On 6 January St John Ambulance declared 2025 the year of holistic workplace health, sounding a warning that traditional concepts of workplace first aid are “dangerously outdated”.
That means it’s time for businesses to proactively address their approach to protect their employees. A core focus? Mental health first aid.
The statistics suggest it deserves attention. The year 2023-2024 saw 33.7 million working days lost due to workplace injury or illness, and sick leave due to stress, depression and anxiety accounted for about half — 16.4 million — of those lost days. For a sense of its financial impact, between 2022 and 2023, workplace illness cost UK businesses £21.6 billion.
Lisa Sharman, Head of Education and Commercial Training at St John Ambulance, calls for “a more sophisticated approach” to both physical and mental first aid as part of workplace employee wellbeing — adding that workplace culture has changed dramatically in recent years, with higher expectations placed on employers for the correct provision.
What does that look like? “Mental health first aid focuses on identifying, understanding, and responding to signs of mental health issues or crises, providing initial support and guidance to professional help if needed,” she says. “Mental wellbeing is about proactively maintaining good mental health through practices like stress management, resilience building, and creating a supportive environment. Together, they complement each other: Mental wellbeing promotes prevention and ongoing health, while mental health first aid equips people to respond effectively when issues arise.”
High-risk workforce
CEO of not-for-profit training consortium The Association of Trainers (ASOT), Ross Lockett, reveals that the coach and bus industry is particularly at risk of mental health issues, with vocational drivers affected more than most other workers for a variety of factors: Lone working, early and late shift times, unpredictable and often unknown shift lengths are coupled with the unpredictable nature of roads to demand high levels of concentration from drivers for extended periods of time.
When the brain is taxed with too many simultaneous actions, performance for each action becomes slower, and that can have disastrous consequences for over-stressed drivers.
Ross, whose transport career has run the gamut from bus and truck driving to transport management and scheduling, became closely involved with driver mental wellbeing some six years ago. He had seen trauma, stress and anxiety in many drivers over the years, and after attending a mental health first aid course in 2019, ASOT took up the mantle and began delivering mental health training to scores of operators.
“Safe driving requires the ability to concentrate, to divide attention between multiple sensory events across visual and auditory modalities,” Ross explains. “Your vision is the most heightened sense; other senses are reduced and restricted due to modern vehicles, not helped by things like power assisted steering and being in an enclosed steel box. Making cognitive decisions in a complex and rapidly changing environment is a challenge.”
Driving for work means staff are particularly prone to adverse stress and fatigue reactions, which can impact on behaviour behind the wheel in several ways. “Stress has a detrimental effect on cognitive functioning, such as inhibiting appropriate decision-making, directing attention towards processing the emotion, and impeding goal-directed choices by reducing self-control,” Ross explains. “The impact of stress on driving performance is therefore mediated by behaviours including cognitive lapses, errors, and intentional traffic violations. Large vehicle drivers often experience symptoms of stress such as worry, irritation, depression, and anxiety. This can lead on to physical health problems too; some of the most common diseases are prevalent within the driver workforce, such as type 2 diabetes, cardiovascular issues, and many others more prevalent in vocational drivers than the rest of the population.”
Driving “time” is also a statistically significant predictor of crash risk, with increasing crash odds as driving time increases from hour five through to hour 11.
Training as a solution
Ross addressed the unique mental health challenges PSV drivers face at a session last year at Euro Bus Expo, where he noted that the benefits of understanding and supporting a driving team in all ways, including mental wellbeing, can reduce stress and mitigate the risk of accidents or incidents at a minimum cost.
But he argues there is a sense that this is still not a topic taken seriously enough — and the gulf has gotten wider between those who understand driver wellbeing in all categories and put structures in place to support it, and those that do not.
ASOT delivers courses built on the back end of coach and bus Driver CPC training. While the courses have been tailored to be open to all parts of the sector, they are approved with and delivered by 60 companies, the majority of which are coach and bus operators.
Three accredited levels are provided. The first is a four-hour awareness of first aid for mental health course; the second and most popular is a one-day, seven-hour first aid for mental health course, while the third is a two-day supervising first aid for mental health course.
Courses are interactive and engaging, and attendees are encouraged to share their own experiences to ensure each session is unique and relevant. Topics covered include stress, mental health conditions such as depression, anxiety, self-harm and eating disorders, drugs and alcohol abuse, and action plans in the workplace.
Ross has a simple request when it comes to advocacy of mental health first aid (MHFA) awareness and training in the workplace, and that is to achieve parity with existing Health and Safety Executive (HSE) requirements when it comes to trained first aiders on site where companies have over five employees.
“HSE should have the same requirements for mental health first aiders across all sectors,” he says. “When you look at the burden on the NHS because of MHFA issues, this would offer an easy fix to some of that burden. Being able to save just 1% of the burden on the NHS would be an astronomical figure, and would be an easy to instigate requirement.”
Word is spreading thanks to Ross’ efforts. He is in communication regularly with the Vocational Training and Testing Advisory Group run by DVSA, along with several training companies and bodies, spinning off which is a “core content group” working alongside the Highways Agency’s Driving For Better Business website.
“We are placing content on to this platform which trainers can utilise. As well as these two projects I am also working with the Road Operators Safety Council and the Guild of British Coach Operators, where this is a growing subject area.
“In addition to all the above, I have also been discussing with the Office of the Traffic Commissioner (OTC) regarding interactions between TCs, drivers and transport operators. I was pleasantly surprised at the attitude OTC is looking to adopt. Indeed, we agreed, although not secured, that we should be producing some new TC video content in many areas. Driver wellbeing was discussed as a top priority.”
Testimonial: Maynes Coaches of Buckie
The course opened my thoughts about mental health and the benefits MHFA can bring, not only for our team, but for our clients, the wider community, and for myself. The point of becoming an MHFA trainer was mainly for the whole of my business around me.
I also sent another trainer to work with Ross to be able to deliver this as well. The effect it has had on my business is amazing. We had a very open and helpful team pre the delivery of the courses, but now with MHFA, everyone has the sense to be there when needed. If you are having a bad day, if you think you’re not showing it to the outside world, those that spend days with you know more about you than you think, and care more than you know.
I completed the MHFA course directly with Ross. I have sat many courses and seminars over the years with him, and nothing has had more effect on me than this by far. Ross’s professionalism and direct approach to this complex subject is amazing. With MHFA and being the first aider, you are a signpost at times and do get and sit with and listen to situations that you in turn help with. I have applied this in my day-to-day life in so many situations. MHFA is an excellent course, it is amazing to deliver it, and it feels great to have an insight into improving and helping people in a positive way. So many of our team come away with things a few days later, and say they have had time to think after the course and thank you for the day. This gives you a boost yourself, that you have given someone a look at life, maybe a different angle — after all, we’re felt my life had changed, over the subsequent months and years.
It has reduced staff turnover, improved morale, brought better engagement with drivers and all staff. This course is a no-brainer financially.
I do, however, feel that we must look at operators’ own mental health. After COVID-19, we as an industry have had a tough time keeping ourselves going. Our operators are mainly family companies and generational ones at that, and have huge stresses put on us 24/7. On delivery of one course, I was simply asked, “what about you? What about the operators?”
That is true, the coach industry is a stressful 24/7, 365-day operation, and we can help by delivering MHFA like this across all our teams and our industry, just as Ross has shown can be done — even if we help just one person at a time. I believe it’s one of the best courses for our industry — and of benefit to deliver it to everyone from drivers, to workshop and admin teams, just as our company has done.
Testimonial: Brett Sweetmore, Skills Group
Last year my colleague and I completed the MHFA course directly with Ross. This course had a real effect on my understanding of mental health, It was not like any other course I have sat before.
Ross was so professional in the way he delivered it and even reduced one attendee to tears. At times it made me think of a lot that I have been through over the years. I even sat down with one of our drivers the very next day as I recognised he was going through a rough time.
It has had a real positive effect on me. It was so interesting, and I cannot recommend this course enough. I think it should be rolled out to everyone across all sectors, not only in the transport industry.
