A cluster randomised controlled trial of mental health first aid (MHFA) in UK workplaces

Purpose Mental health first aid (MHFA) seeks to enhance mental health literacy and encourage help-seeking. No studies have tested its effect on employees’ help-seeking compared to control. This study aims to evaluate MHFA’s impact on UK employees’ help-seeking behaviour. Design/methodology/approach The authors used a cluster randomised controlled trial comparing MHFA and a four-hour mental health and well-being consultation. Participants were employees working in nine UK organisations randomly allocated to MHFA or a control intervention. The primary outcome was employees’ help-seeking behaviour. Secondary outcomes were help-seeking intentions, mental health and well-being and self-efficacy levels. Findings A regression model with a fixed treatment effect showed employees based in clusters that adopted MHFA were significantly less likely to seek help, AOR = 0.34 (95% CI: 0.12, 0.95, p = 0.039), reported lower social well-being (95% CI: −0.40, −0.03, p = 0.024) and higher self-efficacy-knowledge (95% CI: 0.74, 3.06, p = 0.001). Few employees reported receiving direct support from a mental health first aider. MHFA training alone may therefore be insufficient to increase formal help-seeking. Research limitations/implications MHFA training does not significantly increase formal help-seeking among employees. It enhances self-efficacy, potentially encouraging informal support-seeking and social well-being. Trust and awareness of MHFA roles in the workplace are critical for its success. Practical implications Informal help-seeking is apparent when people are exposed to MHFA in the workplace. An important public health outcome of MHFA is enabling people to seek formal help to improve access to services. Social implications MHFA’s reach is global and thriving, but its social impact is under-researched. Originality/value To the best of the authors’ knowledge, this study is among the first cluster randomised trials to examine the effectiveness of workplace MHFA on employees’ help-seeking behaviour. Results indicate that MHFA may minimally affect formal help-seeking and social well-being but can boost self-efficacy knowledge. Despite high work-related mental distress and mental health issues, few employees sought help from mental health first aiders. This underscores the need to raise awareness of mental health first aiders’ role and clearly define how MHFA can support help-seeking, mental health and well-being.