You won’t always know the ‘right thing to say’ and that’s fine. Sometimes careful listening and being there will be all that you can do or all that’s needed.
In the UK mental health charity Student Minds’ 'Looking After a Mate' report into students helping friends struggling with their mental health, it was found that many student supporters wanted more information and advice targeted at them – in particular because many felt that they didn’t know what to do or were unsure as to whether what they were doing was helpful.
So, this article is intended to give guidance – for noticing that someone needs help, bringing up the subject of mental health and being a source of support afterwards. This is by no means a step-by-step guide because mental health is by no means a simple topic; your approach will be informed by, among other things, your relationship with your friend, the specific struggles they are dealing with, and your own feelings and circumstances. Nonetheless, by reading some strategies, you might get closer to finding the best approaches for you and your friend.
First and foremost, you should make sure you look after your own mental health throughout the process of supporting someone else – this is in the interests of both of you. So, you may want to take a look at our advice on looking after yourself when looking out for a friend alongside this article.
Noticing that someone’s struggling
It might sound like an obvious point but there’s no universal ‘sign’ to spot in someone struggling with their mental health. Often, the things to look out for are changes – these can be revealed in many different ways but examples include changes in behaviour, mood, concentration levels, attention span, attitude and how your friend presents themself. It might turn out that there are other explanations for these changes, but it is safer to approach the subject and find out than to assume that this is the case.
As a result of Covid-19, you could find that you have plenty of opportunities to pick up on how your friend’s doing – perhaps, for instance, you’re in a flat with them all day, every day. Alternatively, they might be a face on your phone screen every other Friday. If your catch-ups are virtual, you can still look out for changes: do they seem to act as they normally would? Are they avoiding your chats without an obvious reason, even though they are typically pretty reliable? Do they bring up subjects that you find out of character? If you’re both part of the same group of friends, you could ask someone else you trust whether they have noticed anything different in your friend, too.
Approaching the subject
When you’ve decided to bring up your friend’s mental health with them, it’s a good idea to plan how and when you’ll do so. Think about the time that’s best for the conversation. This will depend on the person; a relaxed Sunday afternoon might mean they are less likely to be distracted by lectures, for example.
When it comes to the how, we have a few suggestions below. However, keep in mind that your friend might not want to talk straight away – or at all. It might be difficult if you can see that they are really struggling but you can’t force them to get help or to talk to you, or see a health professional on their behalf.
As long as you think there’s no physical threat to themselves or anyone else (call 999 if this is the case), you can just make it clear that you’re there for them if they ever need someone to talk to and plan to bring the subject up again in a couple of weeks if they still seem to be struggling. If appropriate, you might also suggest some other sources of support that you think could be useful.
Ask clear questions
While it’s understandable that bringing up such a serious subject could be anxiety-inducing, try not to ‘beat around the bush’ as this could result in both you and your friend feeling confused or unsure. If you’re worried, then ask. You’ll be a better support if you know what you’re helping with.
This is particularly important if you think they may be having suicidal thoughts; it has been proven that you will not be ‘putting ideas in their head’ by asking whether this is the case. If they have had suicidal thoughts, let them know of these helplines and text lines suggested by the NHS and the one-to-one support services provided by Student Space. Student Space is a source of support and guidance for students’ mental health during the pandemic, run by Student Minds. You may also want to send them a text or leave them a note with a few of the numbers on. If there is ever an imminent threat of harm to themselves or someone else, call 999 or (if possible and safe) help them to get to A&E.
Effective listening is an underrated skill. It’s often easy to feel compelled to problem solve or to wonder how to respond to someone, and this can mean you don’t fully take in or understand what is being said.
Particularly during earlier chats with your friend, listening carefully and trying to get your head around how your friend is feeling is crucial. If there’s a pause in their speech, don’t rush to fill it – perhaps they’re trying to collect their thoughts or figure out the best way to let you know something important. Try not to jump to conclusions, and ask clarifying questions if you’re unsure about what is meant by something your friend says.
As well as aiding your understanding – and therefore your ability to support them effectively and empathetically – this should give your friend confidence that you’re taking their struggles seriously. Maintaining eye contact (as ‘naturally’ as possible – ie without staring) and nodding can also help to show that you’re listening carefully.
Focus on feelings rather than symptoms
If your friend is behaving or appearing in a harmful way (eg giving you reason to believe they are self-harming or struggling with food), then you should let them know that you’ve noticed this, talk to them about it and encourage them to get support if they aren’t already. Trying to understand what your friend is going through is one of the most helpful things you can do; Student Minds shares advice on support specific to eating disorders, bipolar disorder, depression, obsessive compulsive disorder (OCD), anxiety and psychosis here .
However, if your friend is acting in a way that’s unusual for them but not harmful, try not to make this the thing you focus on during conversations. This could make them feel self-conscious and be a barrier to discussion of the important issues – their feelings and thoughts. Remembering that differences in the way your friend acts are outward symptoms of an inward struggle could help you to avoid zooming in on them.
By talking to your friend, you’re helping to show them that they’re not alone and that they are valued by others – both of which might encourage them to open up about their struggles and seek out the help they need. However, going into your conversation with a few further ideas for support may help to emphasise this and to give them the confidence that there’s a way to get through how they are feeling right now.
Friends and family members who have your friend’s best interests at heart may be a good place to start. You might suggest that they see a GP and do some research into services together – perhaps sometime soon rather than during your initial conversation if your friend needs a bit of time to process. Student Minds and Student Space provide information and guidance for finding support as a university student. If you’ve graduated, mental health charity Mind also has information about different sources of support. You could also offer to help with making or travelling to appointments and/or to go along with them for the first few.
Keeping communication supportive
You won’t always know the ‘right thing to say’ and that’s fine. Sometimes careful listening and being there will be all that you can do or all that’s needed. Furthermore, supportive communication doesn’t mean losing out on the types of conversations you’d have had previously. Chats about your favourite Netflix show and rants about your least favourite degree modules can help keep up your friendship, along with maintaining a sense of stability/normality for your friend.
You might want to consider some of the below points as you continue to support your friend – particularly when you think they’re having a difficult day or whenever the subject of mental health comes up.
Taking a bit of time to find out about some of the specific struggles your friend is dealing with might improve your confidence when giving support. You could discover what has helped others to manage certain symptoms related to your friend’s condition, for instance. The helping someone else section of the Mind website gives information for how you can support people with different problems associated with mental health. Mind’s A–Z of mental health also gives information on a range of topics – including specific conditions and forms of therapy.
However, try not to let this get in the way of you listening carefully, without jumping to conclusions. And definitely do not use your research to make diagnoses. You’re not expected to be the expert, and both of these have the potential to do more harm than good.
Give sincere validation
For some people, an honest compliment can be a little lift to their mood and sense of self-worth. You might let your friend know when they’re wearing an outfit you like or comment on their clever contributions to seminars. Whatever you say, just make it honest and don’t go overboard on the gushing. Your friend probably won't want to feel like you’re treating them differently to usual.
Let them in on what helps you
You’re probably not experiencing the exact same difficulties as your friend, but talking about some of the healthy ways you look after your wellbeing or manage stress might spark an idea for a helpful coping mechanism. It could also lead to you carrying out an activity together – whether that’s meditation, a yoga class or a film night. You don’t have to share every pastime that makes you feel better, though. As we suggest in our article on looking after yourself while supporting a friend, it’s crucial that you take time out for yourself.
For further support on starting a conversation with a friend, guiding you through the where to talk, when to talk and what to say, take a look at this Student Minds’ article.