The short answer: mental health first aiders need five things once they are trained. Clear boundaries about what their role is and is not. A clear route to escalate concerns. Someone they can talk to after a difficult conversation. Real time in their working week to do it. And regular refreshers so their confidence does not fade. Without these, the people you have trained are likely to become overloaded, or quietly step back from the role.
There is an irony at the heart of a lot of workplace mental health programmes. Organisations train people to support others through stress and distress, then give those same people no support at all. I have met first aiders who have been through genuinely heavy conversations and had nobody to go to afterwards. Some of them were close to burnout themselves.
This article is part of our practical guide to workplace mental health training for UK employers.
Why do mental health first aiders burn out?
The people who put themselves forward for this role are usually the ones colleagues already go to. That is a strength, but it also makes them vulnerable. Common reasons they struggle:
- The role grows without anyone noticing. It starts with the odd conversation and slowly becomes a second job on top of the first.
- No boundaries. Without a clear sense of where their role ends, some first aiders feel responsible for fixing people.
- Nowhere to take it. They hear things that stay with them, and they have nobody to talk to about it.
- Unclear escalation. They are not sure who to tell, or when, so they carry concerns alone.
- Their own experience. Some first aiders have lived experience of mental health difficulties. That makes them brilliant at the role, and it can also mean certain conversations hit close to home.
- Fading confidence. Months after the course, with no refresher, they start to doubt whether they are doing it right.
What are the warning signs?
Keep an eye on your first aiders the way they keep an eye on everyone else. Signs a first aider may be struggling include:
- Spending a lot of their working time, or their own time, supporting colleagues
- Seeming drained, irritable or withdrawn after conversations
- Talking about feeling responsible for how someone else is doing
- Starting to avoid colleagues who have come to them before
- Asking to step down, or quietly going silent in the role
What support should every mental health first aider have?
| What they need | What it looks like in practice |
|---|---|
| A clear role description | A short written summary of what the role involves, and what it does not. They listen, support and signpost. They do not counsel, diagnose or fix. |
| An escalation route | A named person to go to with concerns, and a clear process for urgent situations, including out of hours. |
| Someone to talk to | A named contact they can debrief with after a difficult conversation, and access to your EAP or other support for themselves. |
| Protected time | Agreement with their line manager that the role is part of their job, not squeezed around it. |
| A peer network | A regular get together, even 30 minutes a month, where first aiders can share experiences and support each other, without breaking confidences. |
| Refreshers | A short top up at least once a year, plus resources they can check when a real situation comes up. |
| Visibility and recognition | People know who they are. Leaders thank them. The role is recognised in appraisals. |
| Permission to step back | A simple, no blame way to pause or leave the role when they need to. |
A few of these cost nothing at all. None of them are complicated. But in organisations where they are missing, the programme usually fades within a year.
We have written more about why this goes wrong in Mental Health First Aiders: Great Idea, Bad Execution, The Mental Health First Aid Tick-Box Problem and Why Most Mental Health First Aid Training Fails. And if you are still deciding how many people to train, read How Many Mental Health First Aiders Does Your Organisation Need?
What can first aiders do to look after themselves?
If you are a mental health first aider reading this, a few things I encourage everyone I train to do:
- Remember your role. You are the first step, not the whole journey. Listening well and helping someone reach the right support is the job. Fixing them is not.
- Notice what stays with you. If a conversation is still on your mind that evening, that is a sign to talk to someone, not a sign you are weak.
- Use the support you point others to. Your EAP, your debrief contact, your GP. The same routes apply to you.
- Say no when you need to. “I can’t give this the attention it deserves right now, but let me help you find someone who can” is a responsible answer.
- Keep your own tank topped up. Sleep, time outside work, people who look after you. Supporting others is much harder when you are running on empty yourself.
- Refresh your skills. Every Piece of Mind learner keeps the Reach Out app, with practical guides and conversation prompts for exactly the moments when you are not sure what to do next.
Frequently asked questions
How much time should a mental health first aider get for the role?
There is no set figure. What matters is that the time is agreed with their line manager and treated as part of their job. Review it every few months, because demand often grows once people know who the first aiders are.
Should mental health first aiders have supervision?
They need somewhere to take difficult conversations. That might be a named HR or wellbeing contact, a regular peer group, access to your EAP, or support from your training provider. Formal clinical supervision is not usually needed, but some form of debrief always is.
What should a first aider do if they are worried about someone’s safety?
Follow the escalation route you have agreed, straight away. In an emergency, call 999. They should never be left to manage a serious risk on their own, and they should never promise to keep a safety concern secret.
Can someone stop being a mental health first aider?
Yes, and it should be easy and blame free. People’s circumstances change. Replacing a first aider is far better than keeping someone in the role who is running on empty.
The bottom line
Training mental health first aiders is the start, not the finish. The organisations that get real value from it are the ones that look after the people doing the looking after. If you are not sure whether your current setup does that, our Workplace Mental Health Systems and Support Review looks at exactly this. Or book a free call and we will talk it through.