Mental health: A helping hand

How to help a family member or friend through a mental health episode.

Health Agenda magazine
July 2016

Mental illness is a serious issue that is finally receiving some overdue attention. According to SANE Australia, each year, nearly one in five Australians experience symptoms, with 45 per cent affected at some stage throughout their life. While mental illness isn’t generally life threatening, the suicide rate in people with serious mental illness is 15 per cent, compared with about one per cent for the general population.

Although these figures make mental health look like a growing problem, this may not be the case.

“There's no evidence of a strong increase in common mental illnesses in recent years in Australia,” says Betty Kitchener, the founder of Mental Health First Aid, an organisation which runs training courses on recognising and helping people with mental health issues. “What we are seeing is a greater public awareness and openness about discussing mental illness.”

And that’s a big step forward – particularly as it’s estimated two-thirds of Australians who experience a mental health problem do not receive treatment within 12 months.

How to spot the warning signs

Being aware of the early signs of mental distress can help you detect when someone is struggling. Some symptoms can be physical, Kitchener says, such as someone being tired all the time, being sick and run down, having frequent headaches and/or muscle aches, rashes, weight loss or gain, difficulty sleeping, reduced reaction time and a dishevelled appearance.

There are also behavioural cues that signal things may not be quite right. “These may include withdrawing from others, not getting things done, increased accidents or mistakes, erratic behaviour, an inability to concentrate, indecisiveness, reduced participation in work or social activities, memory problems, loss of confidence, or conflict with work colleagues, friends or family members,” she says.

Of course, when people start making mistakes or being difficult it can be easy to react with impatience. However, this means that, instead of someone getting the help they need, they find their workmates or friends withdrawing from or getting frustrated with them, leading to a downward spiral of alienation and shame. Arming yourself with the right things to say and taking the time to have a chat could be the trigger that encourages the person to get help.

What to ask

Starting a conversation with someone you’re worried about can be difficult but don’t put it off. Try to pick a good moment – when it’s just the two of you and neither of you is in a rush.

“Engage the person by asking about how they’re feeling and how long they have been feeling this way,” Kitchener suggests. “Let them know you’re available to talk when they’re ready. Don't put pressure on them to talk right away.”

It may be enough to show you care. Be prepared if your family member or friend doesn’t want to talk. “Respect the person’s privacy and confidentiality unless you're concerned they’re at risk of harming themselves or others,” she says.

Useful pointers

Ask questions that show you genuinely care. If you’re unsure what your loved one or friend is saying, ask for clarification. For example, statements such as ‘I just can’t take it anymore’ might indicate he or she is having suicidal thoughts. It’s important not to dismiss these.

Instead, try saying something such as, ‘When you say you don’t want to be here any more, are you feeling suicidal?’ It may be a huge relief to the other person to be able to open up. Summarising what your friend has said by restating key facts and feelings may also help you both.

Listen not only to their words but also to the delivery. “Tone of voice and non-verbal cues will give you extra clues about how they’re feeling,” Kitchener says.

Use minimal prompts such as ‘I see’ and ‘ah’ when appropriate to keep the conversation going. Finally, ask if they feel they need help managing their feelings. “If they do, suggest some options for seeking help and encourage them to use them,” she says. One of the first steps they could take is speaking to a mental health professional.

What not to say

It seems obvious but it’s worth repeating: It’s never helpful to say ‘pull yourself together’ to someone with a mental illness.

Some other no-nos, according to Kitchener, include trivialising the person’s experience by pressuring them to ‘put a smile on their face’ or ‘lighten up’. Even saying something you might see as positive, such as ‘you don’t seem that bad to me’ can come across as dismissive and make them feel more isolated.

Aim to keep things empathetic, but matter of fact. “Avoid speaking in a patronising tone of voice, using overly compassionate looks of concern or becoming too involved or over protective. Don’t be hostile or sarcastic about their replies,” Kitchener says. “Rather, accept these responses as the best the person has to offer at that time.”

Lastly, resist the urge to try to solve their problems. You’re helping by just being there to talk. Sometimes that’s enough.