Background Staff wellbeing is a growing concerns in healthcare settings, where increased workload, emotional demand, and organisational pressures contribute to stress, burnout, and reduced psychological safety. Mental Health First Aid (MHFA) training is an evidence-based programme designed to support early recognition of mental distress, provide initial reassurance, and facilitate signposting to appropriate help. Its specific contribution to staff wellbeing within hospital and associated healthcare settings, however, remains underexplored. This paper presents a protocol for a realist review that will examine how, why, and in what contexts an MHFA programme may support staff wellbeing within hospital and associated healthcare settings. Table 1. PICO (Population, Intervention, Context, Outcomes) framework. PICO element Key concept Inclusion/Exclusion criteria Population Healthcare Staff in hospitals and related healthcare settings Inclusion: Healthcare Staff in hospitals and related healthcare settings who have participated in, delivered, or been exposed to MHFA programmesInclusion: Studies from adjacent healthcare contexts (e.g., community or specialist settings) will be considered where they provide transferable explanatory insight relevant to hospital staff wellbeingExclusion: Healthcare Staff in hospitals and related healthcare settings who have not participated in, delivered, or been exposed to MHFA programmes Intervention Mental Health First aid Training and associated Implementation approaches Included: Mental Health First aid Training and associated Implementation approaches Context Time Inclusion: Publications 2010–2026. Limiting the search will support access to more recent date research articles Language Inclusion: Publications in English Hospitals and related healthcare organisational settings Inclusion: Hospitals and related healthcare organisational settings, including leadership support, team culture, psychological safety, stigma, and implementation conditionsInclusion: Studies from adjacent healthcare contexts will be considered where they provide transferable explanatory insights Outcome Proximal Confidence to provide peer support Reduce mental health stigma Improved recognition of mental distress Intermediate Help seeking behaviours Psychological safety Perceived Organisational Support Distal Patterns of absenteeism or retention Use of Staff Supports Broader Impacts on staff wellbeing Methods This protocol for a realist review will follow RAMESES standards to examine the contribution of MHFA training to staff health and wellbeing. The review will proceed through five stages: (1) clarifying the scope of the review; (2) developing initial programme theories; (3) searching for evidence; (4) extracting and synthesising data using realist logic; and (5) refining the programme theories. An expert panel will be convened to support the development and refinement of the programme theories as the review progresses. Conclusions This realist review protocol will guide the development of context–mechanism–outcome (CMO) configurations to explain how MHFA training may operate within different hospital contexts. The resulting programme theories may contribute to organisational strategy, leadership practice, and policy decisions aimed at improving staff wellbeing in acute hospital settings.
Donegan et al. (Fri,) studied this question.