Update
As we mark World Mental Health Day 2025 with the theme “It is time to prioritise mental health in the workplace” it feels timely to revisit my thoughts on Mental Health First Aid (MHFA) training from two years ago. The landscape continues to evolve, research is beginning to surface, and our understanding of what truly supports workplace wellbeing has deepened considerably. Let me be crystal clear from the start: psychological well-being initiatives are absolutely central to healthy workplaces. Just as we wouldn’t dream of operating without proper physical health and safety measures, emotional support must be embedded in our organisational culture. Any effort companies make is a positive step forward – as long as it’s heading in the right direction.
What the Latest Research Tells Us
Recent studies and Health and Safety Executive findings have confirmed what many of us in clinical practice have observed: whilst MHFA increases awareness and reduces stigma, there remains no solid proof that training alone improves workplace outcomes or employee wellbeing.
Multiple reviews highlight research problems, including small sample sizes, lack of control groups, and over-reliance on self-reporting. Most concerning is the tendency for these programmes to become reactive, tick-box exercises rather than the preventive, systemic approach our workplaces desperately need. But here’s what troubles me most as someone who manages and supervises counsellors: we’re placing well-meaning MHFA colleagues in impossible situations without adequate ongoing support.
The Missing Piece: Professional Oversight
In my 23 years as a workplace counsellor and 12 years training others, I’ve witnessed the transformative power of quality, regular clinical supervision. Every qualified counsellor receives this monthly professional oversight not because they’re inadequate, but because dealing with distress requires ongoing support, reflection, and skill development.
Yet we train MHFA volunteers in one or two days, hand them a certificate, and expect them to navigate complex emotional territories without this essential safety net. It’s like teaching someone basic first aid for physical injuries, but never checking if they’re coping with the emotional impact of what they’ve witnessed.
This isn’t just unfair – it’s potentially harmful to both the first aider and those seeking help.
Beyond the Language Trap
One area where I see real progress is in organisations questioning their language choices. Are we talking about ‘illness‘ or ‘distress‘? ‘treatment‘ or ‘support‘? These distinctions matter enormously because they shape our understanding of normal emotional responses.
I’m particularly encouraged by initiatives like Emotional First Aid, which explicitly moves away from illness-focused language and medical thinking. Their approach recognises that emotional struggles aren’t the same as physical emergencies – they require different skills, different responses, and crucially, different ongoing support systems. Their focus on trauma-aware approaches and collaboration with people who’ve lived these experiences shows the direction we need to be heading: away from one-size-fits-all solutions towards a nuanced, contextual understanding of human distress.
What Excellence Actually Looks Like
Drawing from established supervision practices in counselling, here’s what enhanced workplace support could include:
Proper Selection and Screening
Not everyone is suitable to support colleagues in distress. We need thoughtful selection processes for these courses that consider the candidates’ emotional resilience, ability to keep and maintain boundaries, and interpersonal skills.
Structured Ongoing Support
Whether individual monthly sessions, group reflection, or peer consultation models – first aiders need regular spaces to process what they’re hearing, reflect on their responses, and continuously develop their abilities.
Trauma-Aware Foundation
Current MHFA barely touches trauma beyond suggesting someone might have PTSD and should see a doctor. We need training that understands how trauma shows up at work and how to respond without causing further harm.
Clear Boundaries
Unlike qualified therapists, workplace first aiders aren’t bound by professional codes of conduct. We need clear frameworks for confidentiality, when to escalate concerns, and how to manage supporting colleagues who work alongside.
The Bigger Picture
MHFA can be valuable as one part of comprehensive workplace wellbeing – but it’s not a standalone solution. Just as we regularly update and check physical safety equipment, psychological safety measures need ongoing attention and refinement. The most effective strategies I’ve observed combine:
- Trauma-aware management training
- Clear policies addressing the HSE Stress Management Standards
- Flexible working arrangements where possible, that recognise individual needs
- Access to professional EAP services
And yes, properly supported first aiders.
Moving Forward: What We Need to Know
We desperately need more research in this area. I’m not aware of any studies examining the effectiveness of professionally supervised workplace first aiders compared to traditional models – but the benefits of supervision in clinical practice speak for themselves.
Perhaps it’s time for innovative approaches like offering open peer supervision services for trained first aiders, or developing new models that bridge the gap between well-meaning volunteers and qualified professionals.
The Bottom Line
As someone who manages 30+ counsellors providing hundreds of hours of workplace support weekly, I see both the potential and the pitfalls of current approaches. We can do better.
This isn’t about perfect being the enemy of good – it’s about taking good intentions and making them truly effective. It’s about treating our colleagues’ psychological safety with the same rigour we apply to their physical safety.
The 2025 World Mental Health Day theme calls us to prioritise wellbeing at work. Let’s answer that call not with quick fixes and certificates, but with trauma-informed, sustainable approaches that truly support both those giving and receiving help.
Ultimately, creating psychologically safe workplaces isn’t just about training a few first aiders – it’s about fundamentally changing how we understand and respond to human distress in professional settings.
Sources
- Personnel Today, “Why mental health first aid is not the ‘gold standard’”
- Prospect, “No evidence MHFA improves management of mental health, says HSE”
- Yahoo Finance, “Does mental health first aid work?” (June 2025)
- People Management, “Mental health first aid bill could cause unintended and negative consequences, experts warn”
- Mental Health First Aid Course Blog, “Is Mental Health First Aid Evidence-Based?”
- Thoughts on Mental Health First Aid in the Workplace, Society of Occupational Medicine
- Reed, “Mental health first aid: creating thriving workplace communities” (August 2025)
