How to Begin a Conversation

Though it may feel awkward, embarrassing, or intrusive, don’t avoid having a conversation if you suspect your friend has a mental health problem. It’s important to talk about it, so your friend knows he has nothing to be ashamed of. It’s possible he is already being treated and didn’t know how to tell you. In that case, you have an opportunity to offer your support. If your friend hasn’t yet been diagnosed, your concern and encouragement might be just the thing he needs to seek professional help.

Plan Ahead
Before you begin a conversation, have a few action steps in mind that you can suggest to your friend. Gather a list of resources for him, including the phone numbers and Web sites of organizations that offer assistance to people with mental health problems. If your friend is a college student, find the number for the campus student health center so he can make an appointment. Offer to accompany him for moral support. If he’s employed full-time, encourage him to inquire about employee assistance programs at his company.

Choose the Right Approach
The most important thing you can say to a friend when beginning this conversation is that you care. Make it clear that you want to help her. Here are a few ideas to get started:

• “I’ve noticed that you seem a little down lately. Is there anything I can do to help?”
• “I feel as though you’ve been distracted the last couple times we’ve gotten together. Do you want to talk about it?”
• “I’m concerned about you. If something is wrong, I’d like to help.”
• “Because we’re such good friends, I know you well. I can also tell when something seems different. Can we talk about it?”
• “Your friendship means a lot to me. I know when I need help, you’re here for me. It seems like you could use some help right now, and I want to do whatever I can.”

Keep in mind, this conversation isn’t about offering advice. Rather, it’s about listening to your friend without being patronizing, judgmental, or trying to solve her problems yourself. Remind your friend that you care, you want to support her, and that mental illness is treatable. Find out if she has talked with a doctor or counselor and, if not, offer to help her set up an appointment.

What if my friend is being unreasonable?
If your friend is paranoid or having delusions, don’t argue with him. Instead, approach the topic from his point of view: “That must be scary. I’d like to help,” or “I can understand why you’re upset. Can we figure out together how to make this better?” Be supportive and respectful and offer to help find someone he can talk with about his concerns.

What to Say I’m bringing this up because I care about you. Nothing you could tell me would change our friendship. I’m here for you if you want to talk. If you were sick with an illness like cancer or diabetes, I’d be concerned. A mental health problem is no different. What can I do to help? What Not to Say You’re acting really emotional lately. Lighten up! What you should do is… All you need is an antidepressant and you’ll be back to normal. I know you’d be embarrassed if anyone knew about this, so we’ll keep it just between you and me.

Take Action Now: Don’t change the subject when mental illness comes up. Be responsive to your friend, ask questions, and really listen.