Provider Quality

Everyone has mental health needs. You likely have friends or family members who have struggled with a mental health issue – or you have struggled yourself. When people close to you are upset, it can make you uneasy. You want to help, but you may not know how. Sometimes, you don’t even know if it’s OK to talk about it.

Perhaps your friend or family member has told you he or she is having a hard time. Maybe the person asked for help. Or you may have concerns about the person, such as the friend or family member is no longer taking good care of him/herself, or going out or getting to work, or is unusually angry or irritable all the time.

You might “see it in the person’s face” or in their voice, but not always. How can you respond? And how do you know you won’t make things worse instead of better?

The first and most important thing to remember is that talking to someone openly about mental health issues is not going to make anything worse. Reaching out in a caring way is a positive gesture. The best first step is usually to express your concern and support. Tell the person that you care and that you want to help. A good opening might be to say, “I’ve been worried about you. Can we talk, or is there someone else you’d like to talk to? I care and I want to listen.” Be straightforward and listen with compassion, but don’t push. Let the person say as much or as little as they want. Show understanding and don’t judge. Be patient.

Don’t try to fix a problem or try to change the mood by saying things like “Cheer up!”, “I’m sure it will pass,” or “My sister felt the same way and got so much better when she started to exercise.”

It’s easy to fall into the conversational habit of moving from listening to talking about one’s own experiences, and most of us jump quickly to attempt to “fix the problem” because that makes us feel useful. Try not to do that before you have listened carefully and allowed the person time and space to talk. Even if you disagree with what they’re saying, listen without passing judgment, and accept the way they are feeling as valid. Sometimes just being allowed to talk about feelings or problems is helpful and takes away some of the fear that people in a mental health crisis often experience. You can make constructive, gentle comments that remind the person, “I know you sometimes feel as though you’re just not good enough, but I want to make sure you know that I value your warmth, expertise, and friendship.”

Actions are important, too. Continue to include your friend or family member in your plans even if they turn you down. Offer tangible things, like a ride to an appointment, a visit to their home, an invitation to take a walk. And keep trying. Keep calling even if it’s just to say “Hi, I’m thinking about you.” And yes, it is OK to make suggestions, and even better if you suggest something you can do together, like take an exercise class, work on a journal, or watch a movie together. Be ready for them to say “thanks but not now,” but don’t stop trying. Remember, you cannot “fix” this, and your role is to be loving and supportive. A medical analogy is often useful: You wouldn’t try to cure your friend’s diabetes or broken ankle, but you could suggest they see a doctor and help them make an appointment or get to an emergency room or treatment center.

Remind your friend or family member that depression or anxiety or whatever words they use to name the way they are feeling can be signs of a mental illness, and that mental illness can and should be treated. Let them know they deserve to get treatment and to feel better. Look at your own attitudes toward therapy and medication, and remember that medications to treat mental illness have just as much scientific validity as those used to treat heart failure and diabetes. Antidepressants do not “make you happy” and are not a crutch any more than insulin is. They correct an underlying chemical imbalance that, left untreated, leads to negative and hopeless thoughts and feelings, as well as to the mistaken perception that things will never get better and that nothing will help.

Finally, be honest. If you’re worried about someone or if you fear that they are thinking of suicide, tell them about your concern. Remind them that help is available and point them toward help lines and other resources. If your friend or family member admits that they are planning to kill themselves, they need to be connected to a suicide hot line or go to an emergency room.

There are several excellent websites with great information about mental illness and about how to be a helping friend. I encourage you to take a look at them so that you become more comfortable in the knowledge that you can make a difference.

• https://www.samhsa.gov/families
• https://www.nami.org/Support-Education
• https://Mentalhealthfirstaid.org