace along with identifying critical issue s experienced to provide recommendations in supporting effective action of mental health first aiders (MHAs) in the workplace.

The literature review informs that employee well-being is one of the key priorities in the workplace as they influence the working efficiency and productivity from the employees. The review informs that employee well-being leads the organisation to create positive mind-set of the employees by making them feel happy and safe in the working environment out of value and respect towards meeting their needs. The lack of employee well-being leads to create negative impact on the organisation as unsatisfied and sad employees out of lack of value avoid showing concentration at work and perform unnecessary error. The presence of hindered psychological well-being for the employees at the workplaces creates health concern for them and it is found to be evidently linked with their performance. It mentioned that the employers are responsible in managing well-being of the employees at the workplace. In this purpose, the review informed that inclusion of MHFAs in the workplace is an active support to ensure psychological well-being of the employees. This is because they are individuals who work to provide immediate mental health support to the employees facing mental crisis or breakdown at work.

In the workplace, it is seen that due to lack effective awareness of mental health issues and its impact on people initiate to discriminate mentally-ill individuals and raise stigma regarding the mental health issues. However, the MHFAs act as professionals to intervene in this aspect to resolve the misunderstanding regarding mental health crisis of the employees. They promote first aid strategies and treatment present for mental illness for the employees to support them in overcoming the mental crisis. It is proved from the response of the interviewees in the findings where they mentioned that MHFAs educate the people in the workplace about mental health condition and its impact which leads to avoid discrimination and presence regarding the issues at the workplace. This in turn creates opportunity for the employees facing mental crisis to come forward and receive care. It is evident as the presence of MHFAs makes the employees avoid fear of being inappropriately judged for their mental crisis and face isolation. The literature review informed that mental health first aid training program was initiated in the UK in 2007 and the key objective of the program was to educate strategies of first aid for mental health for the public. The training was developed mainly to bring awareness regarding the mental health crisis faced by employees at the workplace and the way they can resolved immediately with the involvement of MHFAs professionals. In order to gather further data, the interpretivism research philosophy is used along with inductive approach and exploratory study design. The interview strategy is taken to gather data regarding the study topic and fulfil the aim and raised questions in the research. The thematic analysis method is used for data analysis of the information identified for the study and themes are developed to systematically present the information.

The findings lead to identify that MHFAs are required in the workplace as they help the employees facing emotional or mental crisis come out to access care. Moreover, MHFAs are mentioned to be needed in the workplace because they act as professional support for meeting psychological well-being of the employees. The benefit of MHFAs presence in the workplace was reported by the interviewees as repository knowledge that creates effective awareness regarding mental health without influence of stigma or discrimination. The other benefit reported is that the MHFAs provides immediate mental health relief to the employees with mental crisis which leads them to avoid their emotional health being deteriorated out of lack of care. The training regarding MHFA was mentioned to be poor in the workplace as most of the MHFAs professional informed they face gap in knowledge while performing their duties. The challenges faced by MHFAs in managing emotional health and provide care to the people is managing confidentiality. Moreover, it was reported that there was lack of awareness regarding MHFA in the workplace due to which the professionals could have adequate resources to support their enhanced working and emotional health being influenced while caring for the employees. It is also reported that the MHFAs had no assistance in providing care and they have personally execute action in resolving problems faced during their actions.

Recommendations

Enhanced awareness of MHFA in the workplace:

The advertisement regarding MHFA in the workplace is to be created so that all the people know regarding its existence and avail care when required for their mental crisis. The awareness of MHFA is also needed to be made in the workplace so that the employers understand its importance for employee well-being at the workplace and invest enough amount of money to make resources available for the MHFA professionals in the workplace to make them provide mental support with adequacy and quality. The awareness regarding MHFA in the workplace is recommended to be built by including it as a vital well-being program for the employees. The benefits to be faced with the program are to be highlighted to the employers to gather effective finances in establishing its awareness in the organisation. The use intranet and mobile media is to be done in advertising the presence of MHFA in the organisation so that employees become aware of its relation to their well-being.

Easy availability of MHFA in the workplace:

The services regarding MHFA in the workplace are made to be easily available to the employees. This is because it would make the employees feel encouraged to access the services as they do not have to overcome complex approaches which make them face problem in accessing well-being. The managers in the workplace are recommended to be provided MHFA training to support psychological well-being of the employees. This is because the managers act as key individuals who mostly interact with the employees to direct them to work. Therefore, the managers having the knowledge regarding the way to support mental health of the employees would make the employees have easier access to the care. The MHFA services in the workplace are recommended to be made available all the time for the employees through the intranet and phone facility so than can use the services as per their convenience.

Training of the MHFA professionals:

The MHFA professionals before being included in the workplace are recommended to be trained effectively under programs. This is because it would make them aware of the real-life issues to be faced in the workplace which they are to tackle in providing care. Moreover, the training leads the MHFA professionals to gain any new skill and knowledge required specific to the workplace to deliver quality care. The training to be provided to the MHFA professionals in the workplace is recommended to include data about the psychological health issues mostly faced by the employees and the nature of treatment available which the professionals can be used to ensure well-being of the employees.

Maintain confidentiality:

The confidentiality in delivering MHFA services to the employees in the workplace is one of the key issues been faced as identified from the interview. In this respect, it is recommended that the MHFA professionals always require availing consent from service user while sharing any data regarding them to ensure privacy is maintained. The MHFA professionals are recommended to store data regarding the employees seeking mental health care through secured password which is to be known only to concerned authorities. Further, during sharing of employee’s data for care purpose with professionals. It is recommended the MHFA professional comply with confidentiality laws as present in the organisation for employee well-being. The threat towards breach of confidentiality in the workplace while seeking MHFA services if identified by the professionals are recommended to be communicated to concerned authorities so that effective actions can be taken to prevent the threat.

Limitation of the study

In the study, while explaining the role of mental health first aiders (MHFAs) in the workplace only perspective from the professional’s side was provided. The way employees perceive the need of MHFA and its benefits are not provided. In insight regarding MHFA from the different industries in the workplace are also not available in the study. Further, only qualitative research is been performed due to which statistical analysis that provides effective quantitative insight is not present in the research. There was limitations faced in arranging financial resources and time for the study due to which enriched analysis and findings can be reached. The use of interpretvism research philosophy leads the study to be analysed from the human perspectives and did not include logical scientific data that may have led to create error in presenting results. This is because the personal beliefs and ideas of the researcher may have influences the representation of the study findings.

References

Bond, K.S., Cottrill, F.A., Blee, F.L., Kelly, C.M., Kitchener, B.A. and Jorm, A.F., 2019. Offering mental health first aid to a person with depression: a Delphi study to re-develop the guidelines published in 2008. BMC psychology, 7(1), p.37.

Chowdhary, A., Zlotnikova, V., Lucas, C. and Lonie, J.M., 2019. How do mental health first aid™ interventions influence patient help-seeking behaviours? A dilemma for pharmacist mental health first aid responders. Research in Social and Administrative Pharmacy, 15(1), pp.106-108.

Haggerty, D., Carlson, J.S., McNall, M., Lee, K. and Williams, S., 2019. Exploring youth mental health first aider training outcomes by workforce affiliation: A survey of project AWARE participants. School Mental Health, 11(2), pp.345-356.

Morgan, A.J., Ross, A. and Reavley, N.J., 2018. Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour. PLoS One, 13(5), p.e0197102.

Terry, G., Hayfield, N., Clarke, V. and Braun, V., 2017. Thematic analysis. The Sage handbook of qualitative research in psychology, pp.17-37.