It’s been a rough few years, hasn’t it? And the result is that more people are dealing with some type of mental health condition. In 2020, 21% of American adults experienced a mental illness and 5.6% experienced a serious mental illness, such as bipolar disorder, according to the Substance Abuse and Mental Health Services Administration. One of them may be someone you love. You may even feel like he needs to help them get the care they need, but how do you start that conversation?
First, you have to listen without judging. It could be the best way to show your support. And, if you eventually want them to open up and start talking freely about how they feel, well, that takes trust, time, and a bit of tact in your approach. “It’s important to set the stage,” says psychiatrist Rhonda Mattox, MD, a board-certified physician and life coach based in Little Rock, AR. “Start these conversations in private where your friend [or family member] they are not afraid of being judged by someone they might overhear, or worried that you are trying to embarrass them.”
Likewise, be prepared to ask for honest feedback that you’ll actually listen to and digest without immediately passing judgment or offering unsolicited advice. Dr. Mattox likes to start with open questions or observations. “Whatever you do, don’t start with ‘We need to talk,'” he says. “That’s a surefire way to shut down a conversation or put your persona in defensive mode.” If he is looking for some specific thought starting points that he can use with a loved one, he has come to the right place.
Strategies for Starting the Mental Health Conversation with Someone You Love
These approaches can help you move from shallow talk to deeper conversation to help your loved one feel emotionally supported and that they have the resources they need for their well-being.
Approach #1: The casual check-in
Break the ice by saying something like, “Hey, I haven’t talked to you in a while; I just wanted to check in to see how you’re doing: the good, the bad, and the ugly,” suggests Nkem Okakpu, Ph.D., a licensed professional counselor and owner of The Greater Zen Counseling & Wellness House in Clifton, New Jersey. Use this informal register instead of the ever popular “How are you feeling?” line of questioning, which can be overwhelming or unpleasant for someone unless a space of vulnerability has already been established.
Broadening the conversation a bit can ease any anxiety your loved one might feel about talking about their emotions. While it may take time to start sharing concrete details about your current state of mind, know that you don’t have to unpack everything in one conversation. “One motivator I tend to keep in mind is that we need to learn the patterns that made us, so we don’t let them break us,” says Okakpu. This, of course, takes time, but it is worth the effort, and sometimes talking about the good things in life can help a loved one feel comfortable sharing their struggles as well.
Approach #2: The Universal Touch Dock
“Another conversation could be acknowledging how hard the pandemic has been on everyone,” says Sarah Berger, Ph.D., a licensed clinical psychologist and director of Capital Psychological Services in Chevy Chase, MD. “Something like ‘COVID has really been hard on everyone. Can you tell me what it’s been like for you?’” Because this questioning construct is all-encompassing, rather than directly targeting your loved one specifically, this could help open the lines of communication in general, leading to a more intimate exchange later. in your talk
However, you may want to avoid direct references to COVID if it’s a known trigger for someone in your circle. That said, you can apply the idea behind this touch base to anything that feels like a shared or collective experience, from major events on the world stage to something more local but still pervasive.
Approach #3: Direct Observation
Your goal here is to discuss something concrete about the way your loved one is acting. Focus on a general behavior like having low energy, being withdrawn, or even appearing sad. That said, it’s crucial that you don’t put words or feelings into another person’s mouth. Dr. Mattox recommends using I-person phrases to start the conversation.
She suggests saying something like, “I don’t want to be nosy, but I’ve noticed that you haven’t been yourself lately. I am available to listen if you need a safe space.” Another example, she says, might be: “I’ve noticed that you seem to have a lot on your mind. I have an unbiased ear to offer if you want someone to listen.”
Berger likes to use direct observations to start a conversation because they encourage sharing in a way that feels safe for an individual’s comfort level on any given day. “This type of statement lets the person know that they are being seen and that you are there for them,” says Berger. “The person can share as much or as little as they want.”
Approach #4: Strategic Participation
A final topic of conversation could be to share your own experience, but you need to tread very carefully in this area because this conversation is not about you, it is about your loved one. Berger suggests saying something like, “Last year when I was having problems at work, it was helpful to talk to a therapist,” and then listening to see where your friend or family member wants to take the conversation from there.
Dr. Mattox suggests a similar thought start, where he talks about a difficult time in his own life: “I’ve been through something a bit similar. I don’t want to take it out on you, but when I was going through it, it was helpful to know that I wasn’t the only person going through a hard time and that I wasn’t alone in my struggles.” The key here, again, is asking permission to share rather than just giving unsolicited advice. Really, this line of conversation is a means of getting the other person to share their struggles, so keep your own comments to a minimum.
What to do if they don’t talk to you
If you meet resistance, don’t give up. Instead, Dr. Mattox suggests coming back with a slightly different approach a few days later, such as presenting the idea of the conversation as a writing exercise. To do this, he suggests offering a notebook and saying something like, “I saw this beautiful journal and thought of you. I realize that he hasn’t really wanted to talk. Sometimes I feel better after writing and putting my worries and concerns on paper.”
Then you can continue with the rationale behind why you’re giving away the diary: “Sometimes just getting it out of my head and onto paper helps me put things in perspective,” Dr. Mattox suggests saying. He always ends with a conviction like “I hope this helps”, to express his concern. One day, his loved one may feel comfortable sharing those thoughts he wrote down, but that’s a conversation for another day.
Ultimately, your loved one may not want to talk to you directly on any given day, even if you use one of these approaches designed to break down walls. In that case, Berger says you can always share a direct line of text with your persona. “It lets them know you care and offers them anonymous help,” she says.
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