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Suggestions and resources, including what to say, if you are concerned about someone else’s mental health.

 

1.  Recognising signs in others

It is often easier for us to recognise that other people are struggling while we have a blind spot about it ourselves. On the other hand, the opposite can be true and people can be very good at hiding what’s going on until things escalate to the point where they can’t hide it any more or a crisis point has been reached. Bearing in mind there is a lot going on beneath the surface with all of us, the kind of signs which are noticeable might be the tip of the iceberg.

 

The signs to look out for in ourselves and others will usually indicate a marked change, for example:

  • Not getting things done – missing deadlines, forgetting tasks, avoiding or putting things off.
  • Irritability, aggression, tearfulness.
  • Generalised anxiety or worry.
  • Indecision.
  • Loss of confidence / self-doubt.
  • Avoiding conversations or not actively participating in meetings they would normally speak up in.
  • Not attending social events they would normally enjoy.
  • Taking on too much work and volunteering for every new project.
  • Tiredness/sleep problems.
  • Headaches, heart palpitations, digestive disorders or other physical complaints.
  • Lack of care over appearance.
  • Being run down.

 

2.  How to have the conversation1

  • Think about when and where to have the conversation. Making it part of a general catch-up meeting is useful. For some people an informal setting, such as over a tea or coffee is easier but for others this might provoke even more anxiety. Often, it can be easier to open up if you are side by side, for example while walking. Check it out with the person.
  • Ask the person how they are, using open questions, if possible, and saying what you have observed, if that feels appropriate. For example, “I’ve noticed you don’t seem yourself recently. Is everything alright?”
  • As they will probably say, “Yes, everything is fine” (because that’s what we tend to do) …
  • …without being too intrusive, try asking again. For example, “Are you sure? It’s been a tough time lately.”
  • You could flag up that you are around for chat later or in the future if they want to talk.
  • Even if the person is unwilling to talk, just showing you have noticed and that you care can be enough to open things up. They may then come back to you (or someone else) at a later date.
  • Or they may want to talk about things in general rather than their mental health difficulties or struggles. This can also be helpful and may pave the way.

 

3.  How to listen2

  • Listening to someone is different to having a conversation. This is about the other person and not you, so try to keep yourself out of it, at least until the person has said all they need to say.
  • Practise Active Listening skills.2
  • Is face to face easier or would they feel more comfortable in a video call or telephone? Would they prefer talking whilst doing something else together, such as a walk or a shared hobby? Don’t make assumptions. Ask them.
  • If you start feeling overwhelmed or out of your depth, remember all you need to do is be there and listen.

 

4.  How to respond1, 2

  • Remember not to rush in with solutions no matter how tempting. It is rarely helpful, especially at the early stage (unless they are asking for specific advice). Just being there to listen is often enough.
  • Sometimes it is hard to be with a person in their pain and distress, especially if it triggers similar feelings for you. It is important to stay listening but also to recognise your own limitations if you feel out of your depth.
  • Try not to trivialise or make light of what people are telling you. It is very common to use humour as a defence when we feel anxious or overwhelmed.
  • You can ask if they are feeling suicidal. Evidence shows this is very helpful. Do not worry that you might be putting the idea into someone’s head. If they are thinking of suicide the thoughts will already be there.
  • Remember your boundaries and be aware when you need to suggest that the person seek help from someone with more expertise, if necessary.
  • Beware, also, of over-promising the support you can give and getting exhausted or overwhelmed.
  • Whilst it is important to respect people’s need for confidentiality, remember we can never promise total confidentiality. Where there is a risk of danger to self or others, there may be times we need to break it.

 

5.  What to do in a crisis

A crisis is when someone needs help right now, for example if they are actively suicidal, becoming psychotic or behaving in a way where they are a danger to themselves or others.

  • If this occurs while at work, consult someone like your manager, a trusted colleague, a mental health advisor (or champion). They will support you in putting the next steps in place to keep the person safe and get them the help they need.
  • Check if they are already being supported by the mental health services. Ask for permission to contact them (unless there is a serious risk of harm to self or others, in which case you don’t need permission).
  • If you feel that they are at serious risk, such as if you think they are actively suicidal or psychotic, you can call the emergency services (an ambulance) or go to A & E.
  • If the person is displaying behaviour which is causing them to be a threat to themself or others, call the emergency services. If there is a direct threat to life, the police might need to be involved.
  • It is especially important to remember your boundaries here and not get over-involved, such as by giving your personal phone number. Even though this can feel very tempting when someone is in distress.

 

6.  References and further information

1. IP Inclusive webinar How to have conversations with ourselves and others”

2. 6 Tips for Active Listening

 

7.  Referral suggestions

GP or practice nurse

Local Mental Health or Improving Access to Psychological therapies (IAPT) service https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/

People can usually self-refer if necessary. 

MIND www.mind.org.uk

Information about mental health.

Samaritans samaritans.org 116 123

Help and information especially when feeling suicidal.

Lawcare www.lawcare.co.uk 0800 279 6888

Help and information about mental health for those in the law profession.

Hub of Hope www.hubofhope.co.uk

For information about mental health agencies in your area.

CALM www.thecalmzone.net 0800 585858

Help and information about mental health difficulties including a chatline.

Citizens Advice www.citizensadvice.org

Practical help, advice and information on a wide range of issues including financial, legal and housing.

Bereavement www.cruse.org.uk

SOBS https://uksobs.org/

For those bereaved by suicide.

SANDS www.sands.org.uk

For all those affected by the death of a baby, including miscarriage.

BEAT www.beateatingdisorders.org.uk

For those affected by an eating disorder.

Menopause www.balance-menopause.com

Rape Crisis www.rapecrisis.org.uk

For help and support after sexual violence including rape, sexual assault or abuse.

Anna Freud www.annafreud.org

Information about mental health in children.

Debt National Debtline www.nationaldebtline.org 0808 808 4000 (Freephone)

Provides a free, confidential and independent telephone advice service.

PayPlan www.payplan.com 0800 316 1833 (Freephone)

Help if you are struggling with multiple debts, providing 100% free, confidential debt advice and support either online or over the phone.

 

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