How do I talk to a friend or family member about mental health?

There could be more to the story. Ask. Listen. Encourage. Check in. Here are some tips for having conversations about mental health with someone you care about.

What should I look out for?

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While everyone feels sad sometimes and has bad days, there are often telltale signs that indicate that there's more to the story. Look out for:

• Lack of engagement: They lose interest in activities they used to enjoy or want to hang out less.
• Change in communication patterns: You used to chat or hang on the regular, and now they’re MIA.
• Changes in hygiene and sleeping patterns: They’re sleeping less — or all the time. Their appearance and hygiene no longer seem to be a priority.
• Displays of sadness or anger: Their temper now has a hairpin trigger, or maybe they seem more down than usual.
• Withdrawal from social outlets: They’re missing from activities where they were formerly fixtures. (source: Cleveland Clinic)

What do I say?

So you've noticed some troubling signs that may indicate that your friend or loved one is going through something. How do you talk to them about it? 

• Ask. Reach out and ask if they're OK. Make sure you try not to accuse or blame them for your observations. A good way to do this is by using "I" statements. For example, instead of saying "You never hang out with us anymore, why is that?" you can say "I've missed hanging out with you recently, is everything OK?" Be direct; being hesitant to address concerns about mental health makes it seem like a taboo topic. This contributes to a stigma that can prevent people from getting the help that they need.
• Listen. This is the most important part. Give them your full attention, be empathetic, and acknowledge how they feel, even if you've never experienced the same feelings. If you have experienced mental health challenges, sharing that information can be a powerful, empowering tool for both you and the person you're trying to help.
• Encourage. Whether it's talking to family, other friends, or looking into therapy, encourage your friend to take action.
• Check in. Let them know you're there to help and that they can talk to you. If you get brushed off the first time, don't give up.

Note: Your friend or loved one may not be ready to talk about what they're experiencing. That's OK. You can't force someone to talk. You can still be supportive by making it clear that you are available when they are ready to reach out.

 

How do you provide support?

You've had a candid conversation, actively listened, and offered support. So what does support look like? Ask. Here are some questions you can ask:

• "How are you today?"
• "How can I best support you right now? Is there something I can do or can we involve others who can help?"
• "Checking in on you, I'm always here - how can I help?
• "Can I help you with the stuff you need to get done until you’re feeling better?"

You can play an important role in helping a friend or loved one build a positive, social support network. Here are ways to do that:

• Check in regularly. Call or text your friend once or twice a week. Check in with them after their therapy appointments to see how things went. Let them know that you are there.
• Include your friend in your plans. Even if your friend doesn’t always come, they will probably appreciate being asked.
• Learn more about mental health conditions. Find out more about what your friend is going through so you are better able to help in future situations.
• Avoid using judgmental or dismissive language, such as “you’ll get over it,” “toughen up,” or “snap out of it.” Your friend needs to hear that they are not alone and that they can get through this. Reassure them that everything will be okay and that you are there for them (source: NAMI). Instead, say encouraging things like "I care" and "I'm here for you." 

 

How do I make sure I'm OK too?

The best way to be supportive is to make sure you're in a good place yourself. Remember:

• Don't think you can fix it yourself. As an ally, your role is to be supportive, not try to fix their problems yourself. 
• Be patient. The recovery process takes time and you should be prepared for that. 
• Set boundaries. It’s OK to be specific about when you can or can’t be there. And don’t accept abusive or violent behavior (what are the signs of an abusive relationship?). If they don’t stop, do what’s best for your health and safety.  
• Don't go it alone. Involve others who can provide added support. Try to find someone who might be understanding of your friend or loved one's situation or be able to help. Your friend or loved one may feel cornered if you start involving others, so make sure to talk to them first. However, if you are concerned it's an emergency, call 9-1-1.
• Don't give up. If they reject you, it may be a defense mechanism. Sticking by someone you care about shows them that you're in this with them.

 

Additional Resources

Network of Care - A Comprehensive Directory of Services in Massachusetts

Emergency/Crisis Mental Health Supports

Cleveland Clinic- Do's and Don'ts for talking to someone with Depression

NAMI - How to talk to a friend