First Aiders for Mental Health: Understanding Their Role, Responsibilities, and Legal Standing

In recent years, mental health first aid has become increasingly recognised as a vital component of workplace wellbeing and community support. Just as we train people to respond to physical emergencies, First Aiders for Mental Health are equipped to provide initial support for mental health concerns. However, there's often confusion about what these valuable individuals can and cannot do, their responsibilities, and how they're viewed under the law.

Because mental health support sometimes overlaps with moments of real distress, it’s important to highlight where immediate help is available.

If you or someone you’re supporting needs urgent help right now

If there is immediate danger, call 999.

The following UK services offer confidential, free support:

– Samaritans – 24/7 listening support
– Shout – 24/7 text support by texting 85258
– Mind – information and local support services
– NHS 111 – urgent mental health advice
– GP services – for referral to NHS mental health services

This blog explores the role of a First Aider for Mental Health, based on the guidance laid out by Nuco, which provides nationally recognised qualifications regulated by Ofqual on the Regulated Qualifications Framework (RQF). Constellation Training offers Nuco-accredited First Aid for Mental Health qualifications at Levels 1, 2 and 3.

In this article

• What First Aiders for Mental Health Are
• What First Aiders for Mental Health Are NOT
• Legal Considerations and Protections in the UK
• Best Practices for First Aiders for Mental Health
• Employer responsibilities

What First Aiders for Mental Health Are

First Aiders for Mental Health are individuals who have completed accredited training to recognise the signs and symptoms of common mental health conditions and provide initial support using the First Aid for Mental Health Action Plan. They serve as a crucial first point of contact within workplaces and communities for those experiencing mental health difficulties.

Those trained under this framework are equipped to:

• Recognise signs and symptoms of suspected mental health conditions including depression, anxiety, stress, psychosis, eating disorders, self-harm, and substance misuse
• Provide initial support and guidance using the First Aid for Mental Health Action Plan
• Start supportive conversations about mental health in a non-judgemental manner
• Signpost individuals towards appropriate professional help
• Support a person whilst they are receiving professional assistance
• Help implement a positive mental health culture within the workplace
• Understand the impact of drugs and alcohol on mental health

Constellation Training offers different qualification levels: Level 1 (Awareness of First Aid for Mental Health - 4 hours), Level 2 (First Aid for Mental Health - 6 hours), and Level 3 (Supervising First Aid for Mental Health - 12 hours). Each level builds upon the previous one, with Level 3 designed for those in supervisory or managerial positions with responsibility for implementing mental health support strategies. These are accredited by Nuco.

What First Aiders for Mental Health Are NOT

It's crucial to understand the boundaries of this role. Training explicitly emphasises that First Aiders for Mental Health are not:

Not Healthcare Professionals: First Aiders for Mental Health are not therapists, counsellors, psychologists, or psychiatrists. Nuco qualifications provide essential knowledge and practical skills but do not qualify learners to diagnose or treat mental health conditions—this can only be carried out by healthcare professionals.

Not Diagnosticians: A fundamental principle of Nuco training is that learners will recognise suspected mental health conditions, not diagnose them. The training teaches recognition of signs and symptoms, not clinical diagnosis.

Not Therapists or Counsellors: First Aiders for Mental Health do not provide therapy, counselling, or treatment. Their role is to provide first aid level support and guide people towards professional healthcare. Professional counselling training typically requires three years of study.

Not a Replacement for Professional Services: The support they offer is initial and designed to bridge the gap until professional help is accessed. They complement, but never replace, proper mental health services. This follows the same principle as physical first aid—providing support before professionals arrive.

Not Crisis Intervention Specialists: Whilst they can provide support in crisis situations using the First Aid for Mental Health Action Plan, in immediate risk situations involving danger to self or others, emergency services should be contacted.

Not Mandatory Reporters Beyond Standard Safeguarding: Unless specific safeguarding circumstances apply (such as concerns about children or vulnerable adults, or immediate risk of serious harm), First Aiders for Mental Health maintain confidentiality within their organisation's policies.

Their Responsibilities

The responsibilities of a First Aider for Mental Health under Nuco's framework include:

Using the First Aid for Mental Health Action Plan

The cornerstone of the training is the First Aid for Mental Health Action Plan, which provides a structured approach to supporting someone with a suspected mental health condition. This action plan guides First Aiders through the process of providing comprehensive guidance and support whilst encouraging the person to seek professional help.

Providing Initial Support and Starting Conversations

First Aiders for Mental Health are trained to approach and engage in sensitive conversations about mental health. This involves:

• Creating a safe, non-judgemental environment for discussion
• Active listening without attempting to diagnose
• Showing empathy and providing reassurance
• Recognising that their role is to support, not to 'fix'

Signposting to Professional Help

A key responsibility is knowing what professional resources are available and helping individuals access them. This might include:

• GP services and NHS mental health services
• Employee assistance programmes
• Crisis helplines (such as Samaritans, Mind, or Shout)
• Community mental health teams
• Specialist services for young people, substance misuse, or specific conditions

Supporting During Professional Treatment

Importantly, training emphasises that First Aiders for Mental Health can continue to provide support to someone whilst they are receiving professional assistance. This ongoing peer support can be invaluable during someone's recovery journey.

Maintaining Appropriate Boundaries

First Aiders must recognise their limitations and stay within the scope of their training. This means:

• Not attempting to diagnose or treat mental health conditions
• Not providing counselling or therapy
• Clearly communicating their role to those they're supporting
• Knowing when to escalate concerns to professionals

Contributing to a Positive Mental Health Culture

Particularly at Level 3, First Aiders have responsibility for helping to implement and maintain a positive mental health culture within their organisation. This includes:

• Reducing stigma around mental health
• Promoting early intervention
• Supporting organisational policies and procedures
• Encouraging open conversations about wellbeing

Maintaining Confidentiality (Within Appropriate Limits)

First Aiders should respect confidentiality in line with organisational policies, except where there's a risk of serious harm to the individual or others, or in cases involving safeguarding concerns. The limits of confidentiality should be explained at the outset of any conversation.

Self-Care and Ongoing Learning

First Aiders have a responsibility to:

• Maintain their own mental health and wellbeing
• Recognise when they need support themselves
• Attend annual refresher training (strongly recommended)
• Requalify every three years to keep their certification valid
• Engage with any supervision or debriefing opportunities provided by their organisation  

Legal Considerations and Protections in the UK

The legal position of First Aiders for Mental Health in the UK involves several important considerations:

Regulatory Status

Nuco qualifications are regulated by Ofqual (Office of Qualifications and Examinations Regulation) and listed on the Regulated Qualifications Framework (RQF), as well as recognised by the Scottish Qualifications Authority (SCQF). This provides a level of quality assurance and recognition, though it's important to note that First Aiders for Mental Health are not regulated healthcare professionals.

Health and Safety Executive (HSE) Guidance

The HSE updated their guidance in November 2018 to encourage companies to consider mental health training. Whilst it is not yet obligatory for employers in the UK to provide workers with mental health training, having First Aiders for Mental Health can demonstrate an organisation's commitment to meeting its duty of care obligations.

Employer's Duty of Care

Under UK employment law, employers have a duty of care to their employees, which includes taking reasonable steps to protect mental health and wellbeing. Having trained First Aiders for Mental Health can be part of meeting this obligation, though it doesn't replace the employer's broader responsibilities for:

• Conducting risk assessments (including psychosocial risks)
• Implementing appropriate workplace policies
• Providing access to occupational health services
• Making reasonable adjustments for employees with mental health conditions

Good Samaritan Principles

In the UK, individuals who voluntarily provide assistance in good faith are generally protected from liability. If a First Aider for Mental Health:

• Acts within the scope of their Nuco training
• Uses the First Aid for Mental Health Action Plan as taught
• Acts with good intentions and reasonable care
• Does not claim to have expertise beyond their qualification

...they are very unlikely to face successful legal claims, even if the outcome isn't perfect.

Negligence and Liability

For a negligence claim to succeed in UK law, a claimant must typically prove:

• A duty of care existed
• That duty was breached
• The breach caused harm
• Actual damages resulted

First Aiders for Mental Health who act within their training, follow the First Aid for Mental Health Action Plan, and do not claim expertise they don't possess are extremely unlikely to be found negligent. The standard expected is that of a "reasonable person who has completed First Aid for Mental Health training," not that of a healthcare professional.

Courts would also consider whether the individual was acting as a trained lay person in a voluntary support role, rather than under a contractual or clinical duty of care.

Organisational Responsibilities

Organisations that implement First Aid for Mental Health programmes should:

• Ensure First Aiders receive appropriate accredited training
• Provide adequate numbers of First Aiders for their organisation size
• Offer opportunities for annual refresher training
• Facilitate requalification before the three-year expiry
• Maintain clear policies about the First Aider role and its boundaries
• Ensure First Aiders are not used as a substitute for proper occupational health provision or professional mental health services
• Include First Aiders for Mental Health in organisational insurance coverage
• Provide supervision or debriefing opportunities where appropriate      

Not a Regulated Healthcare Profession

Unlike doctors, nurses, or clinical psychologists, First Aiders for Mental Health are not part of a regulated healthcare profession. There is no statutory registration requirement, no professional body with disciplinary powers, and no specific legal framework governing their day-to-day practice. This reinforces that their role is supportive and educational rather than clinical.

Data Protection (UK GDPR and Data Protection Act 2018)

First Aiders for Mental Health must comply with UK data protection law when handling any information about the people they support. Best practice includes:

• Keeping written records to a minimum
• Only recording what is necessary for continuity of support or safeguarding
• Storing any notes securely in accordance with organisational policies
• Understanding data subject rights
• Not sharing information outside of established organisational procedures (except in safeguarding situations)

Safeguarding Obligations

When concerns arise about vulnerable adults or children, First Aiders for Mental Health must follow established safeguarding procedures. In the UK, this means:

• Reporting concerns through appropriate organisational channels
• Following local safeguarding children or adults procedures
• Recognising that the duty to protect someone from serious harm overrides confidentiality
• Understanding that failure to report safeguarding concerns could have legal implications

Equality Act 2010

Mental health conditions can be disabilities under the Equality Act 2010 if they have a substantial and long-term adverse effect on someone's ability to carry out normal day-to-day activities. Having trained First Aiders for Mental Health can demonstrate an organisation's commitment to:

• Supporting employees with disabilities
• Creating an inclusive workplace culture
• Preventing discrimination, harassment, and victimisation

However, having First Aiders does not exempt organisations from their legal obligations under equality law, including making reasonable adjustments.

How They're Viewed Under UK Law

First Aiders for Mental Health occupy a specific position in UK law and workplace practice:

In Employment and Workplace Law

First Aiders for Mental Health are increasingly viewed as good practice in meeting duty of care obligations. Whilst not legally mandated for most organisations, they demonstrate:

• Proactive risk management regarding workplace mental health
• Commitment to employee wellbeing
• Early intervention approaches that can prevent escalation of mental health issues
• Cultural change towards openness about mental health

In Negligence and Civil Liability

UK courts would likely view First Aiders for Mental Health as trained lay persons acting in a supportive capacity, not as healthcare professionals. The duty of care and standard of care expected would be appropriate to their level of training and the voluntary nature of their role. Courts would consider:

• Whether they acted within the scope of their training
• Whether they followed the First Aid for Mental Health Action Plan
• Whether they made appropriate referrals to professionals
• Whether they acted in good faith  

In Corporate Manslaughter and Health and Safety Prosecutions

Whilst such cases are rare regarding mental health, organisations could theoretically face prosecution if gross failures to protect employees' mental health led to serious harm. Having trained First Aiders for Mental Health as part of a broader mental health and wellbeing strategy demonstrates organisational commitment and could be relevant to showing reasonable precautions were taken.

Recognition but Not Regulation

Mental health first aid has widespread recognition and support across UK workplaces, charities, educational institutions, and communities. However, unlike physical first aid at work, which has specific regulatory requirements under the Health and Safety (First-Aid) Regulations 1981, there is currently no equivalent legal requirement for mental health first aid. This may change as awareness grows and workplace mental health becomes increasingly prioritised.

Best Practices for First Aiders for Mental Health

To navigate their role effectively, safely, and in line with guidance, First Aiders should:

1. Stay within the boundaries of your training: Always remember you are trained to recognise suspected mental health conditions and provide initial support—not to diagnose or treat.

2. Use the First Aid for Mental Health Action Plan: This structured approach is the foundation of your role and provides a clear framework for supporting others.

3. Be clear about your role: Make sure people understand you're a First Aider for Mental Health, not a healthcare professional, and explain what you can and cannot do.

4. Know your signposting resources: Keep up-to-date information about available professional services, both within your organisation and in the wider community.

5. Maintain appropriate confidentiality: Respect privacy within organisational policies, but never hesitate to breach confidentiality when there's a risk of serious harm or safeguarding concerns.

6. Keep minimal, factual records if needed: Only document what's necessary, store information securely, and comply with UK GDPR requirements.

7. Attend annual refresher training: Nuco strongly recommends this to keep your knowledge current and reinforce your skills.

8. Requalify every three years: Nuco qualifications are valid for three years—ensure you complete the full course again before expiry.

9. Look after your own mental health: Recognise the emotional impact of supporting others, practice self-care, and seek support when you need it.

10. Follow organisational policies: Work within your organisation's mental health and wellbeing framework, reporting procedures, and safeguarding protocols.

11. Contribute to positive culture change: Use your role to help reduce stigma, encourage conversations about mental health, and promote early intervention.

12. Act in good faith: This is both good practice and your best legal protection—always act with honesty, compassion, and within your competence.

Constellation Training provides ongoing support and refresher courses to help First Aiders maintain their skills and stay current with best practices.

Conclusion

First Aiders for Mental Health trained under Nuco's framework play an invaluable role in creating supportive environments where mental health is taken seriously and help is accessible. However, their effectiveness depends on everyone—the First Aiders themselves, organisations, and the people they support—understanding what this role is and is not.

First Aiders for Mental Health are trained lay persons who can recognise suspected mental health conditions, provide initial support using the First Aid for Mental Health Action Plan, and signpost people towards professional help whilst supporting them through their recovery journey. They are not healthcare professionals, cannot diagnose or treat conditions, and must always stay within the boundaries of their training.

Legally in the UK, whilst not regulated healthcare professionals, First Aiders for Mental Health holding Nuco qualifications benefit from clear, nationally recognised training standards via Ofqual regulation. They are generally protected when acting in good faith within their training but must maintain clear boundaries and recognise their limitations. Organisations implementing these programmes bear responsibility for ensuring proper training, support, and integration within broader health and wellbeing strategies.

As workplace mental health continues to gain recognition in the UK, and as organisations increasingly recognise their duty of care obligations, First Aiders for Mental Health represent an important part of the solution, though never the whole solution. They are an important first point of contact and source of peer support, not a replacement for professional mental health services.

If you're a First Aider for Mental Health, thank you for taking on this important role. Remember to look after yourself, stay within your scope of practice, use the First Aid for Mental Health Action Plan, and never hesitate to signpost to professionals. If you're considering becoming one, recognise that it's a rewarding but bounded role that requires commitment to training, ongoing learning, and self-care.

And if you're someone who might need support, know that approaching a First Aider for Mental Health is a positive step—they're there to listen without judgement, provide initial support, and help you access the professional help you need.

About Constellation Training

Constellation Training is a trusted provider of Nuco-accredited First Aid for Mental Health qualifications, delivering Level 1, 2, and 3 training to organisations across the UK.

Our courses are designed to help individuals and employers understand the real scope, boundaries, and responsibilities of mental health first aid — supporting confidence, legal clarity, and good practice in the workplace.

We offer initial qualifications, annual refreshers, requalification courses, and bespoke training aligned to organisational needs.