How to support someone struggling with their mental health

Ask. Then listen.

Those are key actions someone can take if they fear a family member or friend might be struggling with their mental health.

To have a conversation may seem difficult, but it’s better than doing nothing. Make the question “How are you doing?” more than a greeting. Encourage an honest answer. Listen and make a connection with the person.

Ashlea McMartin, a licensed professional clinical counselor and clinical manager for Sanford Health who specializes in trauma and crisis response, offers insights about mental health support. She also has guidance for what to say — and what to avoid — when you’re checking in with someone.

Signs to watch for

When a person isolates from others and stays out of touch, that can be a worrisome sign, McMartin said. An increase in substance use is another sign — and high substance use can affect a person’s ability to make rational decisions.

Watch for other changes in behavior, too, such as their day-to-day routine, McMartin said. Do they show signs of sadness or hopelessness? Do they show less interest in activities they once enjoyed? Consider these signs as an indicator to have a conversation.

What to say and do

Sanford Health recommends using the acronym REACH to help you remember steps to help someone else:

• Recognize a need. Look for changes in how someone looks, acts or speaks. Note any life changes, relationships or responsibilities they may be struggling with.
• Ensure safety. After you identify a need, offer your support by providing a safe space for the person. This includes letting them know you care, not judging or comparing, and contacting resources if there is a safety concern.
• Actively listen. Someone is trusting you with an honest and potentially painful conversation about their mental health. Make sure they see how much you care by giving them your full attention and asking open-ended questions.
• Connect to resources. Find and connect them to information and resources that provide the help they need. Ask about their support system and self-care strategies, and offer resources like crisis hotlines, support groups, mental health professionals and primary care providers.
• Help as needed. Help looks different for each individual and situation. You can follow up with them to see how they’re doing. Be mindful of circumstances that might affect their willingness to get help. Also address your own self-care needs if you’re struggling after helping someone.

What to avoid saying

Although they may be well-intentioned, some statements are best avoided, McMartin said.

• Don’t tell the person, “It could be worse.” While technically it may be true, it’s not helpful.
• Avoid using the words “always” and “never,” which are rarely true.
• Also avoid saying, “It’s going to get better.” That can feel like too much — too overwhelming and unrealistic.
• McMartin says to avoid invalidating statements such as, “Well, at least you have a job,” or, “Well, at least you have your family.” Those types of statements don’t reflect “the current emotional state that people are in,” she said.

Getting professional help

Many resources can help a person struggling emotionally or from a mental illness.

Jeffrey Leichter, Ph.D., is a clinical psychologist and the lead administrator for behavioral health integration for Sanford Health. He recommends that patients consult with their primary care provider first. A primary care provider can conduct mental health screenings and connect them with mental health specialists.

“We find that sometimes these problems have both psychological and physical components,” he said. “We want to make sure that people are medically healthy — that they’re not struggling with something that can be easily corrected by an intervention from the family physician.”

In primary care clinics, screenings and integrated behavioral health therapists can also help recognize potential problems when people have appointments.

“We know that typically, a large majority of people that died by suicide had contact with their primary care within the last six months,” McMartin said.

Another resource is cognitive behavioral therapy for suicide prevention, which is an effective therapy focusing on what people tell themselves about suicide and about the future.

Medications can help treat some mental health disorders. Crisis response teams can provide skilled and experienced crisis care.

Peer support has emerged as an effective role as well, McMartin said. Similar to AA sponsors, these peer supporters have had a similar life experience as the people in crisis they’re working with and are strong advocates for healthy outcomes.

Dr. Leichter wants people who are suffering to know that help and support are there. They should make a call if they’re having a crisis.

“If plan one is call Mom, plan two is call a best friend,” he said. “But if it’s 3 in the morning and nobody answers, call 911 or 988. We consider this a medical emergency. Use the resources available.”

Where to text or call

Whether you’re struggling with suicidal thoughts yourself, or love someone who is, get help now by contacting any of the following:

• Suicide & Crisis Lifeline: 988 or (800) 273-TALK (8255)
• Crisis Text Line: Text HOME to 741741
• SAMHSA National Helpline: (800) 662-HELP (4357)
• SAMHSA Disaster Distress Helpline: (800) 985-5990

When you need compassionate support for your mental health, Sanford Behavioral Health is here for you.

Learn more

• Warning signs and ways to manage stress
• Podcast: How to find a mental health provider
• 5 self-care ways to fight depression

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Posted In Behavioral Health, Family Medicine, Internal Medicine

Katie Wright

Katie Wright was a content strategist for Sanford Health.

Jane Thaden Lawson

Jane Lawson was a senior communications specialist with Sanford Health.