If you feel that a loved one might be in need of some support, here’s how to start the conversation

Have you ever wanted to check in with someone who may be struggling with their mental health but have held off because you’re worried about saying the wrong thing? If so, you’re not alone.

It can be difficult to work out where to start. According to Every Mind Matters, letting someone know that you're concerned is a good way to open up a conversation – it shows that you care about the person, have time for them and that they don’t have to avoid things with you. Offering reassurance that you’re available to listen can really help in combating feelings of loneliness.

“Just knowing someone’s there for me to talk to whenever I’m ready makes a huge difference to me,” says Priya, 35, who has experienced periods of anxiety and depression since she was 16. Having suffered from OCD in the past, her feelings of isolation were often barriers to her opening up to people. “It took me a while to feel ready to talk about it – probably around five years. I eventually did, but only when things were almost unbearable. I wish that it hadn’t come to that point because looking back, there were certain people in my life who would have been there for me, but perhaps both of us were worried about starting a conversation and didn’t really know how to.”

She shares that she was also worried about being judged if she talked about it. “I felt deeply ashamed about what I was going through and saying it out loud was terrifying to me because then it felt real. In a way, I felt bad that I wasn’t able to sort it out by myself. That first talk wasn’t easy at all, but it helped me to start thinking about it differently. Eventually I saw that it was something that I wasn’t supposed to tackle on my own. Looking back, I think it was ultimately what led to me gaining the strength to seek professional help a couple of weeks later.”

So how can you start the conversation? Here, we explore what can be helpful and unhelpful and how to support someone with their mental health when you feel like they may need it most.

What to say to someone struggling with their mental health

Say: “I’ve been worried about you lately and wanted to check in;”
instead of: “You’ve been really off with me lately.”

Struggles with mental health can manifest in a range of ways. Some may experience anger for example, while others may become more withdrawn. Everyone reacts differently and so try to avoid language that may come across as confrontational, so that people who are feeling unwell don’t associate these types of conversations with something negative.

Keep things simple. Just letting people who are struggling know that you’re worried is enough in itself and shows that you’re making the time to listen.

Say: “Let’s go for a walk;”
instead of: “Why are you so anxious all the time?”

The stigma of a mental health problem can sometimes prevent people from talking about it. Bear in mind that the issue that they’re dealing with is just one part of that person’s life and most don’t want to be defined by it. Space and time to be able to bring it up can help. To avoid a situation where it feels forced, try doing things together (go for a walk, watch a film or cook together, for example). You may find that a conversation about it might come up naturally.

Say: “I’m here for you;”
instead of: “Cheer up!”

Being open-minded and non-judgmental is key for helping your loved one to open up. Phrases like “Cheer up” and “It’s not so bad” can trivialise what may be a huge concern. Open questions that start with “How” and “What” can provide a valuable prompt to allow the person who’s struggling to feel better able to direct the conversation in a more comfortable way.

Say: “I see how difficult this must be for you;”
instead of: “I know what you mean, I’ve been struggling with my mental health too.”

It’s completely understandable that you may want to talk about your own mental health experiences in order to connect. However, there’s a fine balance. “A common trap is talking uninvitedly about our own experience too much,” says chartered psychologist Dr Charlotte Hilton and member of The British Psychological Society. “This is most likely intended to relate in some way and enhance some sense of solidarity and shared experience. However this can typically be interpreted as: ‘Oh so they’re talking about themselves now and have stopped listening to me!’ A top tip for checking if sharing your experience is helpful, is to ask the person if they would like to hear it first.”

Dr Hilton recommends trying to listen reflectively in order to validate people’s experiences: “Repeat back key things that you’ve heard. For example, ‘this sounds really difficult for you,’ or ‘you’re wondering how you’re going to cope with the stress of Christmas’. Listening reflectively demonstrates empathy and reduces the risk of misinterpretation.”

Say: “I don’t know what you’re going through, but I’m here to listen and help in any way I can;”
instead of: “We all get stressed at times.”

Similarly, try to avoid diminishing the impact specific worries may be causing someone.“Those who suffer from a mental health disorder can be affected to the point where they cannot perform daily tasks,” says Dr Jon Van Niekerk of the General Adult Faculty from the Royal College of Psychiatrists. “This is different from the regular stressors that most people will face every day. Although this is well-meaning, it can actually make the person feel their distress is not worthy of additional help or support.”

Say: “I’m glad that you felt comfortable sharing this with me;”
instead of: “Why didn’t you say something sooner?”

It’s likely that the person that you’re speaking to is feeling particularly vulnerable right now. After all, it could be the first time that they’re mentioning their worries to someone – which is a huge step. It’s therefore really important to provide reassurance and comforting words and recognise the effort it would have taken to reach this point.

It’s also worth noting that we don’t know all of the reasons for why the person who’s struggling may have found it hard to speak about their experiences. Just knowing that you’re there, talking and listening without judgement will hopefully open the door for many more conversations in the future.

Say: “How can I help?;”
instead of: “You should try X, Y and Z.”

Again, keeping things open and broad can be helpful here. Everyone requires different things at different times and so leave it to the person who’s feeling unwell to let you know when and how you can offer support to them.

Dr Hilton recommends listening to understand, rather than listening to respond. “We’ve all done it but in the context of helping someone who feels unwell to feel safe enough to share their feelings and experiences with us, a top tip is to avoid jumping in with solutions too soon. The unintended interpretation of this could be: ‘I’m only half acknowledging what you have just shared with me about why things are so difficult for you and why you’re feeling unwell, because I’m listening to respond with solutions rather than trying to understand what it’s like for you.’” She suggests adopting a curious mindset, in order to curb the temptation to jump in with our own stories or well-intended solutions too soon.

Say: “I’m here to listen. Tell me how I can help;”
instead of: “You have so much to be thankful for.”

“Pointing out to someone there are others worse off than them is a particularly painful experience,” says Dr Van Niekerk. “Mental health problems do not discriminate and these sorts of statements invalidate someone’s suffering.”

It can be natural to want to ‘fix’ someone’s worries; however, there can be a disconnect between what is said and how it’s interpreted. “This desire to want to 'make better' often takes the form of inviting people who are struggling to see all the things that are good in their life and to eagerly remind them of these things,” says Dr Hilton. “The intention is: ‘I’m really sorry to see that you are feeling unwell and finding things difficult, let me remind you of all the things that are positive in your life in an attempt to help you feel better.’ However, the risk is that what is heard is: ‘You don’t really have any reason to be feeling the way that you are, look at all the positive things that you have in your life.’

“The unintended consequences of this are that the person that just opened up to us feels really invalidated and not particularly listened to,” states Dr Hilton.

For more mental health resources and information about organisations that can help if your loved one needs urgent support, visit the Every Mind Matters website.