Health and courses - a scenario

Adult Staff The Staff Mess
1

Here’s the scenario:

Candidate for course has a history of moderate to ‘moderately severe’ mental health problems and in the run up to the course suffers a minor relapse.

Doctor A says: ‘I don’t understand the course content, my advice is do not attend the course, but it’s your decision’

Nurse (not mental health) with some better knowledge of course says: ‘I’m not prepared to sign off on your health with regards to going away in case a minor relapse becomes major, see Doctor B’

Doctor B does some more in depth work with candidate and says: ‘You test positive for ‘moderately severe’ depression, anxiety disorder and some elements of stress reaction. This course could make you much worse, but if approached well and your symptoms are kept under control, then doing it could help improve your condition. I’m prepared to pass you as fit.’

Candidates family express some concerns about ‘risk’.

Placing yourself in the position of the candidate and/or a close friend/relative/confidant of them, what would your course of action be? (for the purposes of this it could be a course in anything from basket weaving to underwater knife fighting, but presume it places the candidate under a moderate amount of stress and that in a healthy state they would have no problem completing it)

2

Without any further in-depth diagnosis or guidance from a mental health specialist, my view would be no.

“if approached well” - by who? Candidate or course instructors?

“Your symptoms are kept under control” - how? Medication? Lower stress levels (but candidate going to be under a moderate amount of stress).

With one very recent relapse, i would suggest that there is too much risk for things to be made worse.

3

It’s very difficult to say.

Dose the candidate want to do the course? Is the candidate apprehensive about going on the course?

Does the course require the candidate to be responsible for the safety of others?

How severe is the candidates depression? Will being around people and having something to focus on help keep them up, or will their depression mean that they may not be fully committed to the activity?

What kind of a ‘relapse’ have they had? What problems has their illness caused in the past?

All these are questions who’s answer will affect the outcome.

4

Assuming that the subject is a candidate, rather than staff, and will have responsibility only for themselves, then the questions to consider are:

What support will they need / expect, and can this be negotiated in advance with the course commander?
Will this detract from the course for the candidate, and for the rest of the candidates?
Is it reasonable to attend the course, but drop out if not coping well?

ACO Staff are not (except by coincidence) health professionals, or social workers, whilst we are an inclusive organisation and should do our best to accomodate people, there is a limit to what well meaning amateurs can achieve, and of course it would be easy to make things worse!

I’ve taken cadets with known / active issues like this away on camps, but with various safeguards. I would not take a member of staff in the same condition, because they are more of a burden than an asset to the camp.

Certain courses (eg Shooting) would be an absolute no in my opinion.

MW

5

In my opinion (and as hinted above), ACO volunteer Staff are in no position to make a call on this…pass it up the chain to those who are paid to make the call!

6

Cheers for your thoughts. Just to reassure anyone reading, this isn’t an actual situation facing a CFAV or cadet, but it is based on recent events in another organisation (names changed to protect the innocent, etc)

7

[quote=“tango_lima” post=11972]Here’s the scenario:

Candidate for course has a history of moderate to ‘moderately severe’ mental health problems and in the run up to the course suffers a minor relapse.

Doctor A says: ‘I don’t understand the course content, my advice is do not attend the course, but it’s your decision’

Nurse (not mental health) with some better knowledge of course says: ‘I’m not prepared to sign off on your health with regards to going away in case a minor relapse becomes major, see Doctor B’

Doctor B does some more in depth work with candidate and says: ‘You test positive for ‘moderately severe’ depression, anxiety disorder and some elements of stress reaction. This course could make you much worse, but if approached well and your symptoms are kept under control, then doing it could help improve your condition. I’m prepared to pass you as fit.’

Candidates family express some concerns about ‘risk’.

Placing yourself in the position of the candidate and/or a close friend/relative/confidant of them, what would your course of action be? (for the purposes of this it could be a course in anything from basket weaving to underwater knife fighting, but presume it places the candidate under a moderate amount of stress and that in a healthy state they would have no problem completing it)[/quote]

In all honesty, it would depend what the course was. As someone with a history of poor mental health and a sufferer of moderate-severe depression and anxiety, I am worlds better when on medication and when busy.

When I’m not busy doing stuff, even if that stuff is stressful, that’s when I can fall.

It also depends on the person. How do they react? In previous instances, what have they done?

My advice would be offer them as much support as possible and let them go for it if they choose to.