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Should Mental Health First Aiders be qualified?

In light of renewed calls for Mental Health First Aid to be a legal requirement, whatever you think of the proposal, Heather Beach raises questions over whether it should not at least be a qualification

Should Mental Health First Aiders be qualified?

What seems a very long time ago, a senior health and safety friend of mine agreed to sit in on some associate trainer interviews to support me in finding associate trainers for MHFA.

Her conclusion at the end of our day together was “what we need in the field of mental health and wellbeing is qualifications”. So began a long journey for us at Healthy Work Company, working alongside respected provider Highfields to produce peer-reviewed, exam-based, tailorable qualifications.

Just to note, Highfields is not now the only mental health qualifications provider.

It is interesting that in spite of wanting to create parity between mental and physical first aid, where Physical First Aid courses require a test and qualification, until the release of these new qualifications, no checking of the knowledge gained has existed in the mental health first aid arena. In light of renewed calls for First Aid to be a legal requirement, whatever you think of the proposal, should not this at least be reviewed?

Why did my health and safety friend think we needed qualifications?

The world of training in mental health and wellbeing is very different from that of other subjects within health and safety.

Normally official bodies create peer-reviewed learning outcomes which go through rigorous review, but which can be delivered in a way that suits the trainer and the audience (using methods and PowerPoints developed and tailored to the customer by the trainer themselves – with the option to license these from the official qualifications provider).

An exam or test is undergone at the end by the participant, to show the learning outcomes have been appropriately delivered and understood, and the certificate or qualification is issued based on successful completion of that test.  Think of e.g. IOSH’s Managing Safely.

The workplace mental health and wellbeing world is completely different and is currently loosely divided into two types of providers.

  1. Those respected training providers in the mental health world who offer courses where there is no testing of the learning outcomes in place, where the content and presentation is set by the provider of the course, where learning is not tested and which cannot be construed as Ofqual approved qualifications (such as MHFA courses which we together with many other training providers, can provide in England).
  2. Those (generally smaller) consultants and trainers who have created their own courses where the courses are delivered in presentations created by the consultant themselves. Unlike those set courses, they can be tailored to the organisation (This is also us, together with many of our fellow mental health and wellbeing trainers who don’t want to be constrained by someone else’s course design).


No approach to training can be deemed perfect, but it is obvious that neither method ensures that the learning outcomes have been delivered through a test at the end – meaning quality control of the delivery is missing outside of a feedback form. As well as that, the shortfall of the first method is easy tailoring options for the client and in the second is quality control of the learning outcomes.

With a qualification, as long as the learning outcomes are being successfully delivered (which is tested obviously) the training organisation can tailor to your industry, your organisation, your territory in the world. Hence HWC’s version of Highfield’s First Aid for Mental Health will be different from that of other trainers – but the same learning outcomes adhered to.

Why should we care?

In hardly any of the assessed mental health courses, we have delivered has everyone passed the test!

We are very experienced trainers who have delivered on this subject to thousands of people, and yet we have had to support certain participants who wish to be first aiders post the test, to ensure they have understood, for example where confidentiality does not apply, or which laws apply to managers and not to peer support, or what the mental health continuum is….

Does this matter? 

Perhaps if you are wanting the delivery of a course in your organisation to improve literacy and reduce stigma – so training for general awareness – then it may not matter.  If however, you are appointing people with responsibilities for a specific role – then I think it does.

Most large organisations and many small ones have now done some basic mental health training in the UK and attention is moving to more sophisticated approaches, understanding the needs of the different audiences –managers have different duties to those of a first aider or companies are looking at global or EMEA rollouts. With this qualification approach, which is much more in line with the way training normally works, the learning outcomes remain the same and are tested but the course can be adapted to the law in your territory, the culture you are delivering in and can even (with our versions), be adapted to a train the trainer approach.

Workplace applicability

Where MHFA was originally built from a public health perspective, this qualification addresses certain things which we think are important in a workplace context. For example, in the learning outcomes, the difference between wearing your manager/HR hat or your peer support hat is discussed, as well as emphasizing the boundaries within which we operate when supporting someone with their mental health. The focus is on the signs of mental distress in general (where we believe that stress, anxiety depression, and burnout will be the main issues for workplaces) and we spend as much time looking at how to safeguard your mental health and resilience as we do detailing mental illness.

With or without exam

Our approach now is to offer the course with or without the exam but to always assess the learning via a test – regardless of whether someone takes the exam or not. Where you are appointing First Aiders, (rather than just improving general organisational mental health literacy through doing the course) we think it really matters to your organisation from a risk perspective that that person has understood the learning outcomes.

In conclusion

If we are really going to regulate in this area, let’s make sure that we a) have a qualification and b) that the course is absolutely applicable to workplaces

If you would like to learn more about the HWC version of Highfield’s First Aid for Mental Health, please contact

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Heather Beach is the founder and Director of the Healthy Work Company. A former director of a FTSE 250 company, she has studied Applied Positive Psychology and is currently studying Relational Organisational Gestalt.

A key influencer in the health and safety sector, Heather founded Women in Health and Safety and has been featured in numerous consumer publications and on TV.

Heather speaks French, Spanish and Italian and is fascinated by what it takes for human beings to thrive in life.

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As uncertainty, disruption and fear from the pandemic takes its toll on millions of workers around the world we know that anxiety particularly is on the rise.

Within your organisation, as well as training your managers and providing general mental health awareness training for all, you may feel that you want to appoint some Wellbeing Champions or Mental Health First Aiders to encourage people to talk more freely, promote early intervention which enables recovery, reducing stigma and boosting a positive culture.

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