Does mental health first aid work?

Yahoo

3 days ago

If you hurt yourself at work, chances are you'll be treated by a first aider. But mental health problems aren't always as straightforward as a cut or sprain – and it isn't always obvious what to do or who to ask for help.
This is where mental health first aiders come in. Volunteers usually undergo a two-day training course to identify, understand and respond to the first signs of mental health challenges or emotional distress among workers. But they aren't psychologists or therapists; they are simply supposed to listen and direct people to mental health services, with the aim of tackling the growing problem of poor mental health in workplaces.
Now, more than 20,000 employers have used Mental Health First Aid England to train staff members to identify, understand, and respond to signs of mental health challenges among workers. According to MHFA England, more than 1 million people have now been trained to be mental health first aiders. But does it really work?
There is no denying that something needs to change in our workplaces. One in seven people in the UK workplace are currently experiencing mental health problems – and one in four people in the UK feel stressed more days a month than they don't. Despite this, many workers still feel unable to speak to their employers about a mental health problem.
'The purpose of a mental health first aider is to act as an accessible, trained peer who can identify early signs of mental distress, offer initial support, and guide colleagues toward appropriate professional help,' says Maria-Teresa Daher-Cusack, an organisational psychologist at Health Assured.
Read more: How employers can prevent mental health crises at work
They aren't expected to diagnose or treat mental health conditions. Instead, they are trained to listen without judgement and signpost individuals to resources such as Employee Assistance Programmes, GPs or therapists. Essentially, mental health first aiders serve as an initial point of support for individuals who are struggling, and research shows early intervention is widely associated with more positive outcomes for individuals.
'Their presence helps to normalise conversations around mental health, reduce stigma, and create a more open and supportive workplace culture,' says Daher-Cusack. 'Mental health first aiders can be a vital part of a broader wellbeing strategy. They offer a human connection at a time when someone might be feeling isolated or overwhelmed. Sometimes, just knowing there's someone approachable nearby can make all the difference.'
It's easy to see why the scheme has become so popular. It's quick, easy and relatively inexpensive to train a volunteer to be a mental health first aider. In 2023, Conservative MP Dean Russell even proposed that all employers should be legally required to offer mental health first aid training. But, experts caution that it's not a silver bullet.
In fact, there is mixed evidence as to whether it makes a significant difference to workplace mental health overall. A systematic review of nine studies published in 2023 found 'insufficient evidence' that the scheme 'improves the helping behaviours of trainees or the mental health of recipients'.
Another study, in which researchers reviewed 21 trials of mental health first aid training involving 22,604 participants, found no reliable evidence to suggest that the programme is effective. And, studies examining the practice were found to be at a "high risk of bias".
A lack of clear evidence doesn't necessarily mean that mental health first aid doesn't work. However, experts have highlighted that there are limitations. It doesn't address the wider considerations of supporting mental health at work, such as flexibility, culture, leadership and accessing professional support.
'Wellbeing initiatives underpinned by people practices as well as policies, and embedded in the culture of an organisation, can contribute to increased feelings of psychological safety at work. MHFA's can be a part of that mix for sure, but only a part of it,' says counselling directory member Nadia DiLuzio.
According to DiLuzio, a downfall of mental health first aid is that it might be the workplace itself causing, contributing to or exacerbating mental health challenges. Therefore, a volunteer isn't likely to address the underlying problem.
Read more: Why the pressure to be liked at work is holding women back
Another commonly cited concern is the limited scope of training. 'Most MHFA courses last just one or two days – enough to build awareness and basic skills, but not sufficient to equip someone to handle complex or high-risk situations,' says Daher-Cusack.
'There is also a risk that organisations may over-rely on MHFAs or treat the initiative as a tick-box exercise. Without ongoing support, supervision, and integration into a wider mental health strategy, the impact can be limited and the emotional burden on the first aider can be significant.'
Should employers abandon mental health first aid? Not necessarily. It can be effective, but only as part of a broader, systemic approach to workplace wellbeing. This includes fostering a culture of openness, clear referral pathways, access to professional support, and flexible work options. A 2023 University of Pittsburgh study found that companies offering flexible hours and locations saw significantly lower rates of depression.
'As the conversation around mental health in the workplace continues to evolve, mental health first aiders represent a promising step forward,' says Daher-Cusack. 'But like any first aid measure, their value lies in what happens next: the care, the follow-up, and the commitment to long-term wellbeing.'
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