Someone you care about appears to be struggling with their mental health

Questions and strategies to help you have a supportive conversation when someone you care about appears to be struggling with their mental health.

This is one of a series of topics in the Supportive conversation library. Review the guidelines including what to do if you are concerned for another’s safety before engaging in the conversation.

What do you notice?

You notice someone you care about appears to be struggling with their mental well-being. Perhaps you notice a change in their appearance from what’s normal for them, such as a decline in personal care. Maybe they withdraw from activities they previously enjoyed, or they find it challenging to perform in these activities as they once did. Maybe they talk about a general apathy about life or mention they feel disconnected from themselves or others. Maybe you just notice that something has really changed for this individual, from their presenting behaviour to the thoughts they communicate.

What do you need to understand?

We all experience good or poor mental health over our lifetime, just like we go through phases of good or poor physical health. This is expected as we adjust to different life circumstances. Like physical health, we can look at mental health on a continuum in which we are in a “healthy” state on one end to an “ill” state on the other.* Poor mental health is a concern when someone isn‘t able to bounce back, meaning their mental health appears to be stagnant in an unhealthy place or declining further.

*Mental Health Continuum Model, The Department of Defense, 2017

What do you need to consider?

It’s important to catch warning signs of declining mental health early to help an individual bounce back. Catching warning signs early can also help reduce the severity of a developing mental health concern. Noticing changes in an individual’s behaviour or thoughts can help them recognize that things have changed and they might need help. Mental health can be hard for us to recognize on our own, as we experience our lives in our heads and sometimes don’t notice changes to the way we feel or behaviours that negatively impact our lives. Having another’s perspective can help an individual notice if something has changed for them and is negatively impacting their life.

Engaging in a supportive conversation

Have the right mindset


Come into the conversation from a supportive place. Watch out for your hidden agenda, such as wanting to fix or influence the individual. Avoid “you” statements, such as “you always do…”. They often make the person feel judged or invalidated. Be curious and have the mindset that you don’t know anything about their experiences.

Questions to check your mindset:

  • What are my assumptions about this situation?
  • How will I keep my assumptions out of the conversation and be supportive?
  • What do I hope to achieve by having this conversation?
  • How can I keep my desires for an outcome from interfering with my ability to be supportive?

Notice 

Notice changes in behaviour that aren’t typical for the person and ask about them. Don’t add your assumptions or opinions about why those changes may be happening. If you’re wrong, the person may be discouraged from continuing the conversation.

Examples of “noticing” conversation starters:

  • “I noticed that you don’t seem yourself lately, and I’m concerned for you. Are you feeling okay?” [Be prepared to share what’s different.]
  • “I noticed in conversation you sound down. What’s changed for you lately?”

Preparing for the response

Not all supportive conversations lead to an understanding of how you can help. Remember, the goal of a supportive conversation is to understand the individual’s needs and wants and whether they’re open to assistance. The guidelines below can help prepare you to respond when the person is open or not to a discussion.

When the individual doesn’t appear open to discussion – a closed-door response:

Not everyone’s comfortable being asked how they feel or exploring reasons why they’re behaving differently. You might get avoidant responses, like “I’m fine” or “It’s none of your business.” If this is the case, you can reiterate your concern and leave an opening for them to walk into when they’re ready.

  • “I was concerned about you and wanted to ask. If you say you’re okay, I’ll trust you. If that changes, I’m here to support you if you need me.”

If the supportive conversation ends here, you should feel good that you noticed and asked about their well-being. Try not to take the response or tone personally despite the conversation not going anywhere. It takes courage to initiate these types of conversations, and it’s not your responsibility to force another to notice or change their behaviour.

When the individual appears to be open to discussion – an open-door response:

If the person confirms they feel differently or that life circumstances have changed for them, you’ve opened the door to having a supportive conversation.

 The next statement might be:

  • “Tell me more. I want to better understand what you’re going through.”

Continue to follow the guidelines below for having a supportive conversation.

Continuing the conversation

Listen

Listen for where the individual feels unsupported or doesn’t have their needs met. When they’re finished speaking, confirm what you heard by rephrasing it and asking if you understand it correctly.

Examples of “listening” in the conversation include:

  • “I’m hearing that you feel different and don’t really know why, but it’s negatively impacting you. Is that correct?”

Highlight

Highlight strengths you see in the person. Some examples could be courage or persistence in dealing with the situation they just shared with you.

 Here’s an example of “calling out strengths” in the conversation include:

  • “I’m so glad you felt comfortable sharing these changes that you have noticed. I respect the courage it takes to notice these different feelings and thoughts.”

Identify

Identify what support  the individual wants and connect them with relevant resources. Don’t insist on support or resources they don’t want or aren’t ready to accept.

Examples of “identifying support” in the conversation include:

  • “You’ve identified the need to address these different thoughts and feeling, so how can I best support you at this time?”*
  • “I can support you with finding resources that might help to address this – would that be helpful?”

*Note: If there’s a limit on how you can be supportive, be specific about how you can help. The offer of support needs to be realistic and in line with your abilities and available time. Otherwise, talk about what’s realistic for both of you to do to create change in the other’s life.

Create

Create an action plan  with the individual to leverage their strengths and follow up on a regular basis, adding additional resources when they’re ready. Give a clear timeline or understanding of  how you’ll be supportive.

Here’s an example of “creating an action plan” in the conversation:

  • “I’m so glad we had this conversation. You mentioned a few things you wanted to explore to create some change in your life. I’ll follow through with my offer of support in the next week.”

Thank you for being supportive! You’ve taken the time to learn to have a conversation that lets  your loved one or friend know you notice and care about them. By showing concern, you can help them evaluate whether they should continue as is or address certain elements in their life. For some, this may be the beginning of a journey that will require the assistance of additional support services or professionals.

Additional resources

To be an effective supporter, it’s helpful to understand more of what your family member or friend’s experiencing. Check out these resources to provide more context about their experiences: