If a colleague cut their hand badly at work tomorrow, most of us would expect someone nearby to know what to do. In Malta, that expectation is backed by law. Since 2002, the Work Place (First Aid) Regulations have required employers to ensure that enough trained first aiders are present to help employees who are injured or become ill at work.

Now imagine a different scene. The same colleague tells you they have not slept properly in weeks, that they dread coming in, or that they have started to feel others would be better off without them. Who in the building is trained to respond? In most Maltese workplaces, the honest answer is nobody.

That gap makes little sense. Mental health problems are far more common than serious physical injuries at work, and the first person to notice is rarely a doctor or a psychologist. It is a manager, a co-worker, a teacher or a friend. It is time our law recognised this.

Mental health first aid (MHFA) is the help given to someone who is developing a mental health problem, whose existing condition is getting worse, or who is in crisis. It is offered until professional help is received or the crisis passes. Like physical first aid, it does not ask anyone to diagnose or treat.

The course was developed in Australia in 2000 by Betty Kitchener and Professor Tony Jorm, and is now taught in many countries. Its core is a simple action plan. The first aider approaches the person and assesses for risk, listens without judgement, gives support and information, encourages appropriate professional help, and encourages other supports such as family, friends and peer groups. In short, the first aider builds a bridge to help, without trying to cross it on the person's behalf.

We are not starting from scratch. In 2015 the Richmond Foundation was licensed as Malta's national provider of Mental Health First Aid. It runs the standard adult course, a refresher for those whose certification is due to expire, and a youth course for people who work with adolescents. It has also brought the training to voluntary organisations in partnership with the Malta Council for the Voluntary Sector.

Most encouragingly, the Ministry for Health and Active Ageing and the Parliamentary Secretariat for Local Government have launched a nationwide project, run with the Richmond Foundation, that offers MHFA courses through every local council in Malta and Gozo. The Ministry covers the full cost, so participants pay no fees. Local councils are exactly the right place for this. They are close to residents, trusted, and able to reach people who would never attend a course at work.

This is a strong and welcome start. However, voluntary uptake, however generous, depends on individuals finding the time and the interest. Those who most need a trained person nearby, such as the employee in a small business or the student who is struggling quietly, cannot count on one being there.

We made physical first aid a legal duty because we accepted that injuries are predictable, that minutes matter, and that it is unreasonable to leave a response to chance. Each of those arguments applies to mental health. Mental health difficulties are predictable in any group of people. Early, calm support can change the course of a crisis. And leaving it to chance means leaving it to whoever happens to be in the room.

The existing regulations already speak of employees who "become ill at work". Yet in practice, first aid training and kits are designed almost entirely around the body. Placing mental health first aid on the same legal footing would send a clear message: in Malta, the mind is not an afterthought.

Workplaces and educational institutions are natural settings for MHFA. Managers, lecturers and support staff see the same people every week, often notice changes before anyone else, and are well placed to offer an early, informal conversation. That is where a legal duty would make the biggest difference.

A legal requirement need not be heavy-handed. The first aid regulations, now part of the occupational health and safety framework under Chapter 646 of the Laws of Malta, could be amended so that an employer's assessment of first aid needs must cover mental as well as physical health. Larger employers, schools, colleges, universities and the public sector could be asked to train a minimum number of mental health first aiders, with smaller employers given more time and support. The national scheme run through local councils shows how the cost can be shared, so the duty does not fall unfairly on small businesses.

The law should also be clear about what first aiders are not. They are not therapists, and they should never become someone's only source of support. They need clear routes for referral, refresher training, and somewhere to turn when a conversation stays with them.

Some will say this is one more burden on employers. Others worry that a certificate becomes a box to tick while workloads, poor management and stigma go untouched. These concerns are fair. Mental health first aid cannot replace the duty to manage psychosocial risks at work, and it must never become an excuse to ignore them. But nobody today would argue that a first aid kit excuses an unsafe workplace. Both are needed: prevention to reduce harm, and trained people to respond when harm happens anyway.

We would not accept a workplace where nobody knows how to stop a bleed. We should no longer accept one where nobody knows how to begin a conversation that could save a life.

If you or someone you know needs support, call the Mental Health Helpline on 1579, Supportline on 179, or the Richmond Foundation on 1770. In an emergency, call 112.

Dr Katya De Giovanni is a chartered occupational psychologist