Why is END necessary?

In 2003 Rethink carried out a survey of people’s experiences of the mental health system. There were 300 respondents, 29% of whom asked for public education, reduced stigma and mental health awareness.

Why Medical Students?

Third year medical students were considered an important target group because they have not yet specialised in their chosen stream of medicine and could become any type of medical doctor. This is also the first time psychiatry is included in their training.

Why Student Teachers?

Working with teachers will be the first step in promoting a change in their attitudes and those of young people to stigma and discrimination surrounding mental health problems.

The Stigma Shout survey of over 3,000 people was carried out as part of Time to Change. It included people who had experienced mental health problems and carers for people affected by mental health problems.

Amongst its many conclusions, the survey found:

• that interventions with children were to be encouraged to help prevent them developing negative attitudes and behaviour
• just under 25% of respondents highlighted schools as the second most important place to target with anti-stigma campaigns
• almost 30% of respondents said young people should be targeted with anti-stigma training

Teaching is one of the most stressful occupations with one in three teachers experiencing mental health problems according to the National Union of Teachers (Mental Health Foundation/ Press Association, 2007).

END includes training on mental health problems for teachers personally as well as for their students.

Why Educational Professionals?

As well as working with student teachers, it is also important to train senior teachers, head teachers and pastoral care leads within schools, who already have an awareness of mental health within a school environment. Pastoral care leads include Special Educational Needs Officers (SENCO's), Child Protection Officers and Social Inclusion Officers.

Social Inclusion Officers are senior teachers who meet and receive professional training at local authority level at Inclusion Managers meetings.

These Inclusion Managers' meetings influence Children's Locality Trusts which can positively impact local services for young people, including mental health services.

We recognise that nearly all school staff have an influence on pastoral care, so our training sessions are open to all interested staff who are free to attend.

Why GP Surgery Staff?

The GP surgery is often the first port of call for people experiencing mental health difficulties. We want to ensure that all surgery staff have an understanding of stigma and discrimination and feel skilled in dealing sensitively with people experiencing mental health problems.

Our training is open to all surgery staff, including doctors, nurses, receptionists, practice managers and anyone else interested in attending.

The training we provide to GP surgery staff has a particular focus on the experience of people from black and minority ethnic communities, as these communities can find it difficult to access culturally-sensitive mental health services.

What is the Social Contact Approach?

This model of training works by exposing subject groups to people with direct experience of mental health problems, thereby normalising and humaninsing the illnesses.

Previous research by Rethink and the Institute of Psychiatry in their Awareness in Action programme found that social contact was one of the most effective means of tackling stigma and discrimination.

By using the Social Contact Approach, we are committed to providing initial training and ongoing support for our service users and carers (involvement workers) who take part in the training. We have three dedicated END Officers who are in touch with the involvement workers regularly, and whom they can contact if they need support.

Why role play?

Learning how to deal with new or unusual situations can be daunting. Role play creates a safe environment to explore ways of doing things.

We use professional role players to play the parts of the dcotor, the person experiencing mental health problems and their carer or accompanying relative. Where possible, a medical student is asked to volunteer to take part in the role play, acting out improvements to the role of the doctor. This enables the student to try out their role in a safe environment, as well as being able to call for “time out” if they get stuck, when the rest of the group can make suggestions or take over the role.

At the end of a role play, there is feedback from everyone present, including from service users and carers. Involvement Workers give personal examples from their experience, to bring home the reality of these situations.

PR Players

The company we use is called PR Players. The actors attend a six-hour training course prior to taking part in our programme so they are fully able to meet our requirements.

They are made aware of the needs of medical students and also undertake mental health awareness training.

PR Players has an excellent history of working with medical students in their practical examinations and comes highly recommended from previous employers.

Satisfaction Feedback

Here is a selection of comments received from medical students who have been to our sessions:

• “Patients and carer inputs were more useful than text books or consultant viewpoints.”
• "I think that I have become more aware of the problems faced by people with mental health problems and their families. This will help me in the future.”
• “I feel less intimidated at the prospect of interviewing patients in these situations.”