Mental Health First Aid

Why businesses moved away from Mental Health First Aid (and what they did)

Samuel Roberts

Wrote this on, January 2, 2026

We all recognise Mental Health First Aid as one of the most widely adopted training courses for mental health education.

Created in Australia in 2000 by Betty Kitchener (a nurse specialising in consumer education) and Professor Anthony Jorm (mental health researcher), the idea was simple: we need a mental health equivalent of physical first aid, helping the public to recognise when someone is struggling with their mental health, how to offer initial support, and then guide them to professional help.

The programme quickly expanded across Australia, and by 2011 it was adopted by a number of countries, with Scotland as one of the first to adopt the programme.

Fast forward to 2020. COVID hit, and almost overnight, workplace mental health shifted from a “nice to have” to a business priority. Organisations moved fast. Budgets were given. Wellbeing apps, programmes and training were rolled out at pace, with Mental Health First Aid as one of the most obvious choices.

In many cases, decisions were driven by speed and cost. Mental Health First Aid was familiar, relatively low-cost, and low-effort. Identify a group of volunteers, send them on a two-day course, and the box was ticked.

But even at the time, the warning signs were there.

As expectations grew, so did the cracks. The impact of Mental Health First Aid training was often overstated, with some providers positioning it as a way to improve mental health outcomes across the whole organisation. More risk-aware organisations were sceptical. They understood that a standalone two-day course could only ever go so far.

Crucially, even if they didn’t know ‘any theory’ behind workplace wellbeing, they recognised Mental Health First Aid for what it was: a tertiary intervention. Helpful in specific moments, but very limited. What they actually needed, especially in the context of a global crisis, were strong primary and secondary interventions embedded across the organisation. That gap would soon become impossible to ignore, it just took time to learn.

As Mental Health First Aid became the expected response, many organisations followed the herd. And let’s be honest, how often do you meaningfully push back when a solution is already endorsed by the exec team or your direct report?

But some raised concerns early on. Typically, these were the more risk-aware businesses, or those with prior experience of mental health interventions.

Their unease wasn’t really with the training itself. It was with what came next.

They recognised a fundamental flaw in the model: training a group of individuals to hold potentially serious, emotionally complex conversations, often involving risk, without clear oversight, ongoing support, or robust safeguarding. That didn’t just create risk for the individuals involved. It created risk for the organisation as a whole.

In response, many of these organisations began to adapt things into a new model. They built their own internal solutions (such as conversation logs), introduced additional structures, and rebranded roles as Wellbeing Champions, Wellbeing Ambassadors, and a growing list of alternatives, all as an attempt to solve each and every issue, and to distance themselves from the Mental Health First Aid label.

And regardless of where the organisations started and ended, they all arrived at the same question:

Is our Mental Health First Aid programme actually having any impact?

This question wasn’t coming from the sidelines. It was being asked by the people closest to the work: Wellbeing Leads, HR professionals, Health and Safety teams, and even Mental Health First Aid instructors themselves.

The answer, uncomfortably often, was unclear. Many struggled to measure any impact at all, while watching early warning signs turn into real risks. Engagement dropped, credibility eroded, and in the process, confidence in the wider health and wellbeing strategy went with it.

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Asking harder questions about Mental Health First Aid

As this continued, the team at Everymind began to question whether we could responsibly deliver or advocate for Mental Health First Aid within businesses and organisations. It was also clear these challenges were something our founder, Paul McGregor, had seen and experienced firsthand.

During 2024, we then sourced an external partner to conduct research about Mental Health First Aid, hearing from both the business and the volunteers who had gone through Mental Health First Aid training.

Through that research, we ran a survey and captured responses from 738 HR professionals across the UK, from HR Business Partners through to Heads of People, working in organisations ranging from SMEs to large, complex businesses.

Whilst we asked a number of questions, the most crucial question was in asking these HR professionals how effective their Mental Health First Aid network was. We found that only 19.61% said they felt it was working effectively.

When we asked the volunteers who had completed Mental Health First Aid training, we also found that 83.42% said they would benefit from additional support in their role. This highlighted that for both groups, the model wasn’t working.

The picture was becoming clearer, but we wanted more perspectives.

This was when we found that the HSE found no evidence that Mental Health First Aid improved the management of mental ill-health. And this was echoed by Cochrane, which concluded there is no reliable evidence to suggest Mental Health First Aid is effective, with existing studies carrying a high risk of bias.

For example, several systematic reviews and meta-analyses were authored by researchers who were closely involved in the development of Mental Health First Aid, raising legitimate concerns about conflicts of interest.

It was at this point, we decided that delivering Mental Health First Aid training was not in line with who we are. We thought long and hard about this, recognising that whilst good intentions do matter, they are not enough if they do not lead to better outcomes in the workplace. We have to hold ourselves and the impact we deliver into account.

As a result, we chose to stop delivering Mental Health First Aid training, and we found many organisations had already made that move, or decided to join us on that journey.

Some of the concerns raised early on by more risk-aware organisations played out in practice, exactly as anticipated. Over time, the Mental Health First Aid model began to break down. What was originally designed as a course to raise mental health awareness was stretched beyond its intent, reshaped into a workplace intervention it was never designed to be.

Why Mental Health First Aid doesn’t function in the workplace

Let’s dive deeper into why Mental Health First Aid programmes often fall short. A large part of this has to do with the idea that what works on paper vs what works in practice are very different.

Here are some of the common issues we see playing out.

The naming “Mental Health First Aid” is often problematic.
The phrase “First Aid” suggests reaction, and therefore the behaviour and approach are then rooted in reactivity. When the role is framed or thought of as ’emergency’ or crisis-based support, we see mental health conversations happen late, or in high risk moments, rather than earlier when they could have prevented things from escalating.

The ‘train and go’ model introduces risk into every mental health conversation.
Once individuals have completed the 2-day course, they are only asked to do a refresher course every 3 years. What actually happens? The refresher never happens, and the business can hardly keep track of who did what course, and when 3 years is coming up.

More crucially, this model rarely leads to confidence or retention of conversational skills, most individuals forget what they have learned only weeks later. This leads to conversations with blurred professionals boundaries, poorly handled conversations, and unintended harm rather than support.

In most organisations, there’s no formal assessment when appointing Mental Health First Aiders.
In practice, that means almost anyone can end up in the role. As a result, we often see people taking on responsibilities they’re not well suited to, becoming overwhelmed, and in some cases this breaks the trust for those reaching out for support. The same issue shows up in the training course. We’ve never come across a Mental Health First Aid instructor who has failed a delegate. That means someone can attend an online course, half-engage (or do other work in the background), and still be classed as an “active” Mental Health First Aider.

There is often no real support for the Supporters themselves.
By this, we mean there is rarely appropriate, on-hand support available to Mental Health First Aiders when they’re dealing with complex or emotionally heavy conversations. Individuals are left to manage situations alone, despite the fact that even experienced counselling psychologists require regular supervision.

Some organisations try to address this, but often default to the easiest options. Common responses include telling Supporters they can “use the EAP”, or introducing informal buddy systems where volunteers are expected to support one another after difficult conversations. In practice, this simply shifts the burden back onto the network, without the skills, supervision, or professional boundaries required to do this safely.

There is no visibility or oversight of mental health conversations, and management is largely absent.
Instead of logging interactions and conversations with the network to protect both the Supporter and the individual being supported, the model relies on a “train and hope” approach. This means organisations are unable to embed safety behind conversations, unable to track engagement, patterns, or emerging issues, and unable to report any safeguarding risks.

Mental Health First Aid training can unintentionally encourage “diagnosis-style” responses.
We often see Supporters trying to label or diagnose the person in front of them during what should be a supportive conversation, something that is well beyond the scope of the role and potentially unsafe. The training hasn’t kept pace with the realities of the workplace. Rather than trying to cover every mental health condition, the focus should be on building strong conversational skills, boundaries, and safe signposting.

If we were asked to summarise the above, it’s this:

Businesses ask ‘who wants to be part of our Mental Health First Aid programme?’, hands are raised, volunteers complete the training, receive their certificate, and then return to the workplace. And that’s where the journey ends. There’s no structure behind the programme, no measurement, no ongoing skills development, no proactive support, and little visibility into what’s actually happening across the network. Those responsible for the network, are left to figure things out, with any of the necessary tools, frameworks and tech to manage all of this going forward.

How do we ensure safety behind every mental health conversation?

Mental health conversations at work are often difficult. They can be unexpected, or subject matter that’s distressing, or on the flip side they can be very light touch ‘I just needed to talk with someone’.

However, with stress-related absence now one of the leading reasons for time off work, it means more conversations than ever are happening about stress, wellbeing and mental health. This means skills like active listening, emotional regulation and signposting are more important than ever.

Without continual practice or reinforcement, these skills fade. And when there’s no confidence in the network, people hesitate to step in, and any proactive behaviour quickly disappears. This isn’t often a failure of someone’s character or commitment. It’s a reality of being human.

Here’s what it means to have safety behind conversations:

1. Closing the gap between what people know in theory, against what they do in reality – On paper, many people who’ve completed Mental Health First Aid can describe what to do in a crisis. They can recall steps and guidance. But when faced in the moment with a real person, those steps often fall away. The ability to take action with confidence, comes from reinforced skills and a strong foundation of understanding, which is not the type of understanding that’s achieved through a standalone 2-day course.
2. Ensuring every interaction and conversation is logged – This is the single biggest factor in improving safety, for both the Supporter and the person they’re supporting. When conversations are logged, organisations can proactively check in with Supporters after difficult interactions, and review conversations that may need further attention or escalation. Logging also creates anonymised insight into why people are reaching out in the first place, helping organisations spot patterns, understand risk, and take a more preventative approach, without compromising individual privacy.
3. Having clear processes for safeguarding risks, and a trained network – Safeguarding is rarely taught despite the fact any adult can be at risk of harm. Protecting adults from harm requires judgement, boundaries and escalation, not just good intentions. When safeguarding isn’t properly embedded, supporters are left exposed in situations that carry real risk.
4. Have continual structured learning in place – Without any learning or development opportunities following the initial 2-day course, skills aren’t revisited or reinforced. We recommend a minimum of once a month development sessions where individuals are upskilled, so they can reflect on experience, or build confidence over time.

Remember, without regular, applied skills practice, conversations are poorly navigated, boundaries are broken, and people default to avoidance rather than action.

Practising these skills isn’t about perfection. Mental health conversations are rarely clear-cut, and there will always be grey areas. That’s why having proactive, on-hand support behind the programme is so important, giving Supporters somewhere to sense-check decisions, debrief after difficult conversations, and get guidance when situations feel complex.

At Everymind, we solve all of the above: by embedding our platform and professional support behind the network. Every conversation is logged and Supporters have access to experienced counsellors, safeguarding leads and mental health practitioners during working hours, so they’re not left carrying difficult situations alone and organisations have the appropriate oversight.

Workplaces are shifting to preventative programmes, not simply ‘more training’

As touched on earlier, Mental Health First Aid is, by design, a purely tertiary intervention. Because of this, it offers little visibility into what’s actually driving mental health and stress-related conversations at work.

Organisations can continue to run training and hope it helps, but without understanding why people are reaching out in the first place, it’s impossible to address the root causes or make meaningful change.

To do that, we need to understand whether conversations are being driven by internal factors within the organisation, or external pressures outside of it. From the thousands of conversations logged through our platform, a clear pattern emerges: work-related issues account for the majority of conversations, far outweighing any other driver.

In these cases, this points back to work design. And that’s not something another two-day training course will fix.

Why businesses turned to the Supporter Method to solve these challenges

The Supporter Method is a workplace framework designed to help organisations move beyond Mental Health First Aid and towards a safer, more structured, and genuinely measurable model of support.

And we delivere this through our platform, professional support and consulting, all wrapped up into one package to give workplaces every they need to make their peer support programme functional, sustainable, and safe. The framework aligns with HSE guidance and ISO 45003 principles, ensuring safeguarding and risk management are built into every conversation, not bolted on after the fact.

Some of the world’s largest organisations have now adopted this approach, including Xerox, AkzoNobel, Aldermore Bank, Dreams and Marsh McLennan. What they have in common is a move away from relying on training alone, and towards systems that provide oversight, surface issues earlier, and support timely action. To learn more about their stories, you can read more just here.

The result is a shift from late, reactive intervention to earlier, preventative support, and from isolated individuals carrying responsibility, to a connected system that actively supports both people and the organisation. Without these structures in place, mental health remains something that’s “dealt with” after the fact, rather than something that’s continuously and safely supported.

If you’d like to explore the Supporter Method in more detail, we’ve created a free online course that covers the full framework and how it works in practice. The framework is designed for organisations with 250+ employees and is subject to additional suitability criteria.

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Where do we go from here?

Mental Health First Aid didn’t fall short because of poor intent, it fell short because of how it was designed.

Workplaces have matured in how they think about health and wellbeing. Today, they are expected to measure and evidence impact, uphold a clear duty of care, and ensure there is real safety behind every conversation. Most importantly, they can no longer afford to signal proactivity and prevention, they have to actually deliver it. HSE scrutiny won’t ease, and absence figures won’t improve, without meaningful change.

This is why this moment matters. We’re starting to see organisations move away from tick-box programmes and the old world of wellbeing, and towards approaches that are preventative, and grounded in real outcomes.

Peer support has a vital role to play in that future, and one we’re truly proud to be making that future a reality with some incredible brands and businesses.