News : An order of 17 June 2026 has overhauled the standard agreement behind the French public scheme Mon soutien psy. Covered sessions rise from eight to twelve a year, the session fee is set at 50 euros including the assessment interview, access to a registered psychologist becomes direct with no compulsory prior visit to a doctor, and the health insurance system covers 60%, with the balance falling to the complementary insurer (Order of 17 June 2026, Journal officiel). What has just improved is the step after. Someone inside the company still has to spot the problem, say something, and point towards it.
This article is for HR managers, learning and development leads and site directors who hesitate, often for a sound reason: the fear of putting employees with no clinical training in front of situations that overwhelm them. Here is the real role, its exact limit, and how the person holding it is protected.
A workplace mental health first aider is a volunteer employee, trained over two days, who spots the signs of distress or crisis, opens a conversation without judging, listens and signposts towards appropriate help. They make no diagnosis and provide no treatment. They make the connection, they do not stand in for a health professional.
A simple definition of the mental health first aider
The most useful parallel is physical first aid: an employee trained in first aid does not stitch and does not prescribe; they make the scene safe and call for help. Mental health first aid follows the same logic, applied to the mind: spot, make contact, support, signpost.
In France the scheme is run by the PSSM France association, sole holder of the licence for the international Mental Health First Aid programme, and the standard course lasts two days. The country has passed 300,000 trained first aiders, a milestone announced in April 2026 when it had been targeted for 2027, with a new goal of 750,000 by 2030 (Egora, 24 April 2026). It is neither a job nor a position of authority, but a skill exercised by volunteers within a framework the employer sets.
What the role looks like day to day
What strikes me when I talk to first aiders in post is how ordinary their days are: nothing happens most of the time, then something happens, and the fact that they were trained changes the outcome. The role comes down to six moves.
- Notice a change: repeated lateness, someone who no longer eats lunch with the team, unusual irritability. What you observe is a gap against the person themselves, never against a norm.
- Decide to go and see: plenty of people see the signals, few dare say the next sentence.
- Hold a short conversation, somewhere quiet.
- Name a referral route and make the first step easy: a number, a link, an offer to go along.
- Get back in touch a few days later. One sentence, not a follow-up process.
- Report an organisational need, never a named case.
What is not on the list: treating, monitoring, assessing, deciding. A mental health first aider opens no file and writes no named report.
How a conversation actually starts
This is the question that comes up most often when I run a mental health first aid course: “what do I actually say?” What I see is that participants do not dread the serious situation, they dread the first sentence. There is no magic formula, but there is a way of doing it that avoids the two classic mistakes, interpreting and advising.
- Describe facts, not states. Not “you look depressed”, which is a label, but “I saw you stay late three evenings this week.”
- Ask an open question, then stay quiet. Silence is the main tool, and listening without filling the gap is the slowest thing to learn.
- Do not promise a secret you cannot keep. If the person expresses suicidal intent, the first aider does not keep that to themselves, and it is better to say so upfront.
- End with a referral, not a solution: not “here is what you should do”, but “here is who can help you”.
In its Absenteeism study of 9 June 2026, Malakoff Humanis reports that half the employees concerned do not dare raise the subject at work. So the first effect of the scheme is not therapeutic, it is social.
The dividing line: who does what
This is the backbone of the whole thing. A mental health first aider signposts: they do not treat and they do not diagnose. They are not the company psychologist, and no more are they the HR channel for disciplinary matters.
When I work inside a company as a fractional HR director, this is the confusion I watch settle in fastest: as soon as an employee is identified as a first aider, everything gets brought to them, an overloaded department as readily as a team conflict. So I repeat the same sentence, and it is a short one: they signpost, they do not treat, and they do not handle HR matters.
| Situation or action | The mental health first aider | A health professional | The employer |
|---|---|---|---|
| Spotting an unusual change | Yes, this is the heart of the role | The occupational physician, at individual reviews | Creates the conditions: training, time, referral routes |
| Naming a disorder, making a diagnosis | Never | A doctor or psychologist, they alone | Never asks for such an opinion |
| Listening and supporting in the moment | Yes, the course prepares for it | Conducts the clinical interview | Makes the conversation possible in work time |
| Proposing treatment or sick leave | Never | Treating doctor, occupational physician, psychologist | Has no business knowing the medical content |
| Signposting to a named referral route | Yes, this is where the role lands | Receives the person and takes over | Makes the routes visible and known |
| Responding to a life-threatening emergency | Calls 15 and stays with the person | Takes over immediately | Has a written emergency procedure |
| Conflict, discipline, fitness for work, harassment | Outside the role: points to the right channel | The occupational physician, on fitness for work | HR and management, with the occupational health service |
| Assessing psychosocial risks | No | No | Yes, an obligation of its own: articles L. 4121-1 and R. 4121-1 |
Two confusions keep coming back. The first: believing that training first aiders excuses you from acting on causes. The employer’s duty of care, in article L. 4121-1 of the French Labour Code (in French), covers physical and mental health, and cannot be delegated to volunteers. That obligation is the subject of psychosocial risk prevention, which is a different piece of work. The second: seeing the first aider as an information sensor working for HR.
Where my role stops. I am an HR professional, a trainer and a coach. I am not a doctor, a psychologist or a lawyer. This text is a general marker, not medical advice and not legal advice. For an individual situation, the right people are the occupational physician, the treating doctor or a psychologist. In case of immediate danger in France, call 15; in case of suicidal distress, 3114, the national suicide prevention line, free and open 24 hours a day, seven days a week. On any point of law, such as fitness for work, harassment or employer obligations, have your specific case validated by an employment lawyer or by your occupational health service.
Signposting to whom: the real referral routes
“Signposting” means nothing if nobody knows where to. The list of routes should fit on one page, posted up and kept current.
- The occupational physician and the occupational health service. Any employee may request a visit on their own initiative, without going through their manager (article L. 4624-1 of the Labour Code, in French). Many do not know this.
- The treating doctor, often the simplest way in.
- A psychologist, including those registered with Mon soutien psy: since the order of 17 June 2026, access is direct and twelve sessions a year are covered; official directory at monsoutienpsy.ameli.fr.
- 3114, the French national suicide prevention line: free, confidential, round the clock, for the person in distress and for the person who is worried about them.
- 15, the French emergency medical number, in a life-threatening emergency.
- Internal schemes where they exist: a helpline, a workplace social worker. Check they are live before naming them.
Signposting is not handing over and disappearing: it is offering, leaving the choice, staying reachable. The decision belongs to the person.
Protecting the first aider
Almost nobody asks this question before a rollout, and it is the one that decides whether the scheme survives its first year.
The emotional load can be handled
Listening to someone who is struggling leaves a mark. Never train one person alone: isolated, they will have nobody to talk to after a hard conversation. Two at minimum, plus a chance for first aiders to talk to each other two to four times a year.
Confidentiality protects them too
A written rule everyone knows, that what is said does not travel except where life is at risk, shields them from the requests that will come. I have seen managers ask “so, what did he tell you?” Without a written rule, that is a hard question to refuse.
Availability has limits, and they get written down
A first aider is not on call: no personal number circulated, no evening or weekend availability, no long-term follow-up. They are entitled to say “I cannot right now, but here is who can help you”.
They are not responsible for the outcome
This is the heaviest point and the least often said. Their responsibility covers what they do, spotting, speaking, signposting, raising the alarm, never the result. It is for the employer to say so at rollout, not after a serious incident.
What the company has to put around it
Training without a framework produces disappointment. Five points get settled in writing before the first session.
- Genuine volunteering: nobody is appointed by default.
- Visibility: who the first aiders are, and how to reach them.
- Time: a conversation happens in work time.
- The list of referral routes, checked and posted.
- The link to prevention: anonymous collective feedback feeds the assessment of psychosocial risks (in French) and the update of the single risk assessment document (in French).
The first thing I look at, when a management team tells me it wants to “train some first aiders”, is what has been planned around it: who will be visible, in whose time, with which referral routes. Without that, what I mostly see is well trained volunteers who never get the chance to be useful, and a scheme that fades for lack of a framework.
The order that works best is broad awareness first, training second. I often suggest the workshop for talking about mental health at work before the mental health first aid training I run in companies. On who to send on the course, I set out my own criteria in who to train in your company.
What this article does not cover
- No care protocol and no clinical guidance: this text describes a first-contact role, not a health practice.
- No individual situation: only a direct examination allows one to be judged.
- The legal side is a marker only. Fitness for work, harassment, employer obligations: have them validated by an employment lawyer or your occupational health service.
- The official terms of the course are a matter for PSSM France.
- Nothing here about how work is organised: workload, autonomy, recognition, management. Those are the real causes, and first aid does not address them.
FAQ
Can a mental health first aider make a diagnosis?
No, never, and it is the most important point of the whole scheme. They do not identify a condition and do not say “you are burning out”. They observe signals of change, open the conversation, signpost. Diagnosis belongs exclusively to a doctor or a psychologist.
Do they have to report to HR what they hear?
No. What is said does not travel, except where life is at risk, in which case safety comes first. What can travel is anonymous collective observation: recurring tension in one department, a spike after a reorganisation. That rule is written down before rollout.
How many people should be trained?
There is no regulatory ratio, unlike the French workplace first aider for physical injuries. My field marker: never a single person, who would end up alone with the emotional load. Two at minimum on a small site, more as soon as headcount runs into the hundreds.
What happens if a first aider feels out of their depth?
They are entitled to say they cannot, and that has to be planned for. They then signpost to a referral route, the occupational health service, 3114, or 15 if life is at risk, then talk it over with another first aider. Stopping is not a failure: it is applying the limit of the role.
Does this role replace the occupational physician or the psychologist?
No, it makes them more reachable. What it adds is shelter for the first conversation, the one that would not otherwise have happened. Health monitoring stays with the occupational physician, under article L. 4624-1 and following, and psychological support with a professional.
What I take from it
Training first aiders does not turn a company into a place of care, and that is precisely what makes the scheme acceptable. A few volunteers are asked to know how to see, to dare one sentence, to know the right door. The rest belongs to the employer and to health professionals.
If you are unsure whether this role fits your organisation, write to me and let us talk about your context. I also run a workshop for talking about mental health at work, which is often the first step.
Sources
- Order of 17 June 2026 amending the standard Mon soutien psy agreement, Journal officiel, text JORFTEXT000054273988. Legifrance
- “La barre des 300 000 secouristes en sante mentale formes en France franchie”, Egora, 24 April 2026. Egora
- Absenteeism study 2026, press release, Malakoff Humanis, 9 June 2026. Malakoff Humanis
- French Labour Code, article L. 4121-1 (duty of care), article R. 4121-1 (single risk assessment document), article L. 4624-1 (individual health monitoring), Legifrance. L. 4121-1, R. 4121-1, L. 4624-1
- “Prevenir les risques psychosociaux (RPS). Ce qu’il faut retenir”, INRS, accessed 2 September 2026. inrs.fr
- “Remboursement de seances chez le psychologue : dispositif Mon soutien psy”, Assurance Maladie. ameli.fr, official directory: monsoutienpsy.ameli.fr
- 3114, French national suicide prevention line. 3114.fr
