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Mental health first aiders must be comprehensively supported

In 2022, EAPs in the UK provided more than 1.37 million counselling sessions

Are leaders really clear on what the role of a mental health first aider (MHFA) is, and what they can and can’t do?

The training of MHFAs by employers has become commonplace, gaining support as a useful part of workplace mental health strategies.

This in turn led to the introduction of a Private Members' bill, by Dean Russell MP, making the introduction of mental health first aid training a legal requirement in workplaces.

But in such a complex area, that involves such a tangle of personal and sensitive, often built up over time and involving a need for long-term support, are we really clear on what the role of an MHFA is and what they can and can’t do? We’ve reached the stage where clarity is critical. 

Read more: Is compulsory mental health first aid training at work the right move?

In order to test some concerns, we carried out a small-scale, independent and anonymous survey among employees currently acting as an MHFA. Of those who responded, 35% said that the issues they had encountered in the role had exceeded the knowledge provided by MHFA training (an additional 14% reported that this happened frequently).

When asked how often they had been asked to go beyond the signposting role, 37% said ‘occasionally’, 26% ‘frequently’ and 37% ‘never’. Only 29% had been given additional support to help them deal with the challenges of being an MHFA. Less than half (43%) had been pointed towards an employee assistance programme (EAP) for support.

If anyone really appreciates the full spectrum of realities and challenges involved with supporting employee mental health, it’s the advisors and counsellors working for EAPs. Working on the frontline every day, they’ve seen just how the context for providing support has changed.

Over the past five years in particular, EAPs have seen the fall out from the combination of increased awareness of mental wellbeing, the impact of the pressures of the Covid-19 pandemic and the cost-of-living crisis, and in general, more willingness to speak up about personal concerns.

Read more: Mental health first aiders in the workplace: are they effective?

This has led to a much greater volume of contact with EAPs and, more worryingly, a trend for that demand to include far more serious and emergency cases of mental ill health. In 2022, EAPs in the UK provided more than 1.37 million counselling sessions. On average, 1.7% of counselling cases came with a ‘red flag’, involving an immediate and serious risk of self-harm and suicide.

MHFAs have been a positive development in raising awareness of the importance of employee mental health and making it easier for staff to have a first conversation, and an early conversation, about any concerns, and to be signposted to advice, resources and professional support. But, crucially, MHFAs have only been equipped with the training to provide that initial signposting and nothing more. MHFAs can only ever be one element in a package of measures that provide preventative and reactive support.

Former board members of Mental Health First Aid England themselves have argued that the proposals in the Private Members' bill “could create unintended and negative consequences” and that MHFA “is only one piece of the jigsaw when effectively managing and supporting mental health in the workplace”.

Employee mental health is a highly sensitive area which can involve a great deal of complexity, risks and danger. Being identified as an MHFA can put people in a difficult position, under pressure to provide support they are not trained to provide and exposed to intense and stressful situations that can be triggers for psychological distress of their own.

Read more: Mental health first aid can have negative impacts

Working in partnership, employers and mental health professionals can provide an accessible, safe and supportive framework of services for their people. We need to ensure that this kind of comprehensive, planned and strategic approach is not replaced by – or even undermined by – a well-intentioned but limited single initiative.

By Karl Bennett, chair, Employee Assistance Professionals Association