The post-pandemic work landscape – the role (and risks) of mental health first aid

The mental health fallout from the coronavirus pandemic could be immense. Mental health first aid could therefore have a key “front line” workplace health support role. But, as a recent roundtable discussed, it will be even more important first aiders themselves get proper training and support. Nic Paton reports.

Whatever our post-pandemic workplace “normality” ends up looking like, one thing certain is that, for all of us, our mental health has been through the wringer these past few months.

Whether it’s been anxiety and fear about job security and income, the health and safety (and even loss) of our nearest and dearest, the challenges of surviving weeks of lockdown and restrictions, or even just the sudden disappearance of future opportunities or plans, the Covid-19 pandemic has taken a heavy mental health and wellbeing toll on many of us.

The panellists

  • Eugene Farrell, mental health lead at AXA PPP healthcare and chair The UK EAP Association
  • Sam Fuller, managing director, The Wellbeing Project (Europe) (chair)
  • Zoe Puckering, business development lead at Mental Health First Aid England
  • Nigel Wilkinson, head of safety and wellbeing, UK and Scandinavia, Avis Budget Group

If mental health and wellbeing hadn’t been enough of a challenge within the workplace even before the pandemic, this is something employers will therefore be needing to recognise, manage and support as working life gradually resumes.

The role, leadership and expertise of occupational health will of course be a key element within this. But so will access to resources such as Employee Assistance Programmes and mental health first aid.

Mental health first aid in particular can get something of a bad “rep” within occupational health.

The suspicion too often is that employers wanting to be seen to be doing “something” around mental health latch on to the idea of developing a network of first aiders or mental health “ambassadors” but only give them limited training (often just a couple of days) and even less day-to-day support.

Box apparently “ticked”, they are then left to manage potentially challenging situations that may, in turn, put themselves as well those coming to them at risk. Indeed, this very concern was highlighted within Occupational Health & Wellbeing earlier this year.

How mental health aiders can be better – or even just properly – supported within the workplace was the focus of a recent (but pre coronavirus) panel discussion at an Embedding Mental Health “masterclass” run by St John Ambulance.

Two conferences were held either side of the new year, and Occupational Health & Wellbeing was a media partner for each day. But even though both events took place pre pandemic, their message in terms of the ongoing support mental health, and mental health first aiders, will need within the workplace is now even more topical, and arguably urgent, than ever.

Moving away from a ‘tick box’ mentality

Discussion chair Sam Fuller, managing director of The Wellbeing Project (Europe), opened the proceedings by conceding that a “tick box” mentality can too often be the default approach among employers looking to implement mental health first aid within their organisation.

“My team always say to me that, when they go into a first meeting with a client, they can tell within five minutes if the organisation is just ticking a box. If they can see it that quickly, you can imagine the impact that has for employees who are being encouraged to sign up to and engage with things when the intention is not really there,” she pointed out.

“It is so easy just to tick-box your way through a lot of these things,” agreed Eugene Farrell, mental health lead at AXA PPP healthcare and chair of The UK EAP Association. “It’s about considering the broader mental wellbeing alongside physical wellbeing. And then how you make all of the parts fit together in harmony and work together, rather than just buying loads of ‘stuff’. That’s the real work, making it all work together.”

It was important that organisations offered clearly signposted and easy-to-access pathways to support, he suggested. “If you’re in that situation where your mental health is perhaps not great, you don’t want to have lots and lots of different ways that you might be able to go. You need simple pathways that have lots of good things in them.”

“I think the key thing is to get your leadership behind you and I think, now with all the publicity and the trends, that mental health is definitely a key area that businesses need to be focusing on. I think most businesses are aware of this now. But, without a supportive leadership team you will struggle to roll out these, especially if you need some budget,” said Nigel Wilkinson, head of safety and wellbeing, UK and Scandinavia, at Avis Budget Group.

“Leadership is obviously very important but, unfortunately, not all leadership teams already have mental health on their agenda,” conceded Zoe Puckering, business development lead at Mental Health First Aid England. Peer networks and support – so bottom-up as well as top-down – were also important, she added.

Recognise the potential impact on first aiders

Within this, it was vital the business recognised the potential impact, and risks, involved for mental health first aiders within the workplace, the impact the conversations they’re having may be having upon them, highlighted Fuller. It was also important that the definition – the parameters – of their role was clearly highlighted and communicated, the dos and don’ts, the boundaries, when to escalate and ask for more specialised help,

“I think it is perfectly reasonable to be concerned about that, because I do think you have got to be proactive. I think boundaries are incredibly important, and we try and encourage businesses we work with to create boundaries so that people understand what the role of a mental health first aider is and what it isn’t, more importantly,” agreed Puckering.

“You’re not a medical professional, you’re not a counsellor, you’re not going to solve anybody’s problems, and you’re certainly not going to offer them a solution. You are there as a peer-to-peer supporter who can help them understand what options they do have.

“You’re letting them know their options because ultimately, unfortunately, if you are in a bad place with your mental health, often your self-care has already gone out of the window; you’re not thinking about, ‘oh I’ll go and see my doctor or I’ll ring that EAP number or I’ve got private medical insurance’ or whatever it might be. You’re not thinking about that because you’ve stopped caring. So just having somebody who says that they do care and they will listen without judging you and they will look at options, and you can decide when they present the options to you, is something that really, really shouldn’t be under-valued. It’s a massive help,” she added.

Need to set, and communicate, boundaries

But the question of setting, and communicating, boundaries was paramount, Puckering emphasised. “Also, it is just knowing what a mental health first aider is and isn’t that is the fundamental really. Ultimately, it is about looking after your champions, whether they’re mental health first aiders or whether they’re not, whether they’ve done some other type of training, whether they’re general wellbeing champions and not specifically mental health champions.

“Just look after them, because they will be exposed to distressing situations. They might have very, very difficult conversations. So having regular check-ins, having a network event, or creating a social media group, or whatever it might be, so that people can reach out and ultimately you can actively check in with them.

“See how they’re getting on, if they need to step back, do they understand what the benefits are – ‘we’ve changed the EAP platform, what’s the new phone number?’ – all that kind of stuff, it’s proactive. If anybody ever feels they need to step back, because maybe they’re having a distressing time in their own life, they should feel that they can do that. Because it’s been communicated from the beginning that they can do that,” Puckering said.

“I remember talking to a union because it wanted occupational health to turn up on site with a blue light on their head every time there was a mental health risk or concern and deal with the situation,” recalled Fuller.

“But obviously the only place for people to be in that situation is to go and see a professional. People are often unsure about those boundaries. So I think that is something that really needs to be reinforced.”

“At Mental Health First Aid England we do have a defined role of a mental health first aider, and that might be applicable if you have got mental health first aiders,” highlighted Puckering. “If you have got your own wellbeing champions, and maybe they’re not mental health first aiders, maybe they’ve done some other training, then you might want to look at that and look at other role guidance, or use the guidance to create your own role. But I would say you definitely do need to put boundaries around something where you are actively asking people to volunteer and support other people.

“Often the people who volunteer, whether they’re a mental health first aider or a different type of champion, have volunteered because they care, because they bring empathy, and that’s brilliant. But because they care they can over-involve themselves, even if it is with very, very good intentions. So you need to reiterate the boundaries and not let people take personal responsibility for somebody else,” Puckering added.

Manage expectations and provide ongoing support

As an employer, it was imperative to be communicating the extent of the role, setting the expectations and ensuring that people understood that anything outside of or beyond that was not expected of them as a first-line volunteer, she argued.

As the discussion drew to a conclusion, the panel was asked to consider what they would advise for organisations that wanted to help with mental support but did not have much of a budget.

“Advice is free. So talk to some of the providers about ideas that you’ve got,” suggested Wilkinson. “You just need to be aware, because there is a plethora of information out there. There is a bit of a bandwagon, and so you do need to be a bit selective.”

Zoe Puckering then highlighted that Mental Health First Aid England was at the time working on a project around supporting smaller businesses to put in place mental health first aid support. “At the moment we don’t have a ‘go to this place and you can network with mental health first aiders from other SMEs’. That is something we recognise is important.

“We do have areas of the country where mental health first aiders have done that themselves, which is really impressive; they’ve created their own meet-ups in their local areas, where they support each other. But we recognise that is a challenge, and we are definitely on it,” she added.

Subsequent to the event, and during the pandemic, Mental Health First Aid England also updated its Role of the Mental Health First Aider guidance to include advice on remote support.

“Mental health first aid – a ticking time-bomb in the workplace?”, Occupational Health & Wellbeing, April 2020,
“Mental health first aiders – creating a virtual ‘culture of care’ during the coronavirus crisis”, Occupational Health & Wellbeing, April 2020,

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