For someone opening up about their mental health, it is difficult. But it isn’t necessarily any easier to be the person they open up to. It can feel like an immense pressure, especially if you are the only one they have opened up to. Chances are, the reason you were chosen to be spoken to is because they believe you are trustworthy, caring and compassionate – so it is a compliment – but it is a compliment with strings.
Unsure of how to respond when someone opens up to you about their mental health issues? I’ve put together some useful info to help you respond when you don’t know what to say.
Probably the most important part: listen. Try to allow them to complete what they are saying without interruption (including questions). Sometimes thoughts won’t come out in a clear order, but this phase is important for the person opening up.
Take it seriously
Try not to dismiss it as nothing. Saying things like ‘it can’t be that bad’ or ‘you are just having a bad day’ only makes it harder for someone with a mental illness to open up. Being believed is often a major fear for people with mental illness, and trying to minimise how they are feeling with such statements can make them not want to seek help that could potentially be life-saving. It is also important not to try to make light of the situation and make jokes about it – comments such as ‘I had better hide the razors!’ or ‘Well, you can’t have a slice of my birthday cake if you are just going to throw it back up!’ although are most likely to be made in order to defuse tension, are in poor taste and can be hurtful. They minimize the seriousness of mental illness and can make the person who was trying to open up stop talking as they feel they are not being taken seriously.
It is important that you don’t use any thing said to you as gossip material. It is to be assumed that the person opening up expects any information they give to you to be kept in confidence* and in general, this is not something to be shared with others without permission from the person telling you.
*There may be reasons why you should not keep the information you are told to yourself, such as if the person indicates plans to harm themselves or others, or if they are hearing voices no one else can hear or seeing things that aren’t there – in such cases contact the relevant medical professionals (see below ‘Tell someone else if you have to”)
You may have been through something similar, and understand what they are going through: let them know, show empathy. It helps a lot of people to know they are not alone. But remember, this is not about you right now, so be careful not to turn the conversation to be about your mental health struggles, and don’t compare their issues and struggles with your own – this isn’t a competition.
Try to avoid comparing this person’s situation to things you have seen on TV or in movies. Often, mental health is over-dramatised, glamourised and over-simplified in media, so the symptoms presented may not seem as bad as you expect. Equally, there are lots of fairly common symptoms for different mental health issues that are not shown in media, and each person will experience their illness differently, so do not expect to see mental illness as portrayed on film.
It is also important that you don’t try to compare this person’s illness to others. ‘Lots of people have it worse than you,’ ‘you have nothing to be sad about’ – although you may be trying to get the person to realise they have a good life, this will not affect their mental illness (except potentially in a negative way). Mental illness doesn’t affect people based on their social or financial circumstances. Just like the common cold, mental illness can affect any person at any time.
Let them know. Don’t pretend that you understand when you don’t; this is not going to be helpful to anyone. Ask the person if they can explain further or in a different way – they might not be able to as sometimes it is tough to find the words, so let them know it is ok if they can’t. Explain back to them what you have heard and how you understand it and check this is correct – it is good for both of you to know you are on the same page, or if you are not.
If you are looking to understand further, do some research after the conversation has ended. Learn about mental health and how to support others with mental health problems from reliable sources, such as the NHS website, Mind and The Blurt Foundation.
Make time to talk again if needed
Some conversations can take a long time, and there may be reasons that you might need to stop it short. Also, someone’s mental health is not going to be sorted in one conversation (although that initial conversation can take a huge weight from the person). Let them know they can reach out to you again if they feel they need to – but there are times that you may be busy and not available.
Show them you will be there if they need someone
Telling someone you will be there is one thing, proving you will is different. If they try to call you and you are busy, reply as quickly as possible, even if it is a text explaining that you are busy, but are thinking of them and will call them later. Remember that everyone appreciates random messages (for example via Facebook or text) but don’t make the conversation all about mental health. Send a message about something you both enjoy, or have previously found funny together, recommend a book or movie, keep the conversation open and light like you normally would, but allow it to be brought back to their mental health if they want.
Don’t treat them differently because of their mental health
It is really common for people to treat people differently when they are aware of a mental health issue. People often begin with a ‘How are you doing?’ complete with a sympathetic, knowing look that implies they are only referring to the mental health – it isn’t intended, but it happens. You may also feel as though you want to avoid talking about certain topics (your own emotions for example), but this isn’t necessary. Talk to them as you always have, like you would if they told you they had broken an arm. Some things are difficult, but they will tell you if they don’t think they are up to it.
Tell someone else if you have to
It is important that you know that you cannot necessarily provide the help that this person needs. They may be experiencing symptoms that require professional medical help (such as indications of self-harm, or hallucinations). In such cases, encourage them to speak to their doctor, therapist or counsellor – with you present if required. If you can’t encourage them to talk to a medical professional, then call a helpline on their behalf, such as your local crisis support team, the Samaritans or Mind.
If the situation is serious, but not life threatening, call the NHS on 111 – this includes worsening mental health symptoms, experiencing mental health symptoms for the first time, wanting or planning to self-harm, or if the person has self-harmed but it does not appear to be life-threatening.
If the situation is life threatening mental health emergency, call the emergency services on 999 as you would with any medical emergency.
(*Numbers and links are UK based, for other countries search ‘mental health support’ or ‘mental health helpline’ and your country)
Talking about and being talked to about mental health can feel a little daunting at first, but the more we share, the less difficult it becomes. And the more we break the taboo. After all, mental health issues will affect one in four people, it is one of the leading causes of illness worldwide.
It needs to be talked about.