What to do if you think someone is struggling with their mental health

Did you know, 1 in 5 Australians are affected by mental illness, yet many don’t seek help because of stigma?

We can all do something to help shed a more positive light on mental health.

Many of us avoid addressing the early signs of mental illness in those close to us, because we simply don’t know how to approach the person we are worried about. It’s quite normal to attend a physical first aid course, learn how to tie a triangular bandage or initiate CPR, but would you know what to do if you suspected a loved one was showing signs of mental illness?

A year ago, I qualified as a Mental Health First Aider. I initially took the course because I volunteer for a lifesaving organisation that deals with traumatic situations on a regular basis and as the organisation’s appointed Crew Rep and Safeguarding Officer, I wanted to be able to offer another level of support to my crew mates. However, after taking the course I firmly believe these are skills that everyone should have. Since qualifying, I have been able to use what I learned on the course multiple times in both a professional and personal capacity.

Mental health is everyone’s business

We all have mental health! And we all need to look after it. Better mental health is good for everyone and recognising this is good for society.

We all have times when we feel down or stressed or frightened. Most of the time those feelings pass. But sometimes they develop into a more serious problem and that could happen to any one of us.

Here are a few facts about mental health:

  • Approximately 20% of Australian adults experience a common mental illness each year.
  • Nine out of 10 people with mental ill health experience stigma and discrimination.
  • Anxiety and depression are the most common mental illnesses, with around 1 in 10 people affected at any one time.
  • You are more likely to walk past someone having suicidal thoughts than someone about to have a heart attack.
  • In 2018, suicide accounted for over one-third of deaths (38.4%) among people 15-24 years of age and 29.4% of deaths among people 25-34 years of age. In 2018, there were 105,730 years of life lost to suicide. On average, a person who died by suicide in 2018 lost 36.7 years of life.
  • Most people who are at risk only feel suicidal for a brief period in their lives. With proper support, they will probably never be suicidal again.

Mental illness is treatable

Like any other illness or injury, a broken brain needs support, care and treatment to get better or to be managed well enough to create a good quality of life for that person.

Many people who are diagnosed with a mental illness and are treated, recover well or even completely. Mental Health First Aid can be the first stepping stone to diagnosis, treatment and recovery.

What is Mental Health First Aid?

Mental Health First Aid teaches people the skills they need to help someone they’re concerned about. Mental Health First Aid is the help provided to a person who is developing a mental health issue, experiencing a worsening of an existing mental health issue or in a mental health crisis. The first aid is given until appropriate professional help is received or the crisis resolves.

Common barriers to offering support to a someone we are concerned about include fear of doing the wrong thing, or a lack of skills, knowledge and confidence, or awareness of what to look out for.

Could you spot the difference between a bad mood and something more serious?

What are the signs of poor mental health?

No matter what the eventual diagnosis might be, there are some common signs and symptoms to look out for when someone is struggling with their mental health:

  • Avoiding social events and activities they usually enjoy
  • Feeling down, upset or tearful for prolonged periods of time, or they might be restless, agitated or irritable
  • Lacking self-confidence or self-esteem, or have a feeling of hopelessness and despair
  • You notice signs of self-harm or suicidal behaviour
  • They have difficulty speaking, thinking clearly, making decisions, remembering things or concentrating on things
  • You notice they are using more tobacco, alcohol or other drugs than usual
  • They have difficulty sleeping, or they’re sleeping too much, or feel tired all the time
  • They might gain or lose weight suddenly, or experience unexplained physical aches and pains
  • Symptoms of anxiety, for example, may include heart palpitations, shortness of breath, headache, restlessness, diarrhoea or a racing mind
  • You may notice a sudden change in their behaviour, for example someone entering a bipolar manic episode may be more active than usual, talk a lot, speak very quickly, or not make sense to other people

If you’d like to read more about the signs and symptoms of different types of mental health problems (and I encourage everyone to familiarise themselves with this), check out MIND’s information pages HERE.

Of course, someone might just come up to you and tell you they are worried about their mental health, and that’s awesome if they do, because that means you’re working in a culture or living in a community where there is no stigma around mental health, people feel they can talk openly about it and ask for the support they need – and that’s the whole point of this.

What to do if you’re worried about a friend’s mental health

When you’re unsure of what to do in any situation, it always helps to have a process or a plan up your sleeve. For example in physical first aid, we have DRSABC. In Mental Health First Aid, we have ALGEE. This is the Mental Health First Aid action plan.

A is for Approach, Assess for Crisis

This involves a bit of planning. For example, if you work in a busy office, it might not be appropriate to initiate a conversation at your friend’s workstation. Instead. perhaps invite them for a coffee, or a walk, or broach the subject while you’re driving in a car together somewhere. Research shows that being side by side, instead of facing each other, can help someone feel more comfortable and relaxed, and therefore more likely to speak openly.

Think about how you’re going to start the conversation, try not to ask direct questions, make accusations or imply that they have been the subject of conversation behind their back – “we’ve all been really worried about you, you’ve been so sad lately, what’s the matter?” is not the way to go. Instead, ask them how they’re feeling, or if anything is worrying them. Don’t pressure your friend to talk, but let them know if they did want to chat about anything, you are there for them and will listen confidentially and non-judgementally.

One important point that is often overlooked in this part of the plan is how you’re feeling going into this conversation. Is your own mental health strong enough to deal with what your friend might disclose to you right now? Are you ready to listen non-judgementally? You might need to take some time and space to centre yourself and do some deep breathing exercises before you approach your friend.

B is for Listen and Communicate Non-Judgementally

Give your friend space to speak freely and comfortably without feeling judged. You are not here to diagnose them or fix what’s happening, you are here to listen and provide support.

  • Respect your friend’s feelings, experiences and values, even if you don’t personally agree with them, just accept them as they are.
  • Show that you genuinely accept your friend’s thoughts, feelings and values, without moral judgement.
  • Demonstrate empathy – place yourself in their shoes. Try to imagine how they are feeling right now, how you would feel if you were going through what they are going through, without taking their emotions on as your own.
  • Listen, without interrupting, even if that means a few uncomfortable silences. Give your friend space and time to talk.
  • Pay attention – really hear what they are saying, look at their body language, observe their tone of voice.
  • Ask appropriate questions at the right time, be clear about what is being said, you can even repeat it back to your friend to check you are understanding correctly and ask them to confirm e.g.”From what you’re telling me, it sounds like you are feeling like …. would you say that is right?”
  • Maintain an open body position and keep appropriate eye contact – sitting on an angle, walking side by side or sitting next to each other in a car can make the conversation feel naturally more comfortable and less confrontational.

G is for Give Support & Information

Reassure your friend that they have done the right thing by talking to you, that they are not alone in how they are feeling, that they can’t help feeling this way, but there is hope – they don’t have to feel this way forever. Then ask them if they’d like you to help and support them. If they say yes, be prepared to stay true to your word, be consistent and give that support and help.

Perhaps your friend would like some practical help with tasks they are struggling with, or even the logistics of seeking the help they need (just be careful not to ‘take over’ – make sure your friend still feels empowered to make changes to improve their own situation).

Ask them if they’d like some more information about looking after their mental health, perhaps even research together. Mind, Beyond Blue, Sane and Black Dog Institute are some of the many excellent Mental Health NFPs that offer helpful resources and guidance.

E is for Encourage Appropriate Professional Help

Ask your friend if they feel they need help to manage how they are feeling.

If they do, discuss the options and services available and encourage your friend to make use of them.

A good first place to start is for them to talk to their GP. Your friend may ask you to attend an appointment with them as an advocate. If so, try not to take over completely, help your friend to feel empowered in speaking up and seeking the professional help they need.

“Seeking professional help for mental health issues can be a very difficult step for many people to take. Research evidence suggests that in the month before suicide, fewer than half of all people who take their own lives are in contact with a health professional, so it is important to help people make this difficult decision” – MHFA England

E is for Encourage Other Supports

People who feel supported by family and friends recover faster. Family and friends can provide support to someone with a mental illness in exactly the same way as they would someone with a physical illness – get well cards, flowers, phoning, visiting, making dinner or a cup of tea, helping out with household tasks are some simple ways to provide practical support.

Community organisations can offer a range of support services to people experiencing mental illness, and there are many self-help strategies that can complement or even be used instead of professional support from GPs or mental health professionals, enabling people to feel they are regaining control of their own lives in a really positive way. These strategies include mindfulness, exercise, yoga, acupuncture, good nutrition or massage therapy.

What next?

What I’ve shared in this article can not and should not replace the incredible skills and experience you will get from attending a Mental Health First Aid course; however, I hope it has helped you feel more confident to approach that mate who has been a little more quiet of late, or who seems withdrawn and just not themselves. The best thing you can do for them is ask them, really ask them, how they are. Are they ok? And listen to what they have to say.

Find out how you can get certified in Mental Health First Aid at www.mentalhealthfirstaid.org.

If one in ten people were trained in Mental Health First Aid, this would be enough to create widespread and longterm change in society.

One final – very important – thing

“Put your gas mask on first before assisting others.”

Look after yourself first and foremost. You’ll be no good to your friend who is struggling if you are too. Take care of yourself. Be kind to yourself. The Mental Health Foundation has some great advice on how to look after your own mental health here.


Further useful reading and advice can be found at the following links


National Suicide Prevention Alliance

Zero Suicide Alliance


Adult Mental Health First Aid Manual - MHFA EnglandMindHealth DirectSaneMental Health OrgLife in Mind AustraliaMental Health OrgMental Health First Aid AustraliaMental Health First Aid England
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Charli Ferrand Higgins

After a decade working for global and boutique PR and Marketing agencies in Sydney, with clients that included some of the biggest consumer brands in the world, Charli returned to her homeland of the UK in 2017 and decided the time had come to use her professional skills and experience for good. She has since split her time between supporting passionate, purpose-driven small and medium-sized businesses to grow through conscious content marketing, managing and editing the planet-positive content hub Earth Collective (weareearthcollective.com), and hosting the podcast Easy Being Green? Lessons in sustainable business for SMEs.

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