What Does a Mental Health First Aider Do? A UK Guide

A mental health first aider is a member of staff trained to notice when a colleague may be struggling, start a supportive conversation, respond safely in a crisis and guide them towards proper help. They're a first point of contact, not a counsellor. No UK law requires employers to have them, but HSE suggests considering them as part of your first aid planning.

What a mental health first aider does

• Notices. They pick up on changes in a colleague: withdrawing, snapping, missing shifts, seeming exhausted or just not themselves.
• Approaches and listens. They start a private, non-judgemental conversation and listen far more than they talk.
• Responds safely in a crisis. If someone is at risk, they stay calm, ask directly about suicide if they're worried, get urgent help (999 or A&E if a life is at risk) and involve the right people under your policy.
• Signposts. They help the person reach the right support: their GP, the NHS 111 mental health option in England, Samaritans on 116 123, your employee assistance programme or occupational health.
• Checks in, then steps back. They might follow up a few days later, but they don't become the person's ongoing support.

Most of the role is quiet. It's the colleague on the late shift who finds a new starter in tears in the sluice, makes them a tea, listens for twenty minutes and helps them book a GP appointment.

What they don't do

• diagnose, or guess at a diagnosis
• provide counselling, therapy or long-term support
• take over a manager's job on workload, absence or adjustments
• keep a secret when someone is at serious risk
• stay on call around the clock

Be clear about confidentiality from the start. Conversations stay private, with one exception: if someone's safety is at risk, the first aider passes it on. Put that in the role description so staff know before they open up.

In health and care settings there's one more boundary. Mental health first aiders support colleagues. The mental health of the people you support is part of their care, and belongs with the care team and any specialist or clinical team involved. Follow your local policy and the person's care plan.

Where mental health first aid came from

Mental health first aid was created in Canberra, Australia, in 2000 by Betty Kitchener and Professor Tony Jorm. The idea mirrors physical first aid: someone without clinical training gives early help and keeps the person safe until professional support takes over. It has since been taken up widely, including in UK workplaces.

Do UK employers have to have mental health first aiders?

No. In Great Britain, the Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate first aid for staff who are injured or become ill at work. HSE's first aid guidance for employers says that, after your first aid needs assessment, you might decide it would be beneficial to have people trained to understand symptoms and support someone experiencing a mental health issue. It lists appointing mental health trained first aiders as one option, alongside training managers and staff, using occupational health and running employee support programmes.

HSE also says your existing first aiders may already be able to give initial support and reassurance to someone in an acute mental health episode, as long as they know how to get professional help. Consider whether they need further training.

Separately, HSE is clear that employers have a legal duty to protect workers from stress at work by assessing the risk and acting on it. Mental health first aiders can help with that, but they don't meet the duty on their own.

How many mental health first aiders do you need?

There's no legal number. Even for physical first aid, HSE says there are no hard and fast rules on exact numbers: it depends on the circumstances of your workplace. The same thinking works here. Consider:

• Shifts: nights and weekends need someone too, not just office hours.
• Sites and lone working: community, home care and outreach staff need someone they can reach by phone.
• Choice: people talk to someone they trust. A mix of roles, ages and backgrounds, not only managers, gives staff a real choice.
• Cover: leave, sickness and staff turnover will take people out of the role.

Our guide to how many first aiders you need walks through the needs assessment for physical first aid, and the same approach works here.

What the evidence says

It's worth being realistic. HSE's summary of the evidence on mental health first aid training in the workplace, first reviewed in 2018 and updated in 2023, found some evidence that the training improves people's knowledge and understanding of mental health conditions. It found limited evidence that it leads to sustained improvement in how trained staff help colleagues, and noted that nobody has measured whether it improves how organisations manage mental health overall.

That doesn't make the role pointless. It means mental health first aiders work best as one part of a wider approach, not the whole of it.

Supporting your mental health first aiders

• Ask for volunteers. People who want the role tend to do it better than people told to.
• Write a short role description covering what they do, what they don't, confidentiality and who they pass concerns to.
• Give them time. A conversation can't always wait for a break that never comes on a busy shift.
• Tell staff who they are and how to reach them, on noticeboards and at induction.
• Agree what gets recorded, if anything, in line with your data protection policy.
• Debrief them. Some conversations are heavy. Give them a named person to talk to afterwards.
• Keep them current with regular catch-ups and refresher training.

Watch their own wellbeing too. The people who volunteer are often the ones colleagues already lean on.

Fitting it into a wider wellbeing approach

HSE's Management Standards look at six areas of work that cause stress: demands, control, support, relationships, role and change. Mental health first aiders help with support, but they can't fix unrealistic rotas, unclear roles or badly handled change. A sound approach usually includes:

• a stress risk assessment that you act on
• managers who can talk about mental health and make adjustments, which our mental health awareness training covers
• practical help for staff under pressure, such as stress awareness and management training
• clear routes to occupational health or an employee assistance programme
• mental health first aiders as a visible, approachable first contact

How Kasorb can help

Kasorb's mental health first aid training prepares staff to spot the signs of mental ill health in a colleague, start a supportive conversation, respond safely in a crisis and guide them towards the right help. It runs over two days, on-site or live online, for up to 12 staff, and covers common conditions including depression, anxiety, psychosis, eating disorders and substance misuse, responding to a crisis including suicidal thoughts, signposting, stress and wellbeing at work, and looking after yourself as a mental health first aider. Your trainer has used these skills for real and handles the subject with care. Each person receives a Kasorb certificate of completion, emailed the day after the second day, and we recommend a refresher every three years.

This guide summarises the law and guidance; it isn't legal advice.

FAQs

What is the role of a mental health first aider?

A mental health first aider is a trained member of staff who notices when a colleague may be struggling, starts a supportive conversation, responds safely in a crisis and helps them reach professional or workplace support. They are a first point of contact, not a counsellor, therapist or replacement for a manager.

Is it a legal requirement to have a mental health first aider?

No. No UK law requires employers to appoint mental health first aiders. In Great Britain, HSE's first aid guidance says employers might decide it's beneficial after a first aid needs assessment, and lists it as one option alongside training managers, occupational health and employee support programmes.

How many mental health first aiders should a workplace have?

There's no set number. Base it on your own workplace: shift patterns, number of sites, lone and community workers, and cover for leave and sickness. Aim for enough people, in a mix of roles, that every member of staff can reach someone they feel comfortable talking to.

Can a mental health first aider diagnose someone?

No. Mental health first aiders don't diagnose, give treatment or provide ongoing counselling. Their role is to listen, keep the person safe if there's a crisis, and help them get the right support, such as their GP, the NHS 111 mental health option in England or Samaritans on 116 123.