How To Start a Conversation About Mental Health

We all have mental health, just like we all have physical health. You don’t need to be an expert in anxiety or depression to help someone who is struggling.

While you may feel uncomfortable about initiating the conversation with a loved one, letting them know you care, and you are there for them, can make a huge difference to how they feel about themselves. If you ask how they are feeling, and they respond with “I’m fine,” ask again. “How are you really feeling?” and really listen to what they say.

If you are worried about a friend or family member, it can sometimes be hard to know how to start a conversation about their mental health with them. Understanding that anxiety disorders are the most common form of mental ill health can help to put how they are feeling about themselves into perspective and help them to know they are not alone.

By really listening, and giving them your undivided attention, you may encourage someone to seek the help needed.

Maybe you can acknowledge a time when you too felt anxious, worried or overwhelmed, or perhaps initiate the conversation around something you may have seen on TV about mental ill health. The important thing is to enable the other person to have a safe space to open up and talk about their feelings in a non-judgemental way.

Where To Start a Conversation About Mental Health

Start by finding an environment where the person will feel comfortable.

You want to be able to talk without too many distractions, somewhere they are comfortable to open up. You may wish to find a quiet area in a relaxed coffee shop or go for a drive together.

I often talk to my anxious clients while walking in nature. I find this a great time for them to speak more freely if they are especially fearful or nervous as there is no direct eye contact. Their posture is often more upright and open when walking in nature, and I find that they are able to recall times in their lives more easily where they had the courage and confidence to cope with their challenges.

If possible, I love to walk and talk with clients in open areas such as a local park with a great view, or a walk along the beach. The vastness of looking out to sea or into the distance can help put challenges into perspective and the sound of the waves and nature can have a calming effect.

What Words Do You Use to Describe Your Own Vocabulary of Feelings

Before having the conversation with a loved one about anxiety or mental ill health, you may want to think about your own vocabulary of feelings and think of alternative words you could use to describe them. Alternative words may include fearful, sad, nervous, tired, angry, worried, overwhelmed or out of control, and by varying the words we use, we can often see things from an alternative point of view.

You can start the conversation by telling them that you have noticed they don’t seem their usual self right now. What changes have you noticed in their mood or behaviour? Talk about what you have noticed as this provides an opportunity to find out what is really going on for them.

When you suspect they are struggling, it is essential to ask them. Waiting and hoping they will come to you for help might lose valuable time getting them the support needed.

Let them know you are concerned about them. Ask them “What is happening for you right now?”

Know that All Feelings Will Pass

Many clients use the word anxiety or depression to describe how they constantly feel and this can be very overwhelming for them. When we introduce words like fearful instead, you can try and get them to think of an occasion when they felt the opposite, such as confident or brave. By focusing on these positive feelings, we are able to recognise that we have the ability within us to feel many different things. And all feelings, both positive and negative, will pass. Nothing stays the same way permanently.

What coping strategies have they used in the past that have helped them? How have they taken control of a situation previously? It is best to let them talk without jumping in to offer advice initially, as someone who can recall some of their own past strengths is more likely to believe in their own ability to overcome a new challenge.

By keeping a curious mind, you will be able to ask them to tell you more, and give them an opportunity to say something out loud that they may have only internalised up till now.

How To Listen Empathetically

Your role is to listen empathetically and not judge, even when their fears may seem irrational to you. Remember it may be really hard for them to talk about their mental ill health.

Empathy is different to sympathy. Empathy is the ability to understand and share the feelings of another person whereas sympathy is feeling pity or sorrow for someone else’s misfortune. Sympathy will not move them forward, and will keep them stuck where they are. Empathetic statements include saying “I appreciate this must be a difficult time for you”

Listen carefully to what they are saying and try not to interrupt while they are talking. If something is not clear to you, seek clarification when they have finished talking, so as not to interrupt their flow. You may want to say something like, “I can hear you have been having a tough time, please tell me more so I can understand what you have been going through.”

If they are visibly upset, you may want to tell them to “take their time” and “reassure them there is no rush” or acknowledge that “you understand it can be difficult to talk about this.”

Their fears may seem irrational to you, but remember they appear real to them. Don’t dismiss their worries because you believe that the situation they are presenting to you will never happen. They won’t believe you no matter how much you tell them. Right now, their fears are real and logical to them.

What to Do if You Hear Something You Find Upsetting

Some of the things they tell you may worry you or be overwhelming to hear. It is important to stay calm and use positive body language to convey that you can understand and empathise with what they are telling you. If they think you are worried about them, this may cause even more anxiety and is likely to be the reason they initially avoided the conversation.

Your body language should align with your words so nod your head to let them know you are understanding and following what they are saying. Maintain eye contact if you are able to see their face. If they are leaning in towards you or leaning back, mirror the positioning of their body as this will help create rapport and trust.

What To Do If You Believe They Are In Immediate Danger

It is essential to understand your own limits. If you believe they may be in immediate danger, call 999.

Research has shown that talking about suicide does not encourage it or suggest it is the solution. Asking someone if they feel suicidal or are planning to end their life may not feel right to you but professionals do recommend asking questions about suicide.

It is not unusual for some people to worry that having this conversation might indirectly encourage the person who is feeling suicidal to act on their feelings, but evidence confirms that being able to speak openly decreases the likelihood of the person acting on their feelings.

Asking simple, direct questions can encourage them to be honest about how they are feeling. Many people feel relieved and less isolated when they are asked.

Encourage them to contact the Samaritans on 116 123

Thank Them for Being Open and Honest

It may have taken them a lot of courage to open up and they may feel vulnerable. Let them know how much you appreciate the trust they have given you. This may be the first step on their journey of recovery.

Listening and empathising is often more valuable than offering advice or trying to compare their situation to something similar you may have experienced. Reassure them that you are there for them.

You don’t have to have all the answers initially, you are there to support them by allowing them the safe space to open up to their feelings. Ask what else you can do to best support them.

If They Are Not Ready to Talk Just Yet

It is possible that they are not ready to open up just yet and you will need to respect that. Pressuring someone to talk is not effective as they will not talk freely and this may increase their anxiety.

Let them know you are there for them when the time is right. Spend time with them when you can, but don’t try and force a conversation. Right now, it is possible that the best thing you can do is distract them from the constant thoughts in their head.

When struggling with anxiety or depression, it is not unusual for people to shut themselves away from others and neglect themselves. Are they eating well, showering, and looking after their basic human needs? Ask them open ended questions such as “What are you doing to look after yourself” or “How can you be kinder to yourself?”

Can you encourage them to go for a walk each day, or meet someone for coffee? Check in with them regularly as this reinforces that you care about them.

Give yourself time to process what they have told you or what’s happened. Try to help them create a support network of other friends, relatives and mental health professionals who can help them too.

Lastly, don’t forget about your own needs. It can take a lot of time and energy supporting a friend or family member with their mental health so who can you turn to, to support you?