One of the most difficult situations I hear from people about is when they have a loved one who is struggling with mental health issues, but is reluctant to seek professional help.
People often ask advice as to what they can say or do to help someone who is struggling. It's really hard to watch someone you care about struggle & not living life to its fullest.
It's important to firstly understand why people are reluctant to access mental health treatment. In my experience, here are some of the most common reasons people don't seek mental health treatment, & some tips for what to say or do.
Misunderstanding of what causes & contributes to mental illness/ disorders
Many people think mental illness is entirely a psychological issue, so therefor they can 'think' their way into feeling better. Unfortunately, this is rarely true.
Mental illnesses & disorders are a complex mix of physiological & psychological factors, & there are many variations of disorders. For example, one person's 'depression' may be entirely different to another persons experience of depression. There are literally hundreds of sub-sets in the diagnostic criteria for most mental health conditions.
Causal factors often differ greatly, & people respond differently to different types of treatment. If mental illness could be cured by willpower alone, that would be great- but it's just not the case! Most people struggling with a mental health issue try lots of things to feel better, in vain, before they seek treatment.
I commonly hear people suggesting strategies to improve mental health symptoms that are well-meaning, but ill-informed. Things such as elimination diets (maybe it's gluten?!), 'cleanses', vitamin & herbal supplements (can actually make things worse) are not proven treatments for mental health conditions. Drastic changes to diet can often make things worse, as they add stress to the body.
Likewise, crystals, aromatherapy, realigning your chakras & other alternative treatments have all been shown to have no effect on mental health conditions.
Mental health conditions require specialised, medical treatment. It must be evidence based, proven to be effective & not cause harm. That is not to say that complementary treatments can't be helpful for our sense of wellbeing, but they are not on their own proven to be effective treatments.
You wouldn't encourage your loved one who has a cancer diagnosis to treat themselves just with herbs & a scented candle- Please don't suggest this for your loved one struggling with a mental health condition.
Mental illness is treatable & does not have to be a life sentence. But without the proper treatment, it can be deadly. Australia's suicide rate is unacceptably high, & part of the reason is people not accessing evidence- based treatment.
What to do/ say:
Tell the person that mental health issues are also medical issues. They require specialist assessment & treatment. There are psychological factors relating to mental health, & there are also physiological & medical factors. The link between the mind & the body is strong & intricate- we need to look at both these factors in recovery.
Consider saying something like,
"I know you have been struggling with this for awhile, & working really hard to feel better. I think if this was something you could fix yourself you would do that. But after doing some research, I have realised mental health issues require professional treatment. Just like medical conditions require professional treatment. If you had a physical health condition, I would be encouraging you to seek help. That's why I'm encouraging you to seek help for your mental health worries- because it's the same thing!".
Over-emphasis on the role of external factors
Some people believe if they just change their job, leave their partner, take a holiday, eat only natural foods or start exercisiing everyday, their mental health issues will resolve. Certainly lifestyle factors are important, but rarely they are the whole issue.
We take ourselves into all environments & interactions we have. We leave a job, but take ourselves into the new job- the risk is we also take our same problems with us. Akcnowledging the internal factors that contribute to mental wellness is an essential piece of the puzzle in long-term recovery.
What to do/ say:
Validate aspects of the person's life which may be causing them stress, but also gently point out facts about their experience over time, & the complex nature of things.
You could say something like,
"It sounds like your job is really causing you a lot of stress, & it might be worth considering a change. I know you've been feeling down/ stressed/ anxious for awhile though- even before things at work got stressful. Before you make any decisions about a big lifestyle change, maybe it would be helpful to talk to someone who specialises in stress management/ anxiety, so you can feel confident in making a wise decision moving forward, & not taking this same stress into your next job".
Stigma
Many people fear being told they have a mental illness or disorder. They may fear what they think professionals may think of them. Fear of being labelled as 'crazy', is common, but unfounded, as any professional working in mental health would hopefully have the utmost respect for their clients & their clients' lived experiences.
It is true that many people in society have a poor understanding of what mental illness is & how to treat it. However, by educating ourselves we can help our loved one conquer the issue of stigma.
What to do/say:
Provide reassurance to the person that you do not judge them if they are struggling with mental health issues. Do your own research of reputable sources for information about mental illness & treatment. The websites provided at the end of this blog are a great place to start.
If you have experienced challenges with your own mental health, this can be a powerful way to empathize with their experience, & encourage them to get professional help. However, don't assume their experience is the same as yours- it may be very different.
For example,
"I can understand why you might not want to talk to anyone about feeling down/ anxious. There are some people in our society that are ill-informed about mental health issues, & I respect your right to your privacy. However, lots of people seek help for mental health issues- it's actually really common. The statstics show at least 1 in 4 people will have a mental health issue in their life- & the real figure is probaly more common then that."
Or
"I've struggled at times with feeling down/ anxious. I waited until things were really bad before I got some help. I wish I had gone sooner. When I did find the right person to see I started to feel much better, & I realised how common mental heath issues really are".
Not knowing where to go or who to talk to
It can be overwhelming trying to choose a professional to talk to about mental health concerns. These issues are often difficult for people to talk about & are very private.
What to do/ say:
If you know a good GP or counselor, recommend them.
You could say something like,
"I'm not sure if this might be helpful for you, but talking to this person has really helped me. They are really nice & knowledgeable in mental health issues. It might help you to get their opinion on what might be helpful, but you're also under no obligation to take their advice",
Or,
"I'm glad you feel comfortable talking to me about what's going on for you lately, & I want you to keep doing that. But I also think there may be people who might have more experience in dealing with stuff like this- like your GP, or a mental health counsellor. Maybe we could look for some information online together, & that might give us an idea of who you could see in our area".
Lack of insight into the impact mental health issues are having in their life
Some mental health conditions, particularly the more serious & acute conditions, can include reduced levels of insight as part of the illness. This means that the person may not recognize they are actually suffering from a mental health issue.
They may even be experiencing distortions in reality, such as hallucinations or delusions. Mental health conditions of this severity are often apparent to people around them, & it is important serious symptoms such as these are not ignored.
What to do/ say:
If you are seriously concerned about someone's mental health you should your local Community Mental Health Service (listed in all local area directories). Unless there is evidence of acute risk of harm to themselves or others, someone can't be forced to get treatment. However, Community Mental Health services can often give advice on options for treatment & help to assess risk.
If there are no acute risk of harm issues, you might have to talk to the person several times befire they agree to see a mental health professional.
Try saying something like,
"I've notived you haven't seemed like yourself lately. You seem more worried/ down/ anxious then usual. Have you been feeling down/ worried/ anxious?"
Or
"I've noticed you've been acting in a way that is really out of character for you lately. I'm worried you may not be feeling like yourself. What's going on for you?" (give specific examples of behaviours that have concerned you)
Or
"It seems like you have been feeling down for quite awhile. I know life has it's ups & downs, but you seem to be more down then usual. If you're not feeling good, that's not okay- you're missing out on a lot of good times! Would you be willing to look at some info I've found online & see if talking to someone might help?".
So what do I do if my loved one still won't seek mental helath treatment?
Your still have some options if your loved one won't seek help, despite your best efforts.
You could choose to talk a mental health professional yourself to gain information & insight into what your loved one might be struggling with. You might also like support for yourself in how to manage issues in the relationship with your loved one.
You could get in contact with an Accredited Mental Health Social Worker or psychologist, or ask for a referral from your GP. You could also contact your local Community Mental Health Service for advice.
There are also support services specifically for family & friends of people with a mental illness, such as:
* ARAFMI- http://www.arafmiaustralia.asn.au
* SANE- https://www.sane.org
* Beyond Blue- http://www.beyondblue.org.au
& for young people;
* Reach Out- http://au.reachout.com
* Headspace- http://www.headspace.org.au
Final words...
If your loved one is struggling with a mental health issue, don't give up trying to encourage them to seek help. It may take a few conversations. Things might even get worse. But if you continue to point out to them that there are options they haven't yet tried (like seeking professional help), which have been shown to really help, it helps convey a sense of hope that they might be able feel better.
Don't buy into the stigma that mental illness is caused by defects in character, or 'weakness' of mind. Get the facts for your loved one & yourself- We may not cause all our problems, but it is our responsibility to deal with & heal from them.
- Alex.
Tip:
Share a blog post about mental health treatment, or a reputable mental health website (like Mindful Recovery Services) with your friends, family & social media contacts- it may help someone take that brave first step towards getting help.
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