Lorna Fortune – the value of Psychological First Aid

Hello, my name is Lorna Fortune and I’m the Lead Psychologist for Psychiatric Liaison Services in Barnet, Enfield and Haringey Mental Health NHS Trust and I’ve been working with the acute trust to think about how we support our physical health professionals through this crisis period.

So, I’m going to talk about Psychological First Aid. At the moment our physical health colleagues are working in extreme conditions with very high numbers of very unwell patients, with services and resources stretched in ways we’ve never seen before. So, we’ve looked at what’s helped in other countries who’ve been through similar situations and the evidence suggests that Psychological First Aid is a helpful and useful approach for our frontline staff.

Psychological First Aid or PFA provides a compassionate and supportive presence, designed to help support people in the midst of a crisis situation, by helping to stabilise them and mitigate acute stress and assess if there’s a need for continued mental health care. Psychological First Aid uses quite simple yet powerful principles to help people build support and containment within teams.

It’s worth noting that this model largely uses skills that our health professionals will already have. It’s quite an ordinary way of talking to people that optimises their existing communication and interpersonal skills. However, at times like this, teams can benefit from additional training and support in providing PFA as this will give them an opportunity to think about, practice and build upon their existing communication and interpersonal skills so that they feel more ready and confident in supporting their colleagues.

It’s worth saying that PFA is different to counselling and psychotherapy. The goal of PFA is to help stabilise and mitigate distress, rather than provide long term personal growth. PFA can be provided by almost anyone and it’s usually best provided by people within the existing team as this will help to build on and further develop existing team relationships and support.

So, what does PFA look like? It’s quite a simple model, it can be used quickly to increase connection and reduce stress. There are some basic steps. First of all, it’s noticing when colleagues are struggling or in emotional distress, prioritising them, offering them support. An important part of the support is taking time to listen and to respond, understanding and validating that person’s experiences and reactions. And then its about thinking about how to think through with them what might help and what can be done to help stabilise their emotions in the moment and think together about how they can build their existing coping skills. Also, PFA is not a once only intervention, but it’s an ongoing process that can be bedded into the team culture and structures, helping teams to be mindful of each other, the impact of this situation and feel more confident in supporting each other.

Often in these situations people feel like they’re not doing enough or not making a difference, so I want to remind you that being there for your colleagues, noticing when they are struggling and offering them support by listening and helping them through, can make a very big difference too. It might seem like a small thing, but it can have a significant impact, by helping us work together, connect with each other and look after each other.