Worried about someones mental health? 12 things you can do to help.

I spent a year taking calls on a national mental health phoneline serving people experiencing mental health problems and their family members. The callers experiencing mental and emotional distress phoned looking for they knew they needed for themselves, conversation, support, advice, information or to connect with someone who was not afraid of their experience and had some appreciation of the impact of their illness and wouldn't judge them.
The callers who were worried about friends or family members rang in often looking for advice on how to deal with their loved one. Some shared feeling powerless to change the person they could see in distress. Some expressed guilt and doubt at the forceful strategies they had tried to make their loved one change, to seek help, to respond, to open up or stop feeling bad.
All expressed worry and fear at what might happen if they did the 'wrong' thing or if they did nothing at all.

There are typically a few areas of concern when a loved one is in mental or emotional ill health. Here are a series of approaches that address each area of challenge. If you relate to the challenges described below, you and your loved one might benefit from these 12 tips.

Safety
The challenge
Whether your loved one is in a very poor mental health or is feeling down, your concern for their safety is understandable. While is isn't possible to know someone is absolutely safe there are things that you can do and say that can be helpful.
Some helpful approaches
No 1. If you are concerned for their safety tell them so. Ask if they have had thoughts or plans about suicide. When we are in deep distress thoughts about suicide can be common. If they have made plans, this is more of a concern requires action. 

No 2. Contact a GP to share your concerns and ask for and accept their advice and help.

No 3. If you believe someone is at imminent risk of harm contact your A&E or emergency services, try to keep the person safe until help is at hand, do not leave them alone and remove anything they could do themselves harm with, or substances that could lead to impulsive behaviour.

Communication
The challenge
When a loved one is unwell and has a problem we don't quite understand it is frustrating and scary and can lead to us feeling confused angry and guilty. Often our response to these situations is not very coherent, we argue, threaten, get angry, pressure, cajole, plead, make promises, give up, praise, name-call and then get exasperated that nothing we have tried has worked. It is reasonable that when we don't know quite what to do, we try doing everything.
Some helpful approaches
No 4. It is often helpful when people feel really down, distressed or anxious to have some space to themselves. However try clearly sharing that the lines of communication are open without conditions on them doing any in particular and that you welcome being in touch. Perhaps you could even share that you will check in with them regularly, by text, by phone or in person.

No 5. Try to be open, seek to listen and understand the experience of your loved one from their perspective, without questioning or taking it personally, without giving advice or instructions.

No 6. Acknowledge to yourself how distressing their experience is to you.

No 7. If your loved one has a diagnosis read up and understand how that particular illness might account for the mood, motivation, thoughts, emotions and behaviours you are seeing. This will help you see they aren't to blame for their symptoms.

No 8. Communicate your own feelings and thoughts constructively.
Communicating in constructive and positive ways creates a vision for growth, and a relationship of openness and appreciation. Instead of phrases where your loved one is the focus such as “whats wrong with you”, “I wish you wouldn't be like that”, “ “you always....”, “why do you have to be this way” try reframing the sentences to be about your positive emotion and positive outcomes.
Try describing your emotional state and your desire, such as “I really feel good when...”, “I really appreciate when...”, “I'm encouraged when...”,“I really like it when...” “I feel scared when...but it helps when....” It worries me when...and I would love if....”.

Get past emotions
The challenge
When someone isn't well it is easy to slip into talking only about how bad they feel. This is helpful insofar as it acknowledges they feel bad but doesn't create a path to lifting mood and feeling better.
We tend to get trapped in talking about negative emotions because of a bias where we think the solution is somewhere in the symptom of the problem. It rarely is.
Some helpful approaches
No 9 Talk about what the person is doing in particular. For people in low mood, talking about doing small achievable things like diet, exercise sleep, socialising, doing previously enjoyable things, small goals of pleasure and achievement can lead to hope, effort and action and then the mood follows.

Identity
The challenge
It can be tempting to allow your loved ones emotional or mental state to dominate all your thinking about them.
Some helpful approaches
No 10. Try to remember that your loved ones mood or illness doesn't define them or necessarily determine their lives. Continue to talk about and share the things you would share with them if they felt better.

Your Own Health
The challenge
It can be tempting to allow your loved ones emotional or mental state to dominate your life when you care so much about them and are so worried for them.
Some helpful approaches
No 11. Try to be open to how the situation makes you feel and what thoughts it provokes for. It can be very helpful to deal with how the situation is affecting you, separately to dealing with your loved one.

No 12. Keep doing the things that keep you healthy mentally, physically, emotionally, socially and spiritually. This is important when you are worried and stressed. You will have to judge for yourself just how much you need, and how much you can afford to sacrifice while staying vibrant enough to help someone else. You may even find that you can share or invite the person you are concerned about to join you in some of the things that keep you vibrant and healthy.