Spotting Hidden Warning Signs for Mental Ill-Health

This Mental Health Awareness Week, we want to help you take action. The Mental Health Foundation has chosen ‘Action’ as the theme for this year’s Mental Health Awareness Week because while awareness is vital, real change comes with action. They are asking people to engage in actions that promote good mental health ‘for yourself, for someone else, for all of us’. Even small actions can go a long way to helping people feel less powerless.

One of the ways you can take action in a meaningful way is by understanding how to notice that someone may be struggling with their mental health.

When someone is struggling with their mental health, it doesn’t always appear in obvious or dramatic ways. One of the reasons that mental health training is so important is that struggles can often appear in a quiet or silent way. Feelings of low mood are woven subtly into everyday habits as emotions and interactions become shadowed and more difficult to recognise. Often, people have learned to mask deep feelings due to concerns about being seen or treated differently, making the hidden signs of mental health harder to spot. It is more important than ever that we learn to go beyond the surface in an attempt to really understand others and be there for them when they need someone.

When people don’t know what to say, they say nothing. Training gives people the confidence to take action. Not only does it raise awareness, but it also encourages early intervention, increases confidence in dealing with mental illness and reduces stigma. Awareness is a great starting point, but awareness alone isn’t enough. Real change happens when people know what to do next. 

At St John Ambulance, we believe in the power of looking after the whole person. First aid training covers physical injury and illness, while mental health training promotes resilience and well-being. A truly supportive workplace is one where people feel safe, seen, and valued, not just physically but mentally too. Where mental health support is not an ‘extra’ - it’s a core part of effective first aid and essential to a safe and healthy workplace.

 That’s why we’ve created a mental health suite designed to aid an understanding of the hidden signs of mental health. We offer training that can prepare you, or other members of your team, to handle every kind of emergency - from physical injuries to mental health crises. Ensuring proper training is given at every level is an important step toward fostering compassion, awareness, and early intervention as well as helping to build a culture of care where everyone can thrive, not just survive. This helps people to learn skills that will stay with them everywhere: on the commute home, through the weekend and into family life. Because emergency first aid goes beyond the 9-5.

According to research, stress, depression, or anxiety cause 46% of work-related ill health, with 1 in 10 people considering leaving work, citing mental health as the key reason. Mental Health Awareness Week is a great opportunity to open conversations in the workplace and ensure staff feel supported now, and it is a good starting point for conversations that can lead to training that provides cover all year round.

Mental Health in the Workplace

Workplace stress can lead to both reduced productivity and increased absences. In fact, stress, depression and anxiety accounted for the majority of days lost to work-related ill health in 2024/2025 at 22.1million. These figures undoubtedly show why staff wellbeing is so important, and it is everyone’s responsibility to do something about it.

People aren’t suddenly less resilient. They’re responding normally to sustained pressure, and organisations need to respond. Stress, burnout and pressure aren’t just work problems – they're a part of everyday life, which is why spotting the signs as early as possible is so crucial.

Our research shows that over 73% of UK employees believe mental health first aiders would improve workplace culture.  And nearly 90% of employers feel that having trained mental health first aiders helps break the taboo around mental health. That’s why with our specifically designed courses, you’ll find modules on recognising signs, sharing concerns responsibly and creating a culture of confidence – plus much more.

Hidden signs of mental health can surface in even the most unexpected places. You may notice someone becoming unusually withdrawn, easily overwhelmed by small tasks or suddenly showing disinterest in things they once enjoyed. Signs could even appear as changes in sleep, appetite or energy levels – which can be more difficult signs of emotional strain to identify and act upon. How can you tell if someone’s perfectionism is masking something deeper, or if someone’s irritability is a sign of something else? Paying attention to quiet cues both in ourselves and in others can help open the door to more meaningful conversations.

In these scenarios, timely support can make a lifesaving difference. Everyone carries their own unseen burdens, and a little awareness can go a long way in ensuring that these don’t spill over into mental health issues that can have devastating results.

Spotting Behavioural Changes

Behaviour change is key, this may be the more ‘typical’ signs such as: 

• Seeming ‘sad’
• Lacking energy
• Loss of interest in day-to-day life
• Withdrawal
• Negative thoughts
• Anxiety
• Low self-esteem. 

But it can also be less ‘typical’ signs such as: 

• Aggression
• Feeling full of energy
• Forgetfulness
• Sleeping too much or too little
• Eating too much or too little
• Having strict habits or routines around food. 

Just because someone may be showing one or more signs of the above does not mean that they are experiencing poor mental health, but that they could be.

All of these are to be compared to the person’s ‘normal’ behaviour, for example, a person sleeping 10+ hours isn’t unusual if the person normally sleeps for longer periods, whereas it would be unusual for a person who normally only sleeps 6 hours or less.

If we identify these changes in an individual, then remember: 

• Treat the person respectfully. They may not want to talk immediately. This is fine, we may need to come back at another point (if it is not safe to leave the person, contact emergency help)
• You are not a mental health professional and therefore you do not provide a diagnosis or counselling. You can signpost the person to find appropriate support if they wish
• Be an active listener, make sure you don’t try to find a solution to their problems, but act in an empathetic manner and avoid unhelpful phrases such as ‘I know what you are going through’, ‘It could be worse’, 'At least you have’
• Try to signpost the individual to a mental health first aider if these are available