MENTAL health is not the taboo it used to be.
But it’s easy to still feel nervous starting a conversation with someone you love if you’re worried about theirs.
It’s a complicated area, but there’s no need to overthink it, says Dr Mark Graham, lead trainer, workplace training mental health first aid instructor.
He said: “We can all spot changes in mental health, whether we're looking at a young person, whether we're looking at an adult.”
And we can all step in to help if someone is struggling.
Here’s what you need to know…
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1. WHAT TO LOOK FOR
Changes in behaviour and emotions are usually the first sign someone is having issues with their mental health.
For instance, “when you start to see things like sadness, aggression, lower energy levels and them being more withdrawn,” says Dr Mark.
“Maybe when a person becomes frustrated as they can't get out what they want to say; they have brain fog which leads to forgetfulness, where they forget what they've already said or forget to do something they've agreed to do.”
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Their physical habits may change too, and their wellbeing will likely be impacted.
“Poor mental health impacts on your sleep, your connections with others.
"It can impact your eating habits. Quite often when a person again is experiencing mental health distress, you may see that a person eats more, eats less or even changes the nature of their eating behaviour,” says Dr Mark.
2. TIME FRAME
Everyone has a bad day every now and again, what you’re looking for is sustained changes in behaviour.
Specifically: “A sustained change over a period of days, where you are picking up that this is different for that person,” explains Dr Mark.
3. FIND CONFIDENCE
Starting a conversation with someone you’re worried about can be tricky, but you’ve got to go for it.
“Being able to connect with these changes, to actually have the confidence to say, ‘I have seen or heard that you’re not yourself, I have a feeling that is an issue,’ – to be able to have the confidence to start a conversation with them, is crucial,” says Dr Mark.
4. KEEP THE DOOR OPEN
That conversation might not go how you’d hoped, and that’s ok.
“There are times when people might be very open to support,” says Dr Mark. “But there are times when people might just simply say, ‘No, I don't want to do that. I can't do that, it won't work.’
“I call that a ‘person's now'. Their now is their current circumstance and it might be a very negative perspective – their ‘negative now’.
“What we can do in that situation is continue to be supportive, to keep the door open to say to them: ‘I understand how you feel, but you might be able to feel better if you look at some of these things, but if you're not ready to do that at the moment, that's perfectly fine.
“‘But could we touch base again, tomorrow or in the next few days? Next week? Could we still continue this communication?’"
It’s not about being “pushy” says Dr Mark.
“Initially, they might be saying, ‘No, no, no.’ But over time, they might turn to you and say, ‘I trust you, I accept that you're trying to help me’.”
5. ACTIVE LISTENING
When they do feel ready to open up to you, try ‘active listening’ says Dr Mark.
There are different stages to this:
- FOCUS
“We want to show we're listening to the person, we're using positive body language and eye contact.
"We're not showing distraction. We're not looking at our watches. We're not looking at our phones. We're focusing purely on the person – in a way you want to let everything else fall to the wayside.”
- TIME
“We want to give them our time. We don't want to rush this communication.
"If silence comes up a little bit, that's absolutely fine. Giving them time is the most valuable thing you can do.”
- CONFIDENCE
“Be confident that you can help, not to make the situation go away and not to make them better, but that you can help direct them to resources and have that conversation.”
- QUESTIONS
“Participate. Ask open questions: ‘How is this impacting you? How does it make you feel? How long have you felt like this? What would you like to do next? What kind of support do you think would help you?’
"It's all about empowerment.”
- THEY’LL LISTEN TOO
“As a person is speaking to you, they're also listening to themselves. As they're listening to their concerns, their feelings, their experiences, their emotions, they’re hearing what they're going through.
“Quite often when you keep your ideas in your head as you ruminate, they go around and around and around.
"But when you lay them out in a conversation, it can often enable the individual to start to find direction for themselves.”
- VALIDATE
“Show you're listening by repeating back what you've heard so far, that can be paraphrasing or summarising. ‘Is this what you mean? Is that what you're going through?’
“It shows that you're really eager to listen.”
6. YOU CAN’T SAY THE WRONG THING
Worried you’ll put your foot in it or say something wrong?
“Don't be fearful. It's better to speak,” says Dr Mark, who notes that you should be listening more than speaking anyway.
“You might feel you don't know what to say. That's fine. Tell them you don't know what to say.” Just be there for them.
7. REMEMBER SELF CARE
You’ve got to look after yourself too. “We already have self help strategies,” says Dr Mark – even if you think you don’t.
“Ask yourself, when you have stress, what do you do? Go for a walk? Listen to music? Speak with friends?
"We support our wellbeing with those self help strategies. It's important to remember that we can do that.”
Dr Mark also encourages taking “happiness time” where you take a moment just for you – be it having a dance in the kitchen or taking a bath – which will in turn help you help others.
“It's knowing that when we support others, we need to be not necessarily in a strengthened place, but in a safe place ourselves.”
8. ACCESS RESOURCES
If you want to learn more, Dr Mark recommends taking a mental health course, like a St John Ambulance one, and to access services and charities like Mind.
He also champions Hub of Hope, an app which offers a database of local resources.
Want to learn life-saving skills? Click here to book a first aid course, join one of St John’s youth programmes (for ages 5 to 25) or become a first aid volunteer.
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St John’s training will give you essential lifesaving skills and the confidence to use them, and includes mental health first aid and wellbeing courses.
St John is a charity and needs donations to help train and equip its volunteers, to save more lives. Donate at sja.org.uk and follow them using #AskMe
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