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.  

Her conclusion at the end of our day together was “what we need in the field of mental health and wellbeing is qualifications”. 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. So began a long journey to create peer-reviewed mental health qualifications for the workplace with respected provider HighfieldToday this suite of qualifications is not only available, but the training and the exam can be provided online as well as face to face.

The qualifications are:

A couple of things to note here: these are not the only mental health qualifications Highfield has available – these are just those built for workplaces – and they are now not the only qualifications provider in this field.

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 and which cannot be construed as Ofqual registered 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 content itself. 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, and your territory in the world.

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 just 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 how they either deepen learning or look at global or EMEA rollouts. With this new 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.


With certain courses such as First Aid for Mental Health, your internal implementation of the programme is so important to consider before you run the course.  With the version we have developed, which is entirely about the workplace, one of the modules is always tailored so that up front you are thinking about the role as it stands in your organisation. If you are providing it to everyone as general awareness that is made clear, if you are appointing a role, the role description and boundaries of that role, goes in.  Your points of next support (e.g. EAP) are also included.

Workplace applicability

Where MHFA was originally built from a public health perspective, we have taken the opportunity in looking at the content from scratch to address certain things which we think are important in a workplace context. In the learning outcomes, we include the difference between wearing your manager/HR hat or your peer support hat. We emphasise the boundaries within which we operate when supporting someone with their mental health. Our 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.  If you want a qualification, you must take the exam, but if you don’t the same learning outcomes are being delivered (the same course in fact) and the learning is always assessed regardless by a test (called a quiz) at the end.  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, so if someone can’t pass the test after two attempts, we will inform you.

In Conclusion

We are happy to be supporting Highfield in introducing a world where we can ensure we are operating within a quality assured framework and giving mental health parity with physical health, but where we can change our methods of delivery as we learn more about what works without compromising on delivery of the learning outcomes. As we speak, we are rewriting the online delivery of our course in order to deliver the same learning outcomes in a more experiential way – to really deliver participants with the confidence to have those conversations through offering opportunities to practice and deal with concerns in the live sessions, and pre-recording some of the knowledge delivery in short learning so we are combining some pre-recorded modules with lots of exercises and conversation within the live sessions.

If you would like to learn more about the HWC version of Highfield’s First Aid for Mental Health, please contact info@healthy-working.com