Mental Health First Aid: What to Do in Difficult Moments at Work

What is mental health first aid and who can give it at work? The Look, Listen, Link principles, what not to do and the steps for corporate training.

Every factory and every office has a first aid cabinet and employees trained in first aid. What to do when an employee cuts their hand or faints is clear. But what should be done when an employee has a panic attack in the middle of a shift, starts shaking after witnessing a workplace accident, receives news at work that a relative has died, or says "I can't take it any more"? In most workplaces there is no clear answer to this question. The mental health first aid approach aims to fill exactly this gap: offering calm, safe and humane support to a person going through a psychologically difficult moment until professional help is obtained or the situation settles. In this article I look at what mental health first aid at work is, its basic principles, what to do and what not to do, and how you can develop this capability in your organisation.

What Is Mental Health First Aid?

Physical first aid aims to preserve life and prevent the situation from getting worse in the face of an injury or sudden illness until a medical team arrives. First aid in the field of mental health works on a similar logic: at a moment of psychological crisis or intense emotional distress, ensuring the person's safety, calming them, listening to them and linking them to appropriate sources of support.

The psychological first aid guide published by the WHO in 2011 presents the basic framework of this approach. The key points emphasised in the guide are as follows (WHO, 2011):

• Psychological first aid is not professional counselling.
• It is not something only mental health professionals can do; anyone who has received training can apply it.
• It does not force the person to talk or to describe what they have been through in detail.
• It is an alternative to "psychological debriefing" practices, which have been found ineffective.

This approach is not an attempt to diagnose or treat. Its aim is to let the person feel they are not alone in a difficult moment and to carry them safely to the next step.

Why Is Mental Health First Aid Needed at Work?

In Turkey, 66% of employees say they spend most of their day under stress, 36% say they experience anger and 27% say they experience sadness during the day (Gallup, 2026). Worldwide, an estimated 16% of working-age adults had a mental disorder in 2023 (WHO, 2026). This picture shows that encountering an employee in psychological difficulty at work is not the exception but a quite likely situation.

In manufacturing businesses, the need is even more marked. In 2025, 766,039 workplace accidents and 1,931 deaths from workplace accidents were recorded in Turkey (SGK, 2025). Employees who witness a serious accident may show intense stress reactions. In these moments, it helps if the foreman, the occupational safety specialist or a team mate at the scene knows what to do, both for managing immediate reactions and for providing the necessary support in the period that follows.

Examples of situations that may call for mental health first aid at work:

• A panic attack or an episode of intense anxiety
• Witnessing a traumatic event such as a workplace accident, fire or earthquake
• Receiving news of a sudden loss at work
• Shock after a conflict, verbal assault or customer violence
• An employee talking about thoughts of self-harm or ending their life
• An employee who has been struggling for a long time breaking down emotionally at work
• Intense reactions after dismissal, a disciplinary process or a poor performance review

What these situations have in common is that the person's usual ways of coping are not enough in that moment. Having a colleague or manager who knows what to do helps the person get through the moment more safely and can help prevent the problem from growing.

Basic Principles: Look, Listen, Link

The WHO's psychological first aid guide proposes three basic action principles (WHO, 2011). These principles can be adapted to the workplace as follows:

Look

• Check safety: Is there a physical danger in the environment? Is the person at risk of harming themselves or others? Physical safety always comes first.
• Identify urgent needs: Does the person need medical attention? In cases such as injury, fainting or shortness of breath, physical first aid and 112 (emergency services) come first.
• Notice who needs support: After an event, the person who stays quiet, not just the one who talks most, may also be in intense distress.

Listen

• Introduce yourself and offer help: A simple sentence such as "I'm here, can I stay with you?" is enough.
• Provide a calm environment: Take the person somewhere quiet, away from crowds, noise and curious looks.
• Listen without forcing them to talk: If the person wants to talk, listen; if they don't, quietly staying beside them is also support.
• Acknowledge feelings: A sentence such as "What you're going through is really hard" lets the person feel understood.
• Help them calm down through breathing: In a moment of panic or intense anxiety, breathing slowly and steadily alongside them can help the body settle.

Link

• Help with practical needs: Concrete needs such as water, a place to sit, letting their family know or getting home are often the most urgent.
• Connect them to social support: Help the person get in touch with a colleague or family member they trust.
• Share sources of professional support: Give information about the workplace physician, the organisation's psychological support service or a mental health professional.
• Call 112 in an emergency: If the person is at risk of harming themselves or others, do not leave them alone and call 112 without delay.

The aim in this approach is not to solve the problem; it is to help the person get through the moment safely and reach the right support.

What Not to Do in Mental Health First Aid

Even well-intentioned interventions can sometimes do harm. It is important to avoid the following behaviours:

• Forcing the person to describe the event in detail: Pushing a person to recount what they have been through again and again immediately after a traumatic event is not recommended. The WHO recommends that psychological debriefing not be offered to people recently exposed to a traumatic event (WHO mhGAP, 2012/2013).
• Belittling feelings: Phrases such as "don't exaggerate", "be strong" and "men don't cry" leave the person isolated.
• Diagnosing or labelling: Comments such as "you definitely have depression", however well meant, can be wrong and stigmatising.
• Recommending medication or treatment: Decisions about medication and treatment should be made only by doctors and mental health professionals.
• Making promises that cannot be kept: Statements such as "everything will be fine" or "nobody will know" can damage credibility.
• Breaching confidentiality unnecessarily: What the person has been through should not be shared with the curious or with the team. However, where life safety is at stake, the principle of confidentiality does not override safety.
• Overstepping your own limits: A person giving first aid is not a therapist. If there is a need for long-term support, directing the person to professional help is the right step.

Who Should Receive This Training?

You do not have to be a specialist to receive this training at work. Priority groups might be:

• Managers, supervisors and foremen: They are the people who have the most frequent contact with their teams and can notice an employee who is struggling earliest. In the WHO's 2022 guidelines on mental health at work, mental health training for managers is the guidelines' strongest recommendation, with a strong recommendation and moderate-certainty evidence (WHO, 2022).
• Occupational safety specialists and workplace physicians: They are the people present at the scene in accidents and emergencies.
• HR staff: They are in one-to-one contact with employees when difficult news is delivered and in resignation and complaint processes.
• Volunteer employee representatives: Having a few trained volunteer employees on each shift or in each unit makes it easier to access support.

When selecting volunteer first aiders, it is necessary to look not only at willingness but also at qualities such as being able to stay calm, taking care over confidentiality and knowing their own limits. Who these people are should be announced to employees, and they should be accessible by shift and unit. It is also important to remember that the role volunteers take on is an additional burden, and to offer them regular meetings, a specialist they can consult and, where needed, support of their own. Otherwise the most sensitive employees can, over time, become the most exhausted.

Mental health literacy and awareness training for all employees is also included in the WHO guidelines; however, this recommendation is classified as "conditional" and the certainty of evidence as "very low" (WHO, 2022). It therefore makes more sense to plan general awareness training as part of a comprehensive programme together with manager training and organisational measures.

Suppose that in a plastic injection factory, on the night shift, an employee suddenly clutches their chest and says they cannot breathe. The shift supervisor first applies the rules of physical first aid and informs the workplace physician; they do not leave the employee alone until a medical emergency such as a heart attack has been ruled out. After the medical assessment, it is thought that what happened may have been a panic attack. The supervisor takes the employee to a quiet room, breathes slowly alongside them and tells them in a calm voice that they are there. Once the situation has settled, the supervisor arranges their transport home and, the next day, reminds them of the organisation's confidential psychological support service. For more information on panic attacks, you can look at the article on panic attack symptoms.

How to Get Started in Your Organisation

This capability can be treated as a natural part of the workplace's emergency preparedness. The Occupational Health and Safety Law No. 6331 places on the employer the obligation to take every kind of measure, including providing training and information (Article 4), and provides that training be renewed to suit changing and emerging risks (Article 17). The Risk Assessment Regulation also requires psychosocial sources of hazard to be identified (Article 8). For the obligations specific to your company, I suggest consulting your occupational safety specialist and, if necessary, a lawyer.

1. Needs analysis: Review the workplace accidents, crisis events, sudden losses and emergencies caused by psychological difficulty that have occurred at your workplace in recent years. Ask your managers and employees whether they know what to do when they encounter such a situation. Check whether your current emergency plan covers moments of psychological crisis.

2. Programme: Plan hands-on training for the priority groups. The training should cover the basic principles, common situations (panic, reactions after a traumatic event, suicide risk), what not to do, referral resources and the self-care of the person giving first aid. Role plays and case studies make learning stick. Because a meta-analysis of workplace resilience programmes showed that the effect declines over time (Vanhove et al., 2016), support training with short refresher sessions. Add a short flow chart for moments of psychological crisis and a list of support resources to your emergency plan.

3. Measurement: Assess how prepared participants feel before and after the training. Use short post-incident reviews to identify what worked well and what needs to be improved. Monitor support service usage, absenteeism and post-crisis resignations.

You can find the corporate options for psychological first aid and manager training on the corporate services page. The article on psychological support after a workplace accident can also be a useful guide for the process after an accident.

Frequently Asked Questions

Does mental health first aid replace therapy?

No. Mental health first aid aims to offer the person safe and humane support in a difficult moment and to connect them to the right resources. For long-lasting symptoms or mental disorders, an assessment by a mental health professional and, where necessary, treatment are needed.

Who can give this support at work?

Anyone who has received training can. Managers, foremen, occupational safety specialists, workplace physicians, HR staff and volunteer employee representatives may be among the priority groups.

What should be done if an employee talks about suicidal thoughts?

Take the person seriously, do not leave them alone and listen calmly. Call 112 without delay or make sure the person reaches the nearest emergency department. Inform the workplace physician and the relevant people designated by your organisation.

Can the person giving first aid also be affected?

Yes. Giving support in a difficult moment can leave fatigue and emotional strain on the person giving first aid too. For this reason, self-care should be covered in training, and there should be a channel through which first aiders can get support when needed.

• #psychological first aid
• #occupational health and safety
• #crisis response
• #manager training

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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