Implementing Mental Health First Aiders guide for employers

Implementing Mental Health First Aiders Guide for employers


© MHFA England 2021


Whether you already have MHFA England training in your organisation or are considering it, this guide is for you.

MHFA England training is a key component for creating a safe, healthy workplace where the mental health and physical health of employees are valued equally. It gives people the tools to support their own mental health and that of their colleagues, and encourages them to access timely support when needed. But to be effective and have a sustainable impact, the training needs to be implemented as part of a strategic, whole organisation approach to wellbeing. Supporting mental health at work means creating an environment that is psychologically safe for everyone. This guide will take you through the key considerations to help you embed positive, longterm cultural and behavioural change. Every workplace is unique so we encourage you to identify the best ways to apply these in your organisation. Business in the Community’s 2020 Mental Health at Work report found that workplaces have made impressive progress on approaches to employee mental health. There is still work to be done to build inclusive, anti-racist workplaces where everyone’s mental health matters. As employers we are on this journey together, and MHFA England is here to support you.



of employees experience mental health symptoms caused, or worsened, by work 1

of employees told no one about their mental health issues 1



of LGBT+ people have experienced mental health issues as a result of work 3

of managers from a diverse racial group had experienced racial microaggressions at work in the last 6 months 2

1 Business in the Community, 2020: Mental Health at Work report 2 CMI, 2020: Moving the Dial on Race 3 Business in the Community, 2019: Working with Pride


Lay the groundwork for the whole organisation The only effective, sustainable approach to employee wellbeing involves the whole organisation. Attitudes filter down from leaders and must be backed up with policies and procedures. Alongside any training it’s important to review how your organisation can create and nurture an inclusive, supportive culture around mental health. The role of senior leadership

Having a senior leader champion your mental health initiatives is a very powerful way to break down stigma and gain traction across the organisation. Senior leaders should: – Position mental health as a boardroom issue, on par with physical health – Commit to creating a psychologically safe environment for all employees by addressing inequities based on race, gender, sexuality, age, disability or health – Consider that positive wellbeing has a well-documented impact on productivity, performance, and engagement. Supporting equity and wellbeing is good business for everyone Links The Race at Work Charter sets out actions and commitments for race equity in the workplace


Wellbeing strategy


Line managers



Measure impact


How healthy is your workplace now? Understanding where you are on the journey will inform your strategy or approach and how you communicate it to the organisation. If you are new to talking about mental health in the workplace, we recommend you gradually introduce the topic to the organisation, sensitising and raising awareness, before rolling out MHFA England courses. What is your strategy? Your wellbeing strategy should centre around making sure all staff are safe and supported to bring their whole selves to work. It therefore needs to link closely into other strategies, such as on race equity. Mental health is one element of wellbeing alongside others such as physical, financial and emotional wellbeing, which are all connected in a whole person approach. The Thriving at Work report sets out six ‘mental health core standards’ – a set of actions for employers to support mental health. You can use these to build the mental health element of your wellbeing strategy: 1. Produce, implement and communicate a mental health at work plan 2. Develop mental health awareness among employees 3. Encourage open conversations about mental health and the support available when employees are struggling 4. Provide your employees with good working conditions 5. Promote effective people management 6. Routinely monitor employee mental health and wellbeing Lay the groundwork for the whole organisation

Rolling out MHFA England training as part of your whole organisation approach can help you meet core standards two and three, and training line managers will also feed into core standard five. Links Guidance on becoming an anti-racist organisation My Whole Self – resources to create a workplace culture where people have the safety and freedom to choose which parts of their identity they share at work Thriving at Work: a review of mental health and employers The independent review of mental health and employers by Lord Dennis Stevenson and Paul Farmer The role of managers – Make employee wellbeing a key responsibility for your managers. Give them the time, resource and training to proactively support the wellbeing of their teams – Recruit, promote and support managers with excellent interpersonal skills – Put support in place for your managers’ own wellbeing


Working practices Review your processes, working practices and policies throughout the employment lifecycle, from recruitment to exit, considering wellbeing and mental health at each stage. For example: – When recruiting and inducting new employees do you make it clear that the organisation treats mental health and physical health as equally important? – Do you promote the support available to employees at each stage of the employment cycle? – Can you better support employees at milestones such as returning from maternity/paternity leave, promotion, or returning to work after a period of illness? Training framework We recommend training people in mental health awareness and skills at a blend of levels. Consider what this framework will look like for your organisation. Links Being a Mental Health First Aider – information about the roles at different levels of MHFA England training MHFA England Workplace info pack – training options which can be tailored to suit your organisation’s needs Lay the groundwork for the whole organisation

Employer examples: working practices PwC has asked employees to consider what will make the biggest difference to their work-life balance and to make a commitment to it. Watch video Thames Water promotes the importance of achieving a healthy balance between work and home life, and accommodates flexible working requests wherever possible. Three UK has implemented Wellbeing Wednesdays, Personal Days, and Wellness Boxes into their working practices. At office sites, no meetings are booked between 12pm and 2pm on Wednesdays - instead, employees are encouraged to use that time for activities that promote their wellbeing, such as exercising or reading a book to unwind. Personal Days give all staff the option to take three paid days per year to do something important to them. Many choose to spend this time with family or volunteer for a good cause. At various times throughout the year and particularly during busy periods, Wellness Boxes containing healthy treats and snacks are distributed to everyone to show their efforts are appreciated. Wellcome Trust launched a Mental Health Ambassadors Network to sit alongside their MHFA England trained staff and wider wellbeing strategy. The network focuses on ways to lessen the impact of workplace pressures and prevent mental ill health.


Evaluate the support you have in place A vital step in the action plan taught on MHFA England courses is signposting to support. You will need to develop clear referral and assistance pathways so your Mental Health First Aiders can

signpost their colleagues effectively and safely. – What support is available for employees now and is this providing the level and type of support your organisation needs? – What is the uptake of this support? For example, if you have an Employee Assistance Programme or Occupational Health, how often is it used? – Ask for feedback from your employees on the support available, and any barriers to uptake (for example, poor service, unaware it is available, concerned they will be judged for accessing the support). – Is the support widely promoted and easy for employees to locate? If the support is confidential, this must be made clear to ensure there are no barriers to accessing help. Be transparent about the process for getting in touch with the service, what will happen next and expected timelines. – If you do not have support internally , are you connected with any local services/organisations that may be able to offer support? If so, are these links promoted to employees? It is good practice to promote a range of alternative external support sources alongside this, such as Mind , Samaritans , SANEline , and Shout . – MHFA England course manuals contain details of reputable national charities and services that can be approached for support.

Employer examples: support Deloitte ’s EAP was underused, with an average utilisation figure of 7%. An internal survey found that people didn’t know what it was, what it did or how to access it. Those who had some knowledge of the service thought it was only for clinical counselling for people with a diagnosed mental health issue – not a service for everyone offering a wide range of help and advice. Employees said that a simple descriptive name would improve awareness and uptake of the service. The EAP was relaunched as Deloitte’s Advice Line and three years later its utilisation has increased to 27% annually. Exterion Media advertises its own EAP and signposts to the National Advertising Benevolent Society helpline so that employees can access quick, independent support tailored to their industry. WHSmith promotes a range of options for support on posters which are displayed on ‘wellbeing noticeboards’. View their example poster .


Create a clear policy and role document Set out a written policy for your organisation’s approach to MHFA England training. Always seek independent legal advice before finalising and implementing a policy. Give your Mental Health First Aiders clear documentation of the expectations and boundaries of their role within your organisation. The documentation should include: – Self-care and opting out

Mental Health First Aiders can: – Understand the important factors affecting mental ill health – Identify the signs and symptoms for a range of mental health conditions – Use a five-step action plan to provide MHFA to someone experiencing a mental health issue or crisis – Listen non-judgementally and hold supportive conversations using the MHFA action plan – Signpost people to professional help, recognising that their role as a Mental Health First Aider does not replace the need for ongoing support MHFA England courses do not teach people to be counsellors, or provide ongoing support or diagnosis. Instead, the course prepares them to act as a point of contact, reassure a person who may be experiencing a mental health issue or emotional distress, and signpost them to professional support.

Make sure Mental Health First Aiders are aware that their role is voluntary. At times they may need to take a break for their own mental health. Remind them regularly that if the role starts to impact on their own wellbeing, they should consider stepping down, and to communicate with their named contact (below). – Support for your Mental Health First Aiders Name who is overseeing the initiative. Include details of who the Mental Health First Aiders should contact with any questions or concerns about their role, or if they need support themselves (see page 11 for more detail). – Responsibilities What are the specific responsibilities you have decided on for your organisation’s Mental Health First Aiders, and how does this fit with their job duties? – The process for signposting colleagues to support , both within the workplace (e.g. through Human Resources), and to external organisations.


How to confidentially log support conversations We recommend asking your Mental Health First Aiders to log the support conversations they have with colleagues. This will allow you to see how much the support is being used and spot any patterns in areas of the business. Here is an example of how organisations gather useful but anonymous information: Create a clear policy and role document

Time commitments Create clear guidelines on how much time your Mental Health First Aiders should commit to the role and any additional commitments such as meetings and refresher training (see ‘Expected time commitments for Mental Health First Aiders’ on page 9 for more information). Be clear that they should only make themselves contactable during work hours and should not give out personal contact details. If you have an out-of-hours EAP service, make sure this is promoted throughout the organisation. Otherwise, advertise national out-of- hours support should this be needed, such as the Mind urgent help pages and contact details for Samaritans , SANEline , Shout , o r an EAP helpline. Links to other relevant policies For example if you have an organisational policy on responding to crisis situations, signpost to where the policy can be found and give guidance on the circumstances in which it should be used by your Mental Health First Aiders. Links Being a Mental Health First Aider – this can form the basis of your organisation’s policy and role document Mental Health First Aider Support app – provides secure conversation logging, signposting, and data-driven insights Legal FAQ – employers’ legal responsibilities around the provision of Mental Health First Aid

Date of conversation: Department/team: Theme of conversation: (e.g. work-related or personal life) Signposting recommendations given: Length of conversation:

Another way to do this is through the Mental Health First Aider Support app , which allows Mental Health First Aiders to log their conversations and outcomes securely and confidentially. How to handle immediate danger Remind Mental Health First Aiders that confidentiality never applies when a person becomes a danger to themselves or others. Include details of any actions they should take alongside their MHFA England training if they come across a situation at work where someone is in immediate danger. For example, is there someone in the organisation that should be contacted as well as the emergency services?


Recruit your Mental Health First Aiders

How many Mental Health First Aiders do you need? Legislation for Mental Health First Aid provision in the workplace is not yet in place. The Health and Safety Executive recommends: “You should consider ways to manage mental ill health in your workplace which are appropriate for your business, such as providing information or training for managers and employees, employing occupational health professionals, appointing mental health trained first aiders and implementing employee support programmes.” To meet these recommendations and demonstrate that your organisation views mental health as equally important to physical health, we recommend that you consider your organisation structure and the demands on the workforce. For some organisations it may be worthwhile aiming to have as many Mental Health First Aiders as physical first aiders. For multisite organisations it is important that there is always a Mental Health First Aider available to support employees at each location. Many organisations begin by piloting Mental Health First Aiders in one area of the business to establish what works for them before rolling it out more widely.

Who should be a Mental Health First Aider? Mental Health First Aider is a voluntary role. Although MHFA England courses are open to all, asking employees to apply for the training will help you to recruit the people within your organisation who are best placed for the role. We recommend that you train: – A wide range of individuals – encourage applications to represent the diversity of your workforce, from different seniority levels, locations, genders, and ethnic backgrounds. – People who want to learn more about mental health to support others , whether or not they have experienced mental ill health themselves. Make sure that all applicants (not just those who have disclosed personal experience) understand what the role will involve and have considered their own wellbeing to decide if now is the right time for them. – People who spend the majority of their working hours on site at the workplace for which they are nominated and can be called away from their normal duties at short notice if needed. – People who can maintain confidentiality as appropriate and demonstrate an ability to relate well to others. – People who can commit to the time required and who have the support from their line manager to fulfil the role once trained.


Recruit your Mental Health First Aiders

Expected time commitments for Mental Health First Aiders

Initial training:

Two days

Ad hoc conversations with colleagues:

Best practice is conversations of up to 30 minutes. Encourage Mental Health First Aiders to record how much time they are spending on these conversations and review regularly (see page 7 for guidance on logging conversations). We recommend using the Mental Health First Aider Support app reporting function for insights on time spent in conversations.

Taking part in an internal Mental Health First Aider network:

Varies depending on the organisation but monthly or quarterly meetings are most common

MHFA Refresher training:

Half a day, every three years

Supplementary training:

Optional, decided by the organisation


Recruit your Mental Health First Aiders

Application process Invite employees to apply for the MHFA England training via an application form. You could follow this up with informal interviews and a reference check with their manager. When advertising the training you should outline: – What the Mental Health First Aider role entails – Who should apply – How it fits in with other strategies such as your employee training and development programme – The time commitment involved (see page 9 ) – The topics covered on the course On the application form, you can ask questions to determine why the person would like to become a Mental Health First Aider, what they feel they can bring to the role, and whether they have their manager’s approval to apply. If you choose to follow up on the applications with interviews, this is a good opportunity to assess the person’s suitability for the role and discuss in more detail what the role will entail. Example questions for the application process – Why do you think mental health in the workplace is important? – Why are you interested in becoming a Mental Health First Aider? – How do you see yourself using these new skills in your role?

– What would you do if you started to feel like the role was impacting on your own mental health?’ – What would success as a Mental Health First Aider look like to you?

Employer example: recruiting Siemens Mobility looks to train Mental Health First Aiders who may or may not have exposure to mental illness directly, but have the right skills and characteristics for the role. Employees who would like to gain more understanding of mental health are encouraged to take an awareness course first and proceed to Mental Health First Aider training if they wish to use their skills to help others. The training opportunity and responsibilities are advertised business-wide and volunteers apply for the position. Applicants are invited to answer a series of questions on why they would like to take the course and why they are suitable for the role. Once the applicant has passed the recruitment stage, their place on the course depends on a satisfactory behavioural reference from their manager.


Support and develop your Mental Health First Aiders Support is vital to successfully embed MHFA England training into an organisation, and to allow Mental Health First Aiders to perform their role safely and effectively. Here are some examples of support strategies which have proven successful:

– Raise mental health awareness and tackle stigma throughout the organisation to help create an environment where people feel empowered to contact their Mental Health First Aiders for support. Some organisations do this by: װ Circulating free resources and information, e.g. My Whole Self Address Your Stress Take 10 Together Every Mind Matters Mental Health at Work װ Inviting in speakers with lived experience of mental ill health or subject experts to deliver a talk or lunch and learn session

– Follow up after the course with a conference call or meeting. Make sure everyone feels comfortable in their new role, provide written documentation (see page 6 ) and answer any questions around how it works in your organisation. – Set up a Mental Health First Aider network with a clear remit for support and idea sharing. This should be overseen by someone with an HR background or the person who is leading the initiative. The network should meet regularly and is an opportunity to remind Mental Health First Aiders to look out for their own wellbeing too. – Empower Mental Health First Aiders to maintain their skills with regular refresher training. We recommend attending an MHFA Refresher course (half a day’s training) every three years, in line with physical first aid training. – Keep track of when people leave the organisation and more MHFA England training is needed to maintain numbers. – Review and report on the impact of the training regularly, either manually or using the reporting function of the Mental Health First Aider Support app

Links Measuring the impact infographic includes tips for measuring the impact of MHFA England training and other health and wellbeing initiatives


Support and develop your Mental Health First Aiders

Employer example: support and development Siemens Mobility ’s Health & Wellbeing team runs a conference call for each cohort of newly qualified Mental Health First Aiders to put their new MHFA skills into context within the business and discuss how their role fits within the health wellbeing strategy. Quarterly catch up calls between the H&W team and the Mental Health First Aiders are an opportunity to discuss any trends or situations they found particularly challenging. All Mental Health First Aiders have direct access to a Health Psychologist to discuss any cases they are struggling with or that overstep their boundaries. The Mental Health First Aiders also attend supplementary courses, including Safeguarding, Managing Change and Resilience, to further enhance their bank of skills. Thames Water holds quarterly engagement sessions for Mental Health First Aiders. A private discussion group on the company’s online forum provides space for the Mental Health First Aiders and the clinical occupational health team to advise, share tips and support each other. WHSmith facilitates a monthly meeting for their Mental Health First Aiders where they discuss: – Experiences since the training – Where the training has been useful – Questions about applying the training effectively – Tips on ensuring good self-care


Promote your Mental Health First Aiders Make sure the whole organisation is aware who the Mental Health First Aiders are and how to contact them should they need support. Each organisation approaches this differently but you may wish to consider:

When you promote the Mental Health First Aiders to the rest of the organisation, it’s important to include: – Clear information on the boundaries of the role Colleagues must understand that Mental Health First Aiders are not there to give them ongoing support or counselling, but instead to act as a point of contact and reassurance. Be clear that Mental Health First Aiders are not available outside work hours. Include signposts to alternative out-of-hours support should this be needed, such as Samaritans , SANEline , Shout , o r an EAP helpline. – Names, contact details and job titles for the Mental Health First Aiders across the business. Some people may not want to contact a Mental Health First Aider who is based at their own site or on their own team. – The process for getting in touch with them and what to expect Manage expectations here – for example, a Mental Health First Aider may not be able to respond immediately but will arrange a time to call or meet up. Remind staff about the assistance pathways and other support services if they need help urgently.

Links Use these poster templates to promote Mental Health First Aiders around your workplace, or create your own. – Include information in return to work interviews or packs so employees who have been off work unwell are reminded of the support available to them, including how to contact a Mental Health First Aider should they need to – Hold a launch event linking in with an awareness campaign such as World Mental Health Day – Put Mental Health First Aiders’ contact details alongside the physical first aiders’ contact details in key areas around the workplace such as the photocopier, kitchen or toilets – Put each Mental Health First Aider’s name, photograph and contact details on the intranet – Give Mental Health First Aiders lanyards, badges or distinctive email signatures for easy identification. Use the Mental Health First Aider digital badge which comes with their course certificate – Include contact details of all Mental Health First Aiders in new starter induction packs


Helpful resources

ACAS Mental Health in the Workplace guidance Business in the Community’s Mental Health Toolkit for Employers Business in the Community’s Suicide Prevention and Postvention Toolkits Health and Safety Executive guidance on: Mental health conditions, work and the workplace Work related stress Mental Health at Work gateway A hub of links to information and resources for workplaces of all sizes MHFA England website Information on training and toolkits to improve the mental health of your workplace This is Me campaign Encourages organisations to share their employees’ lived experiences about mental health. PwC’s video is a great example Thriving at Work: a review of mental health and employers An independent review of mental health and employers by Lord Dennis Stevenson and Paul Farmer

Hear from other organisations on how they implement MHFA England training Read case studies from organisations across a range of sectors at Watch video case studies on YouTube


Contact Get in touch with our workplace mental health experts to discuss your organisation’s requirements:

0203 928 0760

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