Mental illness has the power to devastate lives, often without alerting those closest to us. In the South Asian community and in many others, mental illness is often characterized by stigma, leading to a feeling of isolation for those affected. For this reason, it is critical for family and friends to step in and offer support when someone is struggling or unable to ask for help themselves.
The following content will walk you through several steps you may wish to take in order to support your loved one through their struggle with mental illness. These include educating yourself, starting a conversation, suggesting appropriate care, addressing concerns, and continuing your support. We hope that this can serve as your framework through this process and encourage you to do further research, beginning with the linked resources below.
Everyone is impacted by mental health differently, because mental health exists on a spectrum of well-being. It is always best to educate yourself on what your loved one is going through, before interacting with them. Here are a few ways to educate yourself on mental illnesses:
There are tons of online resources where you can start your research, and MannMukti is a great first step! You can start with the information on our Conditions page to learn about different types of mental health conditions. In addition, many informative resources are collected on our Great Places to Start page, such as the National Alliance on Mental Illness (NAMI). You should also check out HelpGuide for more information on how to help loved ones with mental illness. These online resources will not give you the full picture of the pain your loved one is experiencing, but they will give you insight into symptoms and possible treatments.
Attend Local Conferences and Events
Many organizations such as NAMI and Mental Health America have local chapters that hold conferences or events around the nation. These are great venues to learn about various mental illnesses from professionals, ask questions, or volunteer. Try searching for your local chapters!
Call your Local Mental Healthcare Providers
Calling local mental healthcare providers or treatment centers offers another option for talking to professionals. First-time consultations can be free and are always kept confidential. This will give you the freedom to openly talk with experts and research the best approach for interacting with your loved one. For help with finding local mental healthcare providers, scroll down to the advice in our “Suggest Appropriate Care” section.
Check your University Resources (if you’re a student)
Apart from local mental health providers, there are also many resources offered by local universities. If you are a student, or simply cannot get in touch with the local treatment center, you can always call the local university and ask for the counseling center. Even if they cannot help you, they will surely point you in the right direction.
Start A Conversation
Cultivate an Open Environment
The first step to starting a conversation occurs well before the conversation takes place. With time, cultivating an environment that welcomes honest and vulnerable dialogue with everyone in your life in incredibly important. A tangible step you can take is to ensure that your day to day language portrays a sensitivity to issues concerning mental illness. Lightheartedness is important in any relationship, but making light of things such as depression and suicide, among other illnesses, sets an unhealthy precedent.
Approach Your Loved One
Approaching your loved one regarding their mental health can be daunting for anyone. Doing so in a setting that is private will facilitate this process. Even so, this approach can be done over the phone or through text, if a face to face conversation seems too overwhelming for either you or them. Start the conversation from a place of understanding and genuine concern, rather than setting the tone as accusatory or combative. Make your concerns heard, but don’t start the conversation with what you believe is the root of the problem or what you think their diagnosis is. Speculating on an issue like this is likely to be counterproductive. Instead, set the stage and let your loved one progress the conversation from there. Some easy ways to start this type of conversation can include:
"I've noticed you're acting different lately, is everything okay?"
"You haven't seemed yourself as of late, so I wanted to check in! Anything you want to talk about?"
Or to be more conversational, "Hey it's been a while since we've sat down and just talked, let's get coffee?"
Whichever ice-breaker that works is fine - you just need to get the conversation started!
Listen without interruption or judgement. Understand that you don’t know what they’re feeling, but you can do your best to support them through it. The conversation may evolve into one that is highly emotional and though it’s okay to feel for them, keep in mind that the focus should remain on them and not you. Don’t allow your emotions to be the biggest ones in the room.
Confidentiality is crucial to building a trusting relationship in which your loved one feels comfortable to continue to discuss their mental health with you. It is important to not allow their situation to evolve into gossip by repeating parts of your private conversation to others. This being said, it is important to understand the line at which confidentiality ends. If your loved one discloses that they are actively harming themselves or others, or have expressed intent to do so, it is more than appropriate to call for professional intervention and contact the necessary authorities. See our “Address Concerns” section below for help with such a situation.
Suggest Appropriate Care
Determine the Appropriate Care
Appropriate care can vary from person to person, so it’s important to understand what your loved one needs. For instance, some like privacy when discussing their mental health, while others prefer a group setting. Start by asking some direct questions about what your loved one is comfortable with. Find out if they have shared their mental health experience before, and if they haven’t, ask if they would like to.
Have they thought about attending any meetings? Any in particular?
Have they thought about getting professional help, or communal help? If not, is there a particular reason?
Find the Best Provider
If your loved one is open to seeking care, it’s time to find the most accommodating environment for them. Look into local therapy clinics or psychiatrists if they want professional help.
A great place to start is the 2017 National Directory of Mental Health Facilities. This directory has a list of available facilities by state, with a breakdown, via a series of codes, of available services and a list of language services as well! This directory does not come with reviews, times, and price points, but it does list the websites of all facilities, so you can obtain the missing information easily.
As you consider different healthcare providers, you might be wondering what your loved one should look for in a provider. Here is a link about what makes good therapy, while this great article discusses what makes a good psychiatrist: ask your loved one to keep an eye and ear out for these qualities as they meet different providers! To help in the search, here is a therapist search engine, made by psychologytoday.com, that can be used to narrow down therapists by area.
For those who are concerned about affording mental healthcare, Mental Health America is a national advocacy organization that provides affordable resources through their affiliates. Click here to check out their homepage, and find a local affiliate location near you.
For those in the USA, community health centers are also a great resource to utilize! The government’s Health Resources and Services Administration has set up several health centers throughout the US that provide holistic healthcare to underserved communities. Click here to locate a community health center near you.
Finally, if your loved one is a student, they can often find professional help within their university's psychiatry division, counseling and mental health center, or student services center. Visit their university's page and become familiar with any and all sessions offered that they could attend. Being informed of all the options helps find the most efficient plan of action.
Help Your Loved One Open Up
What happens if your loved one is fighting against your help or not willing to acknowledge something may be wrong? What if they believe "it isn't your problem to deal with" and insist that they can handle it?
In these cases, it is hard to determine the best plan of action without an understanding of the individual's psyche and situation. Aggressive resistance from your loved one almost always has a reason, but the solution is active and proactive communication. If they aren’t receptive to talking about their issues at first, start by letting them know you’re there for them through acts and words of encouragement.
Eventually, try to build an open, caring, and safe environment so the conversation can begin. See our section above on “Start a Conversation” for more tips.
For further reference, try the guide on Psychology Today for getting someone to open up in 12 steps. Please remember, this guide is meant to serve as a reference, not a strict manual.
Encourage them to Seek Help
On the other hand, what if your loved one is willing to talk about it, but doesn't want to seek help? A great place to start is having a conversation about why they are unwilling to receive help.
Some may feel powerless in asking for help, while others may feel shamed due to stigma. Assure them, in ways they will understand, that you’ll help them get through those feelings. Sometimes, they need to have this talk with their significant other, sometimes a parental figure, and sometimes a professional (clinician, doctor, psychiatrist, etc). Whichever the case, as long as the dialogue is opened with someone they are willing to hear, it can help remove walls that are preventing care.
Pay Attention to Suicidal Thoughts
WARNING: Some of the content in this section may contain sensitive material. If you are having suicidal thoughts, feelings, or urges, contact emergency services at 911, the National Suicide Prevention Lifeline at 1-800-273-8255, or a qualified physician or clinician immediately!
Suicidal ideation can be the most daunting subject to tackle with a loved one, for many reasons. Consider using these five steps, sourced from the National Suicide Prevention Lifeline, to encourage conversation and find a positive resolution.
Try using direct, supportive questions if your loved one is thinking about suicide. "Are you thinking about hurting yourself?", "How are you hurting?", and "How can I help?" are all neutral, supportive questions that allow the conversation to start where it matters, but in a nonaggressive manner.
The second half of asking, is listening. Listen to them, and their perspective.
What matters to them? Are there any sources to the pain they are feeling? Do they maybe have a reason to stay alive?
Listen for these cues as they are often moments where the topic of discussion can lead to a deeper level. Help them focus on the things that inspire them to live, and avoid citing others' reasons for them to live.
Make Sure They are Safe
If your loved one is considering suicide or self-harm, there are a few immediate safety questions to be considered:
Have they already done anything to try to kill themselves before talking with you?
Does the person experiencing thoughts of suicide know how they would kill themselves?
Do they have a specific, detailed plan?
What’s the timing for their plan?
What sort of access to do they have to their planned method?
Understanding their plan is important for considering the severity and urgency of their situation. Single-step plans, like access to a loaded firearm, or multi-step plans that are already in place, are cause for immediate action on your part. Calling the authorities (i.e. police or 911 in the USA) would be advised in these situations.
Whether this is talking over the phone, or spending time with them in person, be there whichever way your loved one can receive your care. Ensure that they are receiving care from a committed source. Only commit to what you can do, and if you can't commit care in a certain form, talk to your loved one about their options for care they would like to receive. Ensure that the source, if not you, is also equally committed.
Help Them Connect
Connectedness to sources of care is vital. Help your loved one connect to the resources, whether they are online or in person, that are sources of care. The Suicide Prevention Lifeline (800-273-8255), and other similar resources help to serve as a safety net and assist in your loved one's willingness to receive the care they need. Work with them on their resources available to them at the time.
Questions to ask your loved one: Is a mental health professional an option? Have they seen one in the past? Are they doing so currently?
After you've helped them identify their immediate sources of care, reach back out to them and follow up. Call, text, take them out on a ice cream run, anything! The time spent and effort provided will further connect them to others and keep them from closing up again. This step is also great to help reassess if you can do anything else to help. Be attentive, engaged, and listen for any important cues.
For a more in depth analysis of each step, check out this guide!
Continue Your Support
Continue to Educate Yourself
The best thing you can do to support your loved one is educate yourself on their specific situation and illness. Doing so will allow you to be sensitive and attentive to their unique needs. This process of education can and should involve directly asking your loved one what kind of support they need.
Set Up a Routine
At this point in your loved one’s life, they may be feeling out of control. Setting up a routine to touch base with them in a consistent and reliable way will help add structure to their life and hold them accountable. If they are doing something to progress their mental health such as counseling, offering to take them out for a meal after every session is another good way of supporting them. Do activities that you both enjoy like exercise, retail therapy, or really anything that will give them something to look forward to. The bottom line: just be available to them to the best of your ability.
Set Reasonable Expectations
In this process, consistency, patience, and understanding are key. Realize that some days might be better than others and that not every setback means all hope is lost. Trust your instincts on how to care for your loved one, because you know them better than anyone else. Finally, ensure that you care for yourself and your own well being. Supporting someone struggling with mental illness is not an easy task, so it’s important that you prioritize yourself if you want to best help someone you care about. Put on your own oxygen mask first, before assisting others.