Could Mental Health First Aid (MHFA) Be More Than It Is?

There is consistent evidence that MHFA training raises employees’ awareness of mental ill-health conditions. There is no evidence that the introduction of MHFA training in workplaces has resulted in sustained actions in those trained, or that it has improved the wider management of mental ill-health. - HSE Summary of the evidence of effectiveness of MHFA in the workplace.

HSE describes MHFA being like a sticking plaster on a wider problem.

The Health and Safety Executive recently released their review of MHFA which set out to answer three main questions.

The review set out to answer three questions.

  1. Has there been an increase in awareness of mental health amongst employees (i.e. all staff employed by an organisation, including leaders/managers) receiving MHFA training?

  2. Is there evidence of improved management of mental health in the workplace as a consequence of the introduction of MHFA training?

  3. Is there evidence that the content of the MHFA training has been considered for workplace settings?

The review came up with the following conclusions:

Based on the published research, it is not possible to state whether MHFA training is effective in a workplace setting to improve the organisational management of mental ill-health. There is a lack of published occupationally‐based studies, and the studies that have been conducted are limited in quality. Based on the evidence reviewed, the following summary statements can be made:

  • There is consistent evidence that MHFA training raises employees’ awareness of mental ill‐health conditions, including signs and symptoms. Those trained have a better understanding of where to find information and professional support, and are more confident in helping individuals experiencing mental ill‐health or a crisis.

  • There is no evidence from the published evaluation studies that the introduction of MHFA training in workplaces has resulted in sustained actions by those receiving the training or that it has improved the management of mental health in the workplace.

  • There is limited evidence that the content of MHFA training has been considered for workplace settings.

The review also recognised gaps in evidence including:

to a lack of well‐designed cross‐industry evaluations of the impact of MHFA training. Other knowledge gaps included:

  • Does MHFA training lead to sustained improvement in trainees’ ability to help colleagues experiencing mental ill‐health.

  • What is the impact of MHFA training on the management of mental health in the workplace?

  • Are the resource requirements and costs of undertaking MHFA training commensurate with the potential beneficial outcomes for the individual with mental ill‐health, and for their organisation.

  • What are the most achieve effective ways to undertake MHFA training in different workplaces to improve personal mental health as well as the organisational management of mental‐ill.

The above all taken from HSE's - RR1135 - Summary of the evidence on the effectiveness of Mental Health First Aid (MHFA) training in the workplace

So what do I think?

After doing my own research into MHFA to becoming a Trainer The Trainer I decided after looking at the process and outcomes not to go ahead with the training. My main reason for this is that I felt it didn't actually help those who needed help with skills.

I initially thought it would be similar to general first aid - giving skills to individuals to help those in need experiencing poor mental heath and crisis. It is an excellent awareness course explaining what mental ill-health is and how it affects those experiencing it - giving confidence to approach others they suspect of difficulties.

What it doesn't do is give anyone the skills to manage their mental ill-health or with support from those who are MHFA trained. The awareness is a big positive towards making more people aware and reducing stigma within the workplace of mental ill-health - but there are still questions around cultural changes and this can vary from industry to industry.

Reading through comments on IOSH Magazine article many people have agreed that the lack of evidence is not proof that it doesn't work - but I am yet to see feedback from those who have been actually been helped by it. One of the comments also referred to physical first aid not being there to prevent injuries - but what it does do is preserve life, prevent it from getting worse and promotes recovery. It is a life saver.

I can see how awareness saves lives but nowhere in the same league as being able to actually do CPR whilst waiting for specialist equipment. Therefore does MHFA help someone stay alive before specialist services or just says you need to go to the doctor? I don't know...can you tell me?

So my understanding is that it gives people the skills to become aware of someone who is struggling, engage with them and then suggest going to see their GP or mental health crisis team.

Even with this recognition and signposting individual could still be potentially off work, struggling with what is causing their mental ill-health and that the workplaces aren't changing their practice to support their staff if they are the potential cause or fuel.

Through antidotal research, there are some great employers offering direct services to their staff through talking therapies and counselling. The cost of these types of services can cost around £40+ for 30 minutes - this can end up costing around £400 per person easily.

MHFA training is around £360 (inc VAT) through St Jones Cymru for a two-day course - for employer this could be include 2 - 5 members of staff so anything between £720 - £1800 (inc VAT)


Previous studies have estimated that for every £1 spent on mental ill-health support it can save a business £8 in potential costs. I believe this could be even more with the right knowledge, skills and behaviours within the workplace.

Am I biased, yes. Am I open about it, yes. So why am I biased?

I have seen first hand from being a user of talking therapies for a short alotted time through the NHS (2-hours 10-minutes) where they cover no useable coping skills or strategies. During this time I did three times the Depression Scale Test and talked about how the dark moments were during this time. I was given a few booklet with information and exercises upon bipolar and anxiety to go through.

However, through self-care, openly talking and taking self control of the things that are causing me issues I have turned a very large corner and now in control. This control also includes how to recognise creeping on changes and ways of dealing with them quickly rather than months.

This self care inspired me to start Rotundus to essentially provide support essentially for men but anyone who needs help. Through bringing awareness to Rotundus, I was advised by two different sources to contact Dennis Laity of

Dennis and his wife both have suffered from mental ill-health and have developed a set of training aids that break down barriers to understanding and taking real steps to control mental ill-health like anxiety, depression, anger, bipolar and confidence. After seeing it for myself and recognising the skills, techniques and my own knowledge in them I genuinely believe this to be a better model than MHFA.

My reason for saying this is that it is a set of tools that can be used by individuals who are suffering within moments of being given the knowledge. This can be the difference between life and death. This helps people who are suffering when they need help and not having to wait over 6 weeks potentially.

Last week I ran a small survey of 100 people who have experienced mental ill-health and asked a few simple question...

Q. How long did you wait for services other than medication? 90 - answered and 10 skipped - with 56% (51 responses) of the total said they waited over 6 weeks and 20% of the total said they waited longer than 20+ weeks (18 responses)

I also asked:

Q. Which of the following would you have used if known about them? 95 - answered and 5 skipped - 71% (67 responses) said they would use anxiety control techniques and 37% (32 responses) said mindfulness classes.

Imagine someone being spotted early as in need of help and they were given:

  • signposted to GP and/or other professionals

  • given access to knowledge of instant understanding and control techniques for anxieties

  • shown mindfulness techniques

  • access to 1-2-1 and group workshops

  • plus access to online peer support group full of people who truly understand what you are going through

So my biased answer would be not to use MHFA alone or at all, but to look at using a different approach like the one above that supports changes in cultures including awareness and skills that helps an individual directly with continued ongoing support without breaking the bank. Rotundus services are aimed at doing this with our growing workshops including Making Tough Conversations Easier and Understanding Anxiety & The Unconscious Mind, 1-2-1 support, online peer group support and signposting.

With our workshops of being able to be run over a short period of time from 2 to 4-hours with changing results that are more than just awareness and then with the ongoing support. Why wouldn't you try it? Feedback from someone using the Understanding Anxiety & The Unconscious Mind workshop through Choices Education is a brilliant testimonial for why you should try it.

Hello Dennis. It is now just over six months since I came to your session in Cardiff with my daughter to learn about controlling anxiety and our unconscious mind. After a friend had recommended this to me. I spoke to you over the phone and booked a place for us to attend the following week. Both of us were getting very frustrated after years of trying to find ways to deal with our anxiety nothing had worked very much. When you told me it was only a morning session. I was sceptical that it would help us. But, as desperate as we were we came along. We could not believe how after just a few minutes everyone relaxed the group were actually talking and laughing. No personal questions but mind blowing examples and explications. The time just flew by as so much sensible information was discussed and absorbed. The coping tools were so simple yet so realistic. We made a pact to complete the homework we were given and to go through the pack for an hour every week for six weeks. Well I must admit in our wildest dreams we never expected such a fast and positive reaction. There is no question that this has changed our lives. Thank you J Davies

What are your thoughts? I would like to know either way as the more we know, the more we can learn.

Have you ever been someone who has received MHFA from someone who recognised you are in need? What did they do or say? #MentalWellBeing #Anxiety #ItsOKNotToBeOK #MentalHealth

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