Mental health first aid. Does it work?

The Health and Safety Executive have published a research report on Mental Health First Aid (MHFA) training that backs TUC concerns that more evidence is needed of whether it works or not.

Earlier this year I wrote an article on MHFA that appeared in Hazards magazine. It expressed concern that there was no evidence that MHFA training actually had any impact in supporting individuals who are experiencing mental health problems in the workplace.

The HSE research backs up my worries. It says that there is ‘no evidence’ MHFA training actually leads to any improvements. The report notes “it is not possible to state whether MHFA training is effective in a workplace setting,” and also that there is “limited evidence that the content of MHFA training has been considered for workplace settings.” Although the HSE research points out that “There is consistent evidence that MHFA training raises employees’ awareness of mental ill health conditions,” its conclusion is that “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.”

Now this is all pretty incredible given that employers are spending millions of pounds training people in MHFA, with over 200,000 people having been trained in MHFA since 2007 but it is important to remember that just because there is a lack of evidence, that does not mean MHFA makes no difference. It just means that there is no proof either way.

The problem however is that many employers are using MHFA as their only way of dealing with mental health issues and, increasingly, as a way of dealing with stress related problems. This is hardly surprising given that by introducing MHFA training they can say that they are doing something about mental health issues even if they are doing nothing about preventing stress-related illnesses such as depression and anxiety, which are responsible for around a third of all sickness absence. Also, because of the lack of any enforcement action, employers get away with this.

Even if we are just looking at training, there are other options for employers and also for staff. This includes Mental Health Awareness Training, which usually has much more emphasis on prevention and is provided my several mental health charities. Also of course the TUC provides mental health awareness training to union workplace representatives. Our Mental health workbook for representatives is a useful resource that covers a range of problems that they might face in the workplace.

I think it is important to stress that the HSE research report in no way means that Mental Health Fist Aid training should not be used in the workplace. The report is not saying that it is just snake oil, only that the impact it has is unknown. However the fact that over ten years after the training was introduced there is still no evidence of what impact it has should start to ring alarm bells. If MHFA training is to continue to be offered as a useful tool and promoted by the Government then there is a responsibility on the Government and the providers to invest in the research that the HSE asks for.

In the meantime, lets make sure that we don’t let employers claim MHFA is a solution to workplace mental health problems. After all, first aid trainers in the workplace are not an alternative to having an occupational health service and good prevention procedures in place. Nor do first aiders seek to replace paramedics. The same is true of MHFAiders. Those who are trained in MHFA are not therapists or psychiatrists.

Any employer who thinks they can deal with mental health concerns just by introducing MHFA, offered to a few handpicked ‘Mental Health Champions’, is very much mistaken. MHFA training must be seen as one of a range of initiatives that employers can introduce. The bottom line is that employers have a major role to play in both prevention and providing support to employees over and above just providing MHFAiders and unions need to work with them to try to achieve that.