Mental Health First Aid in the NHS

Mental Health First Aid in the NHS

NHS England started MHFA training in Jan 2014 and have trained 315 staff so far

“Our main resource is our people and the positive approach they take. The most important step is to get people together and talking, and we’re going to carry on using any platform we can to get the message out about mental health.”

NHS England employs 5,200 people at 50 sites across England. The majority of these employees previously worked for primary care trusts and strategic health authorities. For any employer, with structural change comes the challenge of managing staff morale and wellbeing.

During NHS England’s first 18 months, mental health related issues such as stress, anxiety and depression were the most common reason given by staff for sickness absence and the top reason given for accessing the Employee Assistance Programme (EAP). NHS England decided to take preventative action and is now leading the way when it comes to dealing with mental health as a workplace issue.

Sandra Winters, former Head of Wellbeing and Corporate Responsibility for NHS England set out to address the staff wellbeing issue by introducing more support. “From the beginning there was a strong business case for this initiative,” Sandra says. “We were already seeing high levels of stress and dissatisfaction from staff as they transitioned into NHS England from the previous structure and we were anticipating further impact. At the time, we were offering the standard EAP service but no other supports were really in place.”

To test the existing culture, Sandra asked line managers: “Would you find it as easy to talk to a member of your team who has been off work with depression compared to someone who has been off work with a fractured ankle?” The feedback was that there was a distinct sense that staff didn’t feel equipped to talk about mental health as freely as physical health and so it became clear that more awareness and training was needed to give people the confidence and skills to support employees.

“More than 80% of staff said that the support they receive from their colleagues is their most valued form of workplace support.”

The internal staff satisfaction survey report also showed that more than 80% of employees said that the support they receive from their colleagues is their most valued form of workplace support. This suggested to Sandra that a peer support approach to mental health would likely be accepted and have the biggest impact.

“To see whether there would be interest, we sent out an email to staff explaining what Mental Health First Aid is and offering them the opportunity to apply. Over 100 staff replied with their interest on the first day.”


Two years on from launching the programme, NHS England has made sure that all staff know where to go for support. Every employee has access to a dedicated mental health intranet hub which has seen more than 11,000 visits to date. On this page staff can click on ‘Find my MHFAider’ to be given contact details of their nearest trained colleague. The scheme is publicised prominently on the main intranet site, in the weekly e-newsletter, and through organisation wide health awareness campaigns.

NHS England promotes the training as a voluntary personal development opportunity. Uptake has been consistently high, with so much interest from staff that there is now a waiting list to take the course.

NHS England treats mental health as equally important to physical health, an attitude which is supported at the highest level. In keeping with this, MHFA is not treated as a stand-alone scheme but as a key component of the whole organisation’s approach to health and wellbeing. Sandra explains that the course works smoothly alongside other policies and procedures:

“We recently updated the return to work interview process so that everyone who has been off sick is asked if they have received support from an MHFAider, reminding them of the support available at work. There’s a lot of evidence to say that returning to work and keeping active can be an important part of someone’s recovery.

“Our Supporting Attendance at Work policy encourages people to measure their own health and flags up areas where they may need more support, which might include talking to an MHFAider. It also works well alongside our Equality, Diversity and Inclusion policy – through MHFA people gain a greater understanding of their colleagues who have mental health illnesses and disabilities.”

“Staff reported a 99% increase in their understanding of mental health issues and a 91% increase in personal confidence.”

Sandra notes that getting involved with mental health has seemed to develop people’s self-esteem and confidence encouraging them to become engaged in other areas. And these opportunities for personal development have brought about a wider cultural change. “In regions where we have higher volumes of qualified MHFAiders, we’re seeing a lot more positive activity and engagement.”

What the future holds

NHS England are looking to double the MHFAiders they have in house to 600 this year, and to keep doubling year on year after that.

“Our long term aim is for every person who works for NHS England to have the opportunity to do a Mental Health First Aid course. We will continue to take the training to them anywhere there’s local demand, whether it’s Cornwall or Durham.”


Clive Caseley is a director at Verve and was previously Marketing Director at the mental health charity MIND. He is passionate about understanding mental wellbeing and creating mentally healthy workspaces.

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