I’m no stranger to testing times and traumatic incidents after 20 years in emergency services, beginning in Northern Ireland Ambulance Service, but mostly as a paramedic on search and rescue helicopters. I have also served on the RAF Medical Emergency Response Team (MERT) battlefield helicopter in Afghanistan. 
I have experienced the full range of emotions from euphoria, after risking my own life to save another, through fear during a flashback and the depths of despair when attending many suicide incidents. I have been affected by the cumulative effects of my career, but even more so by the growing pressures of 21st century living in my personal life.
I have learned resilience through my military service and search and rescue career, but my mental strength has been tested most in my personal life through divorce, bereavements, building my own business in my spare time, whilst also changing full-time employment and multiple home relocations.

I became a mental health campaigner in 2016 with a video campaign online, which involved the coastguard helicopter and other 999 services doing press-ups. Our final video broke down some stigma around mental health, with over 45,000 views, but what was really important for me was that I didn’t feel alone anymore. The widespread support from other 999 colleagues made me realise that depression, anxiety and stress were just as common for 999 personnel as for wider society. 

TaIking has been an incredible help to me at critical points in my life. This has allowed me to share the burden of my worries and fears, gain another perspective, see a way forward and realise that I was just being human. This worked for me when I spoke to a psychiatrist after a traumatic incident, during which a patient vomited blood into my eyes and mouth; and also when I talked to my wife after having a flashback to a patient in Afghanistan, five years later, whilst on holiday in France. 

My bravest move v’s Self-Stigma
The largest stigma I have had to overcome, however, was my own self-stigma, when I spoke to my GP last year and admitted I needed some time off work. Burnout had led to depression and a loss of my self-esteem from the cumulative build-up of life stressors since childhood through the Northern Ireland ‘troubles’ and caring for elderly relatives, bereavements, moving home, new job with promotion and running my own business in my spare time. 

The bravest thing I have ever done in my life was to take time off work to rest, reset and then rebuild myself!
I now believe I will save more lives through mental health campaigning, sharing my experience that #itsoktotalk and by delivering Mental Health First Aid training, than I would if I was still dangling under a helicopter, as a paramedic.

Early warning signs
Have you ever noticed any of these in yourself or a colleague?
Irritability, aggression, tearfulness, inability to concentrate, indecision, loss of confidence? Perhaps this could be coupled by increased consumption of caffeine, alcohol, cigarettes or sedatives and some unplanned absences from work… 
Many of us may experience some of these feelings occasionally, which is normal. However, when these feelings start to affect someone’s participation in everyday life or their ability to function safely at work, then we should reach out with support. Mental Health First Aid is just as important as physical first aid. Would you know how best to approach a colleague or loved one, assist them in a crisis and listen non-judgementally? Find out more at https://mhfaengland.org

Simple tips for improving your Wellbeing:
I take a minute each morning and evening to note 3 things I’m grateful for, which gives me a positive focus at the start and end of each day. This allows me to focus on what I have, rather than what I am missing. I have an object on my key ring which also reminds me to be grateful during the day, if I’m feeling low. 
Try it and feel the difference yourself.
I also recommend the Five ways of wellbeing, based on research and recommended by the NHS (1), as a simple guide to improve your mental strength and wellbeing by realising it’s important to: 

• Connect
• Keep learning
• Take notice
• Be active
• Give

The beauty of these simple categories is that you can tailor them to suit yourself and what you enjoy doing. I love the outdoors and nature, so meeting a friend for a walk or bike ride enables me to connect, be active and take notice of the beautiful countryside as we chat and enjoy ourselves. Giving can be as simple as sharing a smile with a stranger… it’s surprising how infectious smiles are, in a good way! 
To keep learning, I have challenged myself to make a short film about a trip, in my classic Land Rover, (#AndysLandie blog) around Scotland this summer to assist the introduction of the UK Search and Rescue Wellbeing & Resilience framework for Mountain Rescue Volunteers in Scotland. I’ll be meeting some amazing people on the journey and some of them are joining me to talk about wellbeing and mental strength from my passenger seat, which will be part of the film. Please get in touch if you’d like to be part of the film or if you’d like to invite me to your base as I journey from the Peak District to Scotland.

Work brings a lot of health benefits through a sense of purpose, fulfillment, being part of a team, especially in our line of work. However, mental ill health is usually caused when pressures at work become more intense, coupled with factors outside work; eg. financial pressures, relationship problems, greater caring responsibilities from an ageing population etc. If the workplace is not supportive at this stage, then mental ill health can be triggered into common conditions such as depression, anxiety or stress-related disorders.

Organisational culture can change for the better, as Mind Blue Light Programme (2) recently highlighted with these research key findings from their targeted support:

• staff improved their mental health, resilience and confidence to seek support
• managers & trainers had more confidence supporting staff in difficult situations
• stigma and lack of awareness still exists, but is improving
• sustained change requires practical investment, commitment, enthusiasm at all levels

Why not do something positive to start the conversation on mental health where you work? Or perhaps you could share some of this information with a colleague to promote some wellbeing in team999?

I’m part of the Paramedic Mental Health & Wellbeing Steering group for the College, a Mind Blue Light Champion and I write a blog called ‘Andy’s Landie’, which discusses Mental strength and Wellbeing. 
You can follow me on twitter and Insta @4ndyElwood
Stay wonky and remember #itsoktotalk
 
1. Five ways to wellbeing. New Economics Foundation. 2008. 
2. Mind Blue Light Programme Research Summary 2016-18. London: Mind. 2018.