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    Would you know what to do if a friend approached you to tell you that they were having mental health issues?   Society has come a long way when it comes to understanding and talking about mental health.  Nonetheless, there is still a stigma about mental health.  It took great courage for your friend to approach you. How should you respond?  What should you do with the information that’s been shared with you?

    How to talk to a friend who is struggling with their mental health was the subject of a recent article in Lifehacker and originated in a story by Anne Thériault in  Thériault has had first hand experience on the subject of mental health having been admitted to a psychiatric ward for suicidal ideation.  She relates what it was like to tell friends and family of her condition.  While she’s learned to talk about her mental health, she’s found other people often don’t know how to respond.

    At Espyr, we’ve had years of experience working with people and employers on the subject of mental health. We believe that talking about mental health is important so we want to share Thériault’s story along with our perspectives where we differ from her suggestions.

    Mostly just listen

    Thériault begins with what’s most important – be a good listener.  “It’s hard to hear that someone you care about is suffering. The impulse is to rush in and try and “fix” everything. But your friend is talking to you because they need to talk. Unless they’re directly asking for help, they probably only want you to listen and commiserate.” Thériault says that unsolicited advice is one of the worst responses you can have:  “Don’t ask them if they’ve seen a doctor. Don’t tell them to try therapy. Don’t suggest medication or yoga or long baths. I guarantee you that your friend has already considered many of these things; you’re certainly not the first person to ask if they’ve tried pot to help their anxiety.“

    “When in doubt, nod and listen some more.”

    We agree with Thériault on the importance of being a good listener.  That doesn’t mean that you’re expected to have all the answers. It is okay to say, “I don’t know what to say, but I care about you.”   Don’t feel the need to play the role of therapist.

    However, after working with thousands of people with mental health conditions, we’ve found that when people are in a crisis or struggling with intense mental health issues, they can be overwhelmed and not know what to do.  You may be the first person they have told and they need help knowing where to turn.

    We’ve found it can be very helpful to encourage your friend in a compassionate way to talk to a counselor with questions such as “Are you talking to a professional about this?”  If they answer affirmatively you can encourage them by saying, “I am so glad you are doing something to take care of yourself.”

    We also suggest using reflective listening skills.  Reflective listening is a special type of listening that involves paying respectful attention to the content and feeling expressed in another persons’ communication.  Katz and McNulty describe it like this

    1. Hearing and understanding what the other person is communicating through words and “body language” to the best of your ability.
    2. Responding to the other person by reflecting the thoughts and feelings you heard in his or her words, tone of voice, body posture, and gestures.

    Take your tone from them

    Thériault goes on to say, “Humor is often used as a defense mechanism, and sometimes someone might want to joke about their depression; if they’re not joking, however, you shouldn’t be either. How someone introduces the topic will tell you a lot about how they want you to discuss it with them. Having been depressed myself, I do sometimes joke about it, but if someone tried to make a joke at my expense in a dark moment, it wouldn’t have gone over well.”

    Offer specific help

    Thériault suggests that this comes up a lot in relation to grief, illness, or other extreme circumstances that might leave someone incapacitated—do not say “let me know if you need anything.”

    “What if I ask for too much, or something they’re not willing to give? Or, sometimes, if I’m really overwhelmed, I know that I need something but I can’t find the words to say what that is. 

    Thériault goes on to say, “Offering specific suggestions like going out for coffee or ordering someone food allows them to simply say yes or no; depression and anxiety makes it hard to think clearly and identify your needs. Someone stepping up with simple ideas helps a lot with decision-making.”

    We’d take Thériault’s suggestion one step further.   Since your friend may not be thinking clearly, being able to suggest a next step can often be very helpful.  A next step could be seeing their Primary Care doctor, contacting their employer’s EAP or college’s SAP if it’s a college student, or contacting the National Suicide Prevention Hotline.

    What about concern for suicide?

    It’s okay to ask someone in the course of a supportive conversation, “Are you thinking about harming yourself or killing yourself?”  Evidence is that this question doesn’t put the idea of suicide in one’s mind.  Most likely they will say no, but if they say yes, you can get emergency services (911) and help them.

    For more on the difficulty in talking about a mental health condition including what to do if the discussion involves thoughts of suicide, please read our blog post, Dying For Help: Addressing Mental Health Stigma In The Workplace.


    Espyr is a leader in behavioral health.  We provide a continuum of care ranging from integrated medical/behavioral health solutions, coaching and leadership development to comprehensive EAP, all designed to help employees and organizations reach their full potential. To learn more about Espyr can help your organization, call us at 888-570-3479 or go to





    Tag(s): Mental Health

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