Mental Health First Aid

Why businesses moved on 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.

This article is the story of how it became the default response to workplace mental health, why the cracks appeared, and what the evidence now says. It’s also the story of why, in 2024, we made the decision to stop delivering it ourselves.

Mental Health First Aid was created in Australia in 2000 by Betty Kitchener, a nurse specialising in consumer health education, and Professor Anthony Jorm, a mental health researcher. The idea was simple: we needed a mental health equivalent of physical first aid, helping the public recognise when someone is struggling, offer initial support, and guide them towards professional help. It spread quickly, with Scotland becoming the first country outside Australia to adopt the programme in 2003, and many others following over the next decade.

For its original purpose, community mental health education, it made complete sense. The problems began when it entered the workplace.

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 released. Wellbeing apps, programmes and training were rolled out at pace, with Mental Health First Aid as one of the most obvious choices.

We should be honest here: we were part of that rush too. Everymind launched a wellbeing app during that period, and we later retired it for the same reason we would eventually stop delivering Mental Health First Aid. When we looked closely at the outcomes, they weren’t there. That experience shaped everything that followed.

Across the market, 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.

The impact of Mental Health First Aid training was often overstated, with providers positioning it as a way to improve mental health outcomes across an entire organisation. More risk-aware organisations were sceptical. They understood that a standalone two-day course would only ever go so far.

Most crucially, they recognised Mental Health First Aid for what it was: a tertiary intervention. In plain terms, it’s reactive and happens far too late, when someone is already struggling or at crisis stage. Yes, this can be helpful in specific moments, but very limited for improving outcomes. What organisations actually needed, were strong primary and secondary interventions: designing work in ways that protect people in the first place, and spotting stress, along with any psychosocial or mental health challenge early, before it escalates.

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?

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 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 adapting the model themselves. They built their own internal solutions, such as conversation logs and spreadsheet trackers. They introduced additional structures. They rebranded roles as Wellbeing Champions, Wellbeing Ambassadors, and a growing list of alternatives, partly to solve each emerging issue, and partly to distance themselves from the Mental Health First Aid label.

And regardless of where these organisations started, 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.

If you’re looking to assess your own Mental Health First Aid or Champion programme and you’re unsure where to start, we recommend taking our free online Mental Health First Aid risk assessment below.

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Asking harder questions about Mental Health First Aid

As these challenges kept surfacing, the team at Everymind began to question whether we could responsibly deliver or advocate for Mental Health First Aid within businesses and organisations.

For our founder, Paul McGregor, this wasn’t abstract. After losing his dad to suicide and spending years sharing his story publicly, Paul experienced firsthand what happens when someone becomes a point of support without boundaries or supervision behind them. People opened up to him in numbers he wasn’t equipped for, and he had to learn, the hard way, that good intentions alone don’t make support safe. It’s the same position thousands of trained volunteers now find themselves in inside workplaces.

So in 2024, we commissioned an independent research partner to study Mental Health First Aid in practice, hearing from both the businesses running these programmes and the volunteers who had been through the training.

Through that research, we surveyed 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.

We asked a number of questions, but the most crucial was how effective HR professionals felt their Mental Health First Aid network was. Fewer than 1 in 5 said they felt it was working effectively.

When we asked the volunteers who had completed Mental Health First Aid training, we found that more than 4 in 5 said they would benefit from additional support in their role.

For both groups, the people running the model and the people inside it, the model wasn’t working. (Full methodology and findings are available on request.)

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

That was when we looked closely at the 2018 evidence review commissioned by the HSE, which found no evidence that Mental Health First Aid training improved the organisational management of mental ill-health. This was echoed by Cochrane, which concluded there is no reliable evidence that Mental Health First Aid is effective, with existing studies carrying a high risk of bias. Several of the systematic reviews and meta-analyses in circulation were authored by researchers closely involved in the development of Mental Health First Aid itself, raising legitimate concerns about conflicts of interest. It’s a standard we hold ourselves to as well, which is why we commissioned our research externally and share our methodology openly.

It was at this point that we decided to stop delivering Mental Health First Aid training.

We thought long and hard about it. Good intentions matter, but they are not enough if they don’t lead to better outcomes in the workplace, and we have to hold ourselves, and the impact we deliver, to account. As it turned out, many of the organisations we work with had already made that move, or chose to join us on the journey.

Over time, the concerns raised early on by those risk-aware organisations played out in practice, exactly as anticipated. What was originally designed as a course to raise mental health awareness had been stretched beyond its intent, reshaped into a workplace intervention it was never designed to be.

Why Mental Health First Aid breaks down in the workplace

Let’s dive deeper into why Mental Health First Aid programmes often fall short. A large part of this comes down to the difference between what works on paper and what happens in practice.

Here are the most common issues we see playing out.

The name “Mental Health First Aid” is often problematic.
The phrase “First Aid” suggests reaction, and so the behaviour and approach become rooted in reactivity. When the role is framed as emergency or crisis-based support, 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 two-day course, they are only asked to complete a refresher every three years. What actually happens? The refresher rarely happens, and the business can hardly keep track of who did which course and when the three years are up.

More crucially, this model rarely leads to lasting confidence or retention of conversational skills. Most individuals forget much of what they learned within weeks. That leads to conversations with blurred professional boundaries, poorly handled situations, 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. There is no meaningful competency gate: attendance functions as qualification. As a result, we often see people taking on responsibilities they’re not well suited to, becoming overwhelmed, and in some cases breaking the trust of those reaching out for support.

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 it safely.

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

The role drifts into territory the training was never meant to license.
In supportive conversations, we often see well-meaning Supporters trying to label or diagnose the person in front of them, something well beyond the scope of the role, and potentially unsafe. This isn’t a failure of the individual. It’s what happens when a course built around recognising mental health conditions meets the messy reality of workplace conversations. The focus should instead be on strong conversational skills, boundaries, and safe signposting.

If we were asked to summarise all of 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 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. The volunteers were trained, and then everything else was left to the person responsible for the network, without the tools, frameworks or support needed to manage any of it.

What safety behind every mental health conversation actually requires

Mental health conversations at work are often difficult. They can be unexpected, or involve distressing subject matter. On the flip side, they can be very light touch: “I just needed to talk to someone.”

With stress-related absence now one of the leading reasons for time off work, more conversations than ever are happening about stress, wellbeing and mental health. That means skills like active listening, emotional regulation and signposting matter more 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. That isn’t a failure of someone’s character or commitment. It’s a reality of being human.

Here’s what safety behind conversations actually requires:

1. Close the gap between what people know in theory and 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 faced in the moment with a real person, those steps often fall away. The ability to act with confidence comes from reinforced skills and a strong foundation of understanding, and that isn’t the kind of understanding a standalone two-day course can build.
2. Ensure 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, all without compromising individual privacy.
3. Have clear processes for safeguarding risks, and a network trained to use them. Safeguarding is rarely taught, despite the fact that any adult can be at risk of harm. Protecting people 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 development opportunities following the initial course, skills are never revisited or reinforced. We recommend development sessions at least once a month, where individuals can build on their skills, reflect on experience, and grow in 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.

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 safe, structured and measurable model of peer support. It provides a clear five-step approach to building a fully functioning programme. Think of it as the operating model for peer support inside your organisation.

Some of the world’s largest businesses and brands have now adopted this approach, including Xerox, AkzoNobel, Aldermore Bank, Dreams and Marsh McLennan.

If you’re wondering where Everymind fits in, our role is simple:

We make the framework work in reality.

We help you move beyond traditional Mental Health First Aid, and in its place we implement the Supporter Method: a structured model underpinned by safety, safeguarding and data. You can watch a short 5 minute video walking you through it just here. The result is a peer support network that isn’t simply trained and launched, but embedded, measurable, sustainable and safe.

Increasingly, the organisations doing this well are going one step further: moving towards a single, live measure of whether their network is safe, engaged and effective, so the question “is this actually working?” can be answered at any moment, not just at renewal time. It’s a shift we’re investing in heavily, and one we’ll have more to share on soon.

Best of all, our framework aligns with HSE guidance and ISO 45003 principles, ensuring safeguarding and risk management are built into every conversation. You can explore some of our customer stories just here.

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, and how far beyond that design it was stretched.

Workplaces have matured in how they think about health and wellbeing. Today, they are expected to measure and evidence impact, especially with peer support programmes. 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 a positive moment. We’re seeing businesses move away from tick-box programmes and adopt approaches that are preventative and grounded in outcomes.

Peer support has a vital role to play in that future, and it’s a future we’re proud to be building with some incredible brands and businesses.