Are you worried about a friend?

Asking for help and encouraging a friend to seek help can sometimes be a difficult task because we may not be used to talking about issues related to mental health. Here are some tips and guidelines for how to determine when to encourage help-seeking behavior and how to start the dialogue between you and a friend, family member, coworker, or peer.

 

First let's start off with some triggers that might spark the idea that you or a friend might benefit from speaking with a counselor or mental health professional.

Signs a friend might need help:

1. Feelings of hopelessness, worry, poor self esteem, depressed mood, guilt

2. Withdrawal from friends, family, hobbies

3. Changes in eating and/or sleeping patterns

4. Feelings of anger, rage, craving revenge

5. Tiredness and exhaustion

6. Difficulty concentrating, thinking clearly or remembering/poor academic performance

7. Restless, irritable, anxious

8. Neglect of personal care

9. Regular crying

10. Reckless or impulsive behavior

11. Persistent headaches, digestive problems, chronic pain

12. Thought about suicide or death*

*If you think a friend may be suicidal or mentions thoughts of suicide, take immediate action:

Call the campus emergency number at 1 (909) 869-3070, dial 911 if you are off campus, or call the National Suicide Prevention Hotline at 1 (800) 273-8355(TALK). This lifeline is free, confidential, and always available. Take any talk or plans of suicide seriously. If you are afraid for your friend’s safety, stay close and make sure your friend is not left alone until help arrives.

 

Warning Signs of Suicide: These signs may mean someone is at risk for suicide. Risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change.

1. Threats or talk of hurting or killing oneself

2. Talk of being a burden to others

3. Talk or writing about suicide or death, when this is out of the ordinary for the individual

4. Feelings of hopelessness, feeling trapped or in unbearable pain

5. Withdrawal or feeling isolated

6. Obtaining or seeking access to firearms, pills or other means

7. Showing rage or talking about seeking revenge

8. Increased use of alcohol or drugs

9. Giving away prized possessions

10. Displaying extreme mood swing

 

 

What to do if you are worried about a friend

Talk with your friend, share your concerns, and don’t forget to take care of yourself.

1. Talk with him/her as soon as possible. Ask questions, listen to ideas, be responsive

                Examples of what to say to prompt a conversation:

• “I’ve noticed you haven’t been acting like yourself lately. I’m worried about you, is something going on?”

• “How can I help you?”

• “How long have you felt this way?”

• “Have you spoken with anyone about this? Can I help you find someone to see about your concerns?”

1. Approach your friend in a comfortable and safe environment, speak calmly and tell your friend specific behaviors you have seen that worry you.

Example: “I value our relationship and I am concerned that you seem depressed. You’ve been sleeping a lot more, not eating as much and don’t seem you want to hang out with your friends. I want to help.”

1. Listen in a sensitive, non-threatening way. Repeat back the overall message of what your friend tells you and ask if you understand them correctly. Use “I” statements instead of “you” statements.

2. Encourage your friend to seek help, offer to go with them to find the counseling center, help schedule appointments by finding phone numbers, or research support groups in the area.

3. Be prepared for all possible reactions-hopelessness, anger, etc. Consider telling someone else (a trusted adult, an RA, a counselor). By telling someone else you are being the best friend possible and helping your friend get the support he/she needs

4. Remember that you cannot make someone get help or change their behaviors and attitudes. Practice patience and offer encouragement.

5. Know your limit, remember to take care of yourself too. You can’t be there to help others if you become ill.

6. Don’t try to take over your friend’s life. Be patient.

7. Offer reassurance, mental health concerns are often hard to explain and your friend may have difficulty putting how they feel into words.

8. Never keep talk of suicide a secret.

 

What isn’t supportive?

1. Don’t tell someone with depression to get better, as they can’t  “snap out of it,” or “get over it”

2. Do not be hostile or sarcastic in response to their attempts to open up, rather be accepting of what the person can share at this time.

3. Do not adopt an overinvolved or overprotective attitude toward someone who is depressed.

4. Do not trivialize the person’s experience by pressuring them to “put a smile on your face,” to “get your act together,” or “lighten up”

5. Avoid belittling or dismissing their feelings by attempting to say something positive, such as “you don’t seem that bad to me.”

6. Do not use a patronizing tone or overly compassionate looks of concern.

 

 

The "ALGEE" Mental Health First Aid approach encompasses the previous steps into an acronym that may be easier to remember:

Assess for risk of suicide or harm. If you notice the warning signs and suspect the person is at risk, it is important to directly ask about suicidal thoughts. Do not try to tread around the subject, ask without dread or expressing negative judgment. It is a myth that asking about suicide will put the thought in their head. Ask “are you having thoughts of suicide?” or “are you thinking about suicide?”

Listen nonjudgmentally. Adopt an attitude of acceptance, genuineness, and empathy. Do not interrupt the person, especially to share your own personal opinions or experiences.  Use minimal prompts such as “I see,” to keep the conversation going. Be patient, the person may not be speaking clearly, talk slower or be repetitive. Pay attention to your body language: maintain comfortable eye contact, open body language, sit down alongside and angled toward the person rather than directly across.

Give reassurance and information. Treat the person with respect and dignity, do not blame them for the illness, have realistic expectations, offer consistent emotional support and understanding, give the person hope for recovery, provide practical help, and offer information.

Encourage appropriate professional help. Primary care physicians, mental health professionals, certified peer specialists, and psychiatrists can all help. Keep in mind that health professional often do not recognize depression right away and it may take time to get a diagnosis and find a health care provider with whom the person is able to establish a good relationship.

Encourage self help and other support strategies. It is important that family and friends provide the same kind of support to someone with a mental disorder as they would a physical disorder. There are many self-help options available such as exercise, diet change, books, relaxation training, and computerize CBT.

 

Where to turn for help

1. Talk with a parent, medical doctor, religious leader, trusted professor or advisor, RA or a friend.

2. If you are enrolled in school, visit your university health center or counseling services.

3. Search “mental health services in [your city’s name]”

4. Get in touch with local chapters of national organizations

                Ex: National Alliance on Mental Illness (NAMI) www.nami.org

5. Check out support groups on campus, community centers, local hospitals or faith centers.

 

 

In the meantime…take care of you!

1. Exercise regularly, at least 2 ½ hours a week

2. Eat healthy meals throughout the day

3. Strive for 7-8 hours of sleep a night

4. Get connected with friends, family, peers, or coworkers

5. Set realistic goals

6. Remember to set aside time just for you

7. Remember you are not alone