Is Mental Health First Aid Evidence Based? - The Mind Map
By Ellis Toner

Is Mental Health First Aid Evidence Based?

MHFA courses are evidence based, designed to raise awareness and increase knowledge.

Published 12/07/2021
What is the evidence base for Mental Health First Aid Training?

MHFA training works as one part of a holistic mental healthcare system.

Each MHFA course is based on research and created to raise awareness and increase knowledge.

Mental health experts have helped to develop the courses.

They have worked  to do this alongside those who have first hand experience of mental ill health.

There is a huge and worrying gap between public health spending.

Money spent on preventing physical health problems comes to over £1 billion.

However, that spent on preventing mental health issues comes to £40 million

There is overwhelming evidence that the two are inextricably linked.

Physical health problems dramatically increase the risk of poor mental health, and vice versa.

In-fact 30 per cent of all people with a long-term physical health condition also have a mental health problem.

Most commonly this is depression/anxiety

Mental health problems can seriously worsen physical illness.

They can affect outcomes and the cost of treatment.

Poor mental health affecting physical illnesses is estimated to cost the NHS at minimum £8 billion a year.

Physical symptoms which are unexplained often have a basis in poor mental health.

These unexplained ailments are estimated to cost the NHS £3 billion each year

People with severe mental illnesses also have much higher rates of physical illness.

This has a devastating effect on life-expectancy

To empower individuals to make healthy choices in their lives, addressing mental health needs to be a priority.

This is because the links between poor mental health and poor physical health have been repeatedly proven.

People with mental health problems are up to four times more likely to die prematurely

Complex, long-term health issues such as substance and/or alcohol misuse or smoking

  • are also more frequently found in people with mental ill health.

The Royal College of Psychiatrists found:

  • Depression doubles the risk of developing coronary heart disease
  • People with a mental disorder account for almost half of all smoking-related deaths.

Many people with mental ill health who are undiagnosed self-medicate with drugs and/or alcohol.

This of course then worsens their mental health problems.

The impact of these mental health problems is undeniable. There is much evidence to support it.

Some suicide statistics:

Around 6000 people take their lives every year in the UK

The suicide rate for females under 25 has increased by 93.8% since 2012

12 men in the UK commit suicide everyday

The male suicide rate has reached a two decade high in England and Wales

An average of 579 people take their lives in London alone, each year.

A further 4.2% of Londoners (almost 300,000) have contemplated suicide in the past year.

The latest suicide statistics show an increase in deaths in line with the economic downturn

At the less extreme end of the spectrum, the impact is felt, too:

Half of the UK describe themselves as anxious,

One-third report low levels of happiness.

Life satisfaction is behind the national average

The Greater London Authority estimates the total cost of mental health – to London alone- at £26 billion each year

Across the UK the cost of poor mental health is £70 billion. This equates to 4.5% of the country’s gross domestic product.

These figures do not even take into account the links between complex public health issues:

For example, sexual health or obesity, with mental health

(although these are well established. There is much further evidence to support these links.)

If a high proportion of people affected by these physical health concerns have

  • underlying and unaddressed mental health issues
  • and there is a clear gap between the need for better mental health services and current levels of funding, then:

There is a strong argument for increasing the focus on prevention and early intervention work.

Significantly lower levels of funding are needed to simply increase the nation’s mental health literacy,

Yet, the benefits are well documented in evidence.

it is possible to bridge this gap through MHFA training– while these other access and funding issues are addressed.

The two-day MHFA course equips delegates with the skills to recognise the early warning signs of mental ill health

(in co-workers, family or friends)

and: to provide help on a first aid basis, with the ability to signpost to further support.

This greatly improves chances of recovery in those suffering.

Many independent evaluations demonstrate that MHFA is effective at meeting its aims.

A recent study by Coventry and Birmingham University (presented at Public Health England’s conference in Birmingham) found

  • Large increases in knowledge and understanding of mental ill health (average increase of 3.8 points)
  • Increased confidence in helping someone with issues (average increase of 3.5 points) in a total size of 11,502 participants.

These results are echoed in evidence found by Westminster University.

This evidence based research supports the effectiveness of Youth MHFA, a two-day course.

This course is targeted at those working with, caring for or living with young people aged 11–18 years.

This research noted significant increases in knowledge and confidence ratings from 5 to 8 points

The courses focus on the issues faced by young people today and teaches protective factors and good parenting.

Youth MHFA courses include two day, one day, and half day

Roberts-Holmes G, Mayer S, Jones P & Lee SF found in the Evaluation of Phase One of the Youth MHFA in Schools programme that participants reported that : “The training has given us a vocabulary to use.”

During the first year of the programme over 1,200 school staff attended a Youth MHFA One Day course.

They qualified as Youth MHFA Champions. This means they are skilled in understanding how to spot:

The signs and symptoms of mental health issues in youngsters.

And, that they have the confidence and awareness to guide a young person to a place of support.

The study involved over 1,000 school staff and found evidence that:

Following the training, staff reported around a three-fold (190%) increase in confidence, in knowledge, skills and awareness to support a young person struggling with their mental health.

– Previous to taking Youth MHFA training just 30% of employees said they felt knowledgeable, skilled and aware

(to support a young person experiencing mental ill health)

– After acquiring Youth MHFA skills, a highly improved 59% of staff said they felt very knowledgeable, aware and confident to support a young person

Take a look at our Youth MHFA course here:

– This increased to 87% up to three terms later, highlighting a sustained improvement as staff put their skills into practice and had time to reflect on their training

More evidence has found that MHFA training

  • increases mental health literacy in those who take the course
  • increases attendees’ willingness and confidence to help someone experiencing mental ill health
  • helps lower stigma and discrimination around mental ill health
  • enables participants to better their own overall wellbeing and find their own coping tools and strategies.

This research is also reflected on an international scale and in minority ethnic groups

It is reported that sadly these groups are actually more likely to access mental health services via the criminal justice system.

Overall: Compared to the £3,210 estimated spend on mental health per person per year:

MHFA is a stunningly cost-effective tool in helping people and communities to help themselves.

By building more aware and empathetic communities where residents are willing and able to support one another,

MHFA strengthens communities and increases resources and resilience.

It also helps to change business cultures by creating and sustaining empathetic environments where people feel more able to disclose mental health problems and address them productively at the crucial early stage.

The London Health Commission has recognised this in its recommendations.

Recommendation 9 states that

‘The Mayor should encourage all employers to promote the health of Londoners through workplace health initiatives. The NHS should lead the way by introducing wellbeing programmes, including having a mental health first aider for every NHS organisation”

Major employers are rapidly waking up to the necessity and importance of increasing the mental health literacy of their workforce.

They are realising the tools and expertise that are needed to improve wellbeing across the workforce.

Evidence based MHFA forms a big part of this.

The Mind Map has provided MHFA training for large companies like Netflix, Ebay, sketchers, and the NHS

This demonstrates that the biggest companies and organisations in the world can see the evidence base for MHFA training and believe MHFA is an essential part of a healthy workplace.

Yet, with the United States recognising the evidence base fully and investing $15 million to roll out MHFA training to frontline workers such as police officers, first responders, primary care professionals, social workers and university staff,

the United Kingdom has a long way to go before equal regard is shown to mental and physical health.

Based on the evidence The Mind Map strongly feel equal value should be placed on protecting and supporting people’s mental health.

When MHFA is an accepted part of every workplace we will be building empathetic, compassionate and well informed communities which form the bedrock of a resilient society.

Browse our MHFA courses here:

What is MHFA?

Mental Health First Aid (MHFA) is an international mental health skills and awareness programme of training. It was developed in Australia in 2000. It is now internationally recognised in over 25 countries.

Mental Health First Aiders are taught how to spot the signs and symptoms of different mental health issues.

They learn how to provide help on a first aid basis and efficiently guide the person towards appropriate support services.

Across the world, nearly three million people have been trained in MHFA skills.

A wealth of evidence for MHFA training has been developed globally and in England over the past 10 years.

As with all public health initiatives, the evidence base for mental health and Mental Health First Aid is constantly evolving

There are many opportunities to gain deeper and varied insights.

Building a strong MHFA evidence base means more and more training being given, improving the mental health of our nation. 

All mental health interventions must be values driven –

  • positive about mental health
  • about wellbeing
  • about help seeking behaviours.

Evidence shows that workplaces, schools, and all organisations need to have a shared understanding of what they are trying to achieve. Also, how they intend to achieve it and how they will know if they have been successful. MHFA helps to

  • build literacy
  • challenge stigma
  • increase knowledge
  • develop skills
  • build confidence to talk, to listen, to ask for, give and receive help.We all have a responsibility to monitor, evaluate and

The Mind Map feels privileged to be working in mental health.

We each have different lived experiences, strengths, specialisms and expertise.

Evidence across the board shows that there is so much excellent work being done in the mental health sector on limited resources.

MHFA allows this work to continue across many different platforms – providing a good basic grounding in Mental Health awareness and knowledge.

Evidence also shows that there isn’t one solution for addressing public mental health.

However, a range of approaches including MHFA training are likely to be most productive.

Repeated evaluations have provided evidence that the skills learnt on MHFA courses:

– Increase knowledge and confidence in how to support someone experiencing a mental health issue

– Improve attitudes towards mental health issues, reducing stigma and at the same time normalising mental ill health. This  promotes more empathetic approaches

– Are used by between 68.5% – 88% of Mental Health First Aiders if they encounter someone experiencing any mental health issues after attending a course. Many are recorded as providing support to more than one person

– Have a direct positive impact on attendees’ own mental health and wellbeing.

Many reporting an increased ability to manage their own mental health

Some recent studies provided evidence of MHFA trainings effectiveness:

1) This study set out to evaluate the effectiveness of Adult MHFA Half Day training for nurses. It considered the management both their own wellbeing, and that of their patients.

Nurses are under huge amounts of stress. They are also likely to encounter patients with a variety of diagnosed and undiagnosed mental health issues.

Second year nursing students at Coventry University were asked to evaluate their own ability and confidence levels in assisting people with a mental health issue – both before and after they had attended the half day MHFA course.

Evidence demonstrated that;

They reported a significant improvement in confidence, knowledge and skills for helping people in emotional distress

Qualitative comments on what had been learnt throughout included:

– “We all experience a mental health problem in different ways.”
– The words and the language you are using matter so that you don’t stigmatise.”
– “it’s always better to talk. Although it can be worrying discussing self-harm and suicide is important.”
– “Techniques to improve own resilience.”

The study concluded that

Bringing MHFA training into the current programmes of nursing teaching is a great move forward towards encouraging nursing students to provide a person centred approach to care.

2) This next study considered the effect of three different training conditions on 106 managers, within the fire service in Northumberland. One of these trainings was MHFA.

Evidence found that:

MHFA training brought about a statistically significant improvement in attitude to mental ill health.

As well as this it gave participants an increased ability and confidence to help someone experiencing mental ill health.

(In stark contrast, a combined leafleting and Q&A session did not achieve nearly a similar result)

  • MHFA was assessed from both quantitative and qualitative evaluations, and it was found to be an appropriate tool to address issues around stress in the fire service; to promote understanding of workplace influences on stress; increase awareness of how colleagues and managers can help each other and promote much more positive approaches to mental health.

3) This wide ranging study considered the course evaluations from 11,502 delegates.

These delegates attended MHFA courses between October 2011 and December 2012. It found evidence that:

– Confidence and belief in their ability to support others with a mental health issue, increased on average by 3.5 points (from 4.49- 7.99/10)

– Knowledge and understanding of how to best to support others with a mental health issue rose on average by 3.78 points (from 4.42-8.2/10)

– Both pre- and post-course confidence in how to help someone were highly reflective of knowledge of how to support others (correlation of .89 and .8 respectively)

– 96.6% of delegates went on to assess the training as very good/good.

The study concluded that MHFA training aligned with public health priorities by increasing mental health literacy

MHFA training allows managers to mitigate and assess the risks of harm in the workplace.

It gives them the tools to support people with mental health issues.

Evidence based MHFA research demonstrates that mental health should be treated in a similar way to physical health.

Some evidence demonstrates that to be most effective organisations need

  • as many first aiders for mental health as they have for physical health.

Approximately 1 in 4 UK residents will experience a mental illness each year.

In 2016, 15.8 million UK work days were lost because of mental ill health

The biggest causes of absence for our country’s workforce are depression, stress, and anxiety.

Mental illness costs UK businesses in the area of £35 billion every year.

This equates to:

£10.6 billion lost to sickness absence,
£21.2 billion in reduced productivity,
£3.1 billion in replacing employees who are unable to undertake their roles due to mental illness.**

Independent research and assessment shows that – taking part in a Mental Health First Aid course:

  • raises awareness of mental illnesses
  • encourages early intervention to aid recovery,
  • increases confidence in dealing with mental illnesses
  • reduces stigma around mental health issues.

In the workplace, there is still a big gap in knowledge around mental health issues.

Much of the workforce are unsure and uncertain about how to recognise mental illness.

They are also unsure about how to react when faced with it.

This can cause further damage to those around them who may be struggling – for example, they may unwittingly show stigmatising behaviours and attitudes.

This means that those in need of mental health support do not always seek it, or receive it.

By becoming more informed and aware, evidence shows that managers and employees who are MHFA trained, will be able to more easily spot the symptoms, signs and signals of mental health issues.

They can then go on to provide the right support.

Someone with poor mental health may sometimes not even be aware that they are suffering. This is another reason that everybody having awareness is so important.

Even if they do know they are suffering, they may be reluctant to seek help, or might simply not know where to turn.

For an employee experiencing a mental health issue, an informed and supportive responsewhich evidence shows that MHFA provides – is likely to lead to a much better outcome.

Evidence suggests that improving UK workplace mental health could reduce employers’ losses greatly

(The losses attributed to mental illness could be reduced by a staggering 30%, collectively saving £8 billion a year)

Researchers will often review research which already exists in a certain area to better comprehend the current evidence base.

This enables them to answer specific questions (e.g. whether a training program is effective for a particular group of people).

Reviews help people to become familiar with the evidence in any given field of research.

A special type of review, called a systematic review, is often done to gather all of the available studies on a topic in a rigorous way, and forms the basis for Level I evidence. Importantly:

The MHFA Program has been included in a great number of different reviews since 2006, with most of these reviews supporting the positive effects of the training on people’s knowledge, attitudes and confidence.

For more information about the MHFA training we offer click here: