How to Help Someone With Mental Illness

The Benefits of Offering Support

Supporting a friend or loved one can make a positive difference. Having support is often a factor in whether someone seeks treatment. With support and treatment, people living with mental illness or other mental health struggles can manage their symptoms and live full lives. Unfortunately, though, up to 75% of people in North America and Europe don’t seek professional help because of the fear of being judged negatively because of their struggles.¹

For people with mental illness, the help and assistance of caring individuals can:

• Be reassuring and confidence-building as it communicates that someone in this world thinks they’re worthy
• Help neutralize the stinging effects of mental health stigma and sense of shame often faced by people experiencing mental health issues
• Act as a safety net that can “catch” them when they stumble
• Be life-saving in times of crisis

Recognizing the Warning Signs of Mental Illness in a Loved One

When you begin to notice that your loved one’s behavior or emotions have changed and that this change is long-lasting and becoming a pattern rather than just an off day or two, it may be time to approach them. While each mental disorder has its own distinct set of signs and symptoms, there are general red flags and warning signs of mental illness that often indicate that someone’s mental health may be faltering.

Signs that someone needs help include:²

• Frequent displays of negative emotions (such as sadness or anger) for no apparent reason
• Appearing emotionally numb
• Heightened sensitivity to stress, often seeming frazzled and on-edge
• Sudden loss of interest in people, places, and activities they used to enjoy, often resulting in social withdrawal and isolation
• Increased absences from school or missing work
• Changes in eating or sleeping habits
• A pervasive sense of hopelessness
• Difficulty concentrating or having memory problems
• Increased substance use

Signs of Self-Harm

Also, be on the lookout for signs of self-harm.³ Be aware that people sometimes attempt to hide evidence of self-harm with clothing; if your loved one is suddenly wearing long sleeves or noticeably covering areas of their body they didn’t used to protect, they might be hurting themselves.

Signs of Psychosis

Some serious mental illnesses involve psychosis. If you notice any of the following signs of psychosis, start having conversations right away:⁴

• Focusing on unusual ideas or beliefs
• Increased suspiciousness of others, a sense that others are watching them or out to get them (paranoia)
• Hearing or seeing things that others can’t
• Believing that they’re receiving special messages (on billboards, in magazines, through television, etc.)
• Extreme isolation

How to Help Someone With Mental Illness

Deciding that you want to help is the easy part of the process. Knowing what you can do that will help rather than push your loved one further away is much harder to determine. The best place to start is with a willingness to listen and asking them what they need from you. They must be responsible for their healing, but you can support them on their journey.

Here are 11 tips for helping someone with a mental illness:

1. Educate Yourself About Mental Health

Mental health is a broad topic with a lot of information available, so decide to take advantage of the opportunity for education. Learn what you can from reliable resources about your loved one’s mental health condition, how it may be affecting them, and the best ways to lessen the impact. The goal is not for you to become their therapist, it is only to grow your understanding and ability to support them well.

2. Talk About Mental Health

Knowing what to say and how to say it can be difficult. After all, you want to help, not cause further problems or push your loved one away. One of the most important elements in conversations about mental health is compassion.⁴ This involves openness and a willingness to listen without judging or criticizing.

It helps to see your loved one as a whole person, not just as their illness or symptoms to avoid, which can inadvertently convey that you think they’re broken and need to be fixed.⁵ When you approach your loved one with empathy and patience, you’re likely to build trust and encourage them to open up.

Here are some tips for talking to someone about their mental health:^6,7

• Be intentional about timing, avoiding times when your loved one is tired or frustrated
• Choose a comfortable, private location
• Use “I” statements rather than “you” statements to avoid making them feel criticized or cornered (“I’ve noticed that you’ve been spending a lot of time alone lately and I’m wondering if you’re doing okay” is more compassionate and inviting than “You don’t seem to want to be around me anymore. Is something wrong?”)
• Listen fully, giving the person your complete attention and avoiding interrupting with advice
• Ask questions to encourage conversation, and do so in a supportive, non-accusatory way (“What is it like for you when you have to miss work?” is more helpful than “Why are you missing so much work?”)
• Keep the conversation in the present rather than dragging up issues from the past
• Normalize their experience to let them know that they’re not alone (without switching the focus of the conversation to you, you can briefly mention a struggle you’ve had or share some statistics you’ve looked up ahead of time)
• Be straightforward and keep thing simple to avoid overwhelming them
• Watch for their reactions, and if they seem upset or resistant keep the conversation short (you can revisit it again a different day)
• Emphasize that you care about them and want to be supportive in a way that would be helpful to them
• Don’t dismiss, brush off, or minimize their experiences (by telling them it’s all in their head or they should just snap out of it, for instance)
• Don’t become emotional (if you find yourself becoming anxious, angry, or sad, admit it and suggest a break so you can calm down and be more present for them)
• Don’t use “shoulds” or “shouldn’ts” (for example, telling them that they “should” get help sounds forceful and can shut down communication)
• Don’t assume that you know what your loved one needs (they’re more likely to be open to your help and support if you ask them what would be helpful)

3. Normalize Going to Therapy

Stigma around mental health is unhelpful and unnecessary. Going to therapy is a helpful tool for so many to help live the life they want. Encourage therapy as a normal and healthy activity that promotes so much good in a low-risk way. Without making any comparisons, if you have had your own positive experience with therapy, sharing that with them may help them feel more comfortable to seek help.

4. Don’t Diagnose Them

You don’t have to label or even try to figure out their issue; instead, just listen to their experiences and how their symptoms are impacting their life. Further, avoid begging your loved one to get help or threatening them with consequences for not seeking help.⁹

5. Suggest a Screening Test They Can Easily Take at Home

If your loved one is having a hard time articulating what’s bothering them, you might suggest that they take an online mental health screening test, such as those offered by Mental Health America.¹⁰ They can then share their result with you as well as use it as a tool when meeting with their doctor or a mental health professional.

6. Encourage Them That There Is Hope

One of the most important things to convey when talking to your loved one about their mental health struggles is a sense of hope. Let them know that treatment is available and that, even though some illnesses are permanent, they can improve and experience mental health and wellbeing in spite of challenges.

7. Don’t Wait

Often, people are hesitant to reach out to offer support because they worry that they don’t have enough information about mental health issues to be useful. That’s a legitimate concern and one that you can put to rest. You don’t have to be an expert to help a loved one with a mental illness or any other mental health challenge; in fact, you don’t have to have a single answer or solution but simply a willingness to listen.¹¹

8. Ask What They Need & Follow Their Lead

Another key component in knowing how to help someone is to simply ask them what they need. It can be frustrating and heart wrenching to watch someone you care about struggle. As an outside observer, it can seem like you know what would help them. Remember that experiencing mental illness doesn’t mean that your loved one isn’t an independent person with their own unique desires, needs, and approach to problem-solving. The best way to help someone is to be supportive in a way that is meaningful to them, and the way to discover that is to ask.

Let your loved one guide you in the exact type of help you provide. In general, think in terms of offering emotional support and practical support. The following ideas can help you and your loved one determine what specific measures would be most helpful.

9. Offer Practical Support

Practical support involves actions that facilitate their healing. Ways to offer this type of help include:

• Helping them find a therapist and make appointments
• Brainstorming with them and writing down questions for doctors and therapists
• Attending appointments with them and taking notes to review with them later
• Assisting with transportation, either giving them rides to and from appointments or helping them obtain a bus pass and learn how to use the public transportation system
• Connecting them with local mental health organizations and support groups (you can offer to attend support groups with them, too)
• Offer to do daily tasks such as grocery shopping, cleaning, or helping with child care (often, something as simple as calling them and saying, “Hey, I’m at the store right now. What can I grab for you?” is extremely helpful and doesn’t make them feel like a burden)
• Picking up prescriptions, organizing medication, and helping them make a schedule to stick to

10. Offer Emotional Support

Emotional support involves being present, open, and accepting of your loved one to help them feel less alone and afraid.

Some ways to be emotionally supportive include:

• Providing reassurance, reminding them that this illness doesn’t define them and that treatment can help them overcome or manage their symptoms and reclaim their lives
• Remind them that they’re not alone, that you and others are their for them
• Remind them that they have many strengths and gifts
• Remain calm even when they aren’t
• Stay in contact and continue to invite them to do things with you (they may decline your offers because of their urge to withdraw and isolate, but continuing to check-in and provide opportunities communicates that you’re not giving up on them)
• If it could be helpful, offer to attend family therapy with them

11. Be Patient With Them

Disappointment, irritability, and anger will never help a person with mental health concerns. Your loved one needs patience, understanding, and support when managing their health. They may not do what you want when you want, but by maintaining a strong relationship, you can offer support in the long-term. Their improvement won’t happen overnight so sticking with them is important.

How to Help Someone With Mental Illness Who Doesn’t Want Help

It can be hurtful when a loved one resists your support. It can also be upsetting because you know that they could feel better more quickly if they would allow you to help them. The bad news is that you can’t force someone to seek or accept help. Trying to pressure them into doing so can alienate them and damage your relationship.¹² The good news is that even if your loved one resists your help, there are still little things you can do.

Things you can do when a loved one doesn’t want your help include:

• Telling them that you are there for them when they are ready
• Conveying that they are important to you, that you love them completely, and that you’re on their side and are not out to “fix” them
• Educating yourself about their symptoms so you know what to expect and how to respond
• Remaining calm rather than reacting in anger or other negative emotions (it might help to remind yourself that they might have reasons for resisting that you aren’t aware of)
• Giving them resources and information, such as links to websites or brochures and other educational materials from local mental health organizations (don’t try to force it on them but simply have it present)

Your best tool when a loved one resists is patience. Sometimes, what someone needs most is space and time. Providing that is supportive and helpful in and of itself.

Can You Force Someone to Get Mental Help?

Typically, you cannot force someone to start or continue with mental health care. There is one exception, though. If someone is indicating that they are in danger of hurting themself or someone else, they can be involuntarily committed to inpatient treatment for a short period. Otherwise, you can only strongly encourage treatment, not force it.

What Should I Do in an Emergency or Crisis?

Seeing a loved one in crisis, harming themselves or talking about harming themselves, including suicide, is terrifying. Directly asking them if they are thinking about ending their life will not cause them to follow through on their thoughts.¹³ Being direct will help you get them the help they need faster.

Knowing the warning signs of suicidal ideation can help you know when to take action. If you or someone you know shows several of these warning signs then it is time to take action.

Signs of suicidal ideation include:¹⁴

• Appearing depressed or sad most of the time (untreated depression is the number one cause for suicide)
• Talking or writing about death or suicide
• Withdrawing from family and friends
• Feeling hopeless
• Feeling helpless
• Feeling strong anger or rage
• Feeling trapped—like there is no way out of a situation
• Experiencing dramatic mood changes
• Abusing drugs or alcohol
• Exhibiting a change in personality
• Acting impulsively
• Losing interest in most activities
• Experiencing a change in sleeping habits
• Experiencing a change in eating habits
• Losing interest in most activities
• Performing poorly at work or in school
• Giving away prized possessions
• Writing a will
• Feeling excessive guilt or shame
• Acting recklessly

Where to Get More Information on Suicidality

Helpful resources for suicide information and help include:

• Suicide.org
• National Institute of Mental Health (NIMH)
• American Association of Suicidology

How Do I Respond to Someone Who Is Suicidal?

Take these steps to help someone who is suicidal:¹⁵

• Ask if they are thinking about harming or killing themselves (or someone else—follow these steps whether your loved one is threatening themselves or another person)
• Stay with them and remove anything they may use to hurt themselves
• Call 911 or take them to the nearest emergency room

While you wait for emergency responders, simply listen to your loved one. Ask them about their thoughts and emotions, and empathize. If you have access to a phone or the Internet, connect them to a crisis center. There are numerous centers available.

Two prominent suicide hotlines are:

• The National Suicide Prevention Lifeline (1-800-273-8255)
• Crisis Text Line (Text “Home” or “MHA” to 741741)

How to Support Other Family Members When Someone Has a Mental Illness

When someone struggles with mental illness, it can send shockwaves through the family. Many people will need love, patience, and support.

To best support family members of someone with mental illness:

• Avoid blaming and finger-pointing
• Stop analyzing the past and plan for the future
• Build better communication skills
• Find opportunities for fun and relaxation
• Seek family counseling
• Encourage support groups
• Find times for yourself and maintain self-care
• Connect to community or online resources for people in similar situations

Make Sure You’re Caring for Yourself, Too

First and foremost, give yourself a break. You alone are not responsible for your loved one’s mental health. Of course you play an important role in their life, but resist the urge to take complete charge of your loved one, their illness, and their treatment. Hovering over someone or trying to force certain actions isn’t good for you or your loved one. Be confident in the knowledge that the emotional support and practical help you are able to give is enough, and trust in your loved one’s ability to do things for themselves.

Setting boundaries will help you maintain your own mental health:

• Acknowledge and allow your own reactions (feelings of stress, anxiety, guilt, fear, anger, and sadness are normal and not a sign that you are an uncaring person)
• Know and honor your limits by doing what you can and letting others, such as mental health professionals, do their part
• Avoid taking your loved one’s negative reactions personally by remembering that mental illness involves thoughts, feelings, and behaviors that interfere in the way someone interacts in the world
• Give yourself permission to be your own person, pursue your own interests, and take breaks—being there for someone does not mean being available 24/7

Find a Support Group

Many people who are helping loved ones through mental health challenges find caregiver support groups to be outstanding resources for themselves. Sharing stories, challenges, and tips with others in a similar position can help you thrive during this challenging time.

Many mental health organizations offer support groups for individuals living with mental illness as well as for their family members or friends, including:

• National Alliance on Mental Illness (NAMI)
• Mental Health America (MHA)
• Depression and Bipolar Support Alliance

An important takeaway is that mental illness doesn’t have to ruin lives. Treatment and support resources are available, and people can and do overcome difficulties to live full and satisfying lives.