Conversations you need to have about mental illness

If It’s an Emergency

If someone is talking about ending their life, perhaps even describing ways they could do it, this may be a medical emergency.

1. Listen to them and take them seriously. Don’t judge or minimize their feelings. Be positive and hopeful, and remember that suicide can be prevented.
2. Ask them if they are thinking about suicide or having suicidal thoughts. Don’t be afraid that you will put the idea in their head. It may be a relief for them to talk about it.
3. Let them know help is available and that the cause of their suicidal thoughts can be treated.
4. Make a safety plan with them. Who will they call if their feelings get stronger? Who can stay with them to keep them safe? Make a list of phone numbers of people and services they can call if they feel unsafe.

I'm Worried About Someone

A conversation is a great start, and an important way to let the person know that they are not alone. However, mental illness can be just as serious as physical illnesses, and getting medical attention or professional help is just as important for both. A family doctor or primary health care provider is often a good place to start.

There are many things you can do to help:

1. Stay supportive. Try to make it as easy as possible for them to get the help they need. Offer to help them find resources in their community, make their appointments, or keep them company if they are nervous about going on their own.
2. Stay in touch and follow up regularly to see how they are doing. Being present can make all the difference.
3. Keep the conversation going. Offer to connect them with counselling services such as Connex Ontario or Kids Help Phone for children and teens
4. Reflect on the signs in the following pages if you are worried about someone in your life.

Thoughts and Feelings

Has the person said they are experiencing any of the following thoughts or feelings:

• Angry, irritable, short-tempered or full of rage
• Disconnected, lonely or isolated
• Hopelessness, guilt or shame
• Apathetic, sad or depressed
• Confused, overwhelmed or struggling to concentrate
• Desperate or trapped

Behaviour

Have you witnessed any of the following behaviour?

• Withdrawing from activities or people they normally enjoy
• Using alcohol or drugs more than usual, or saying that they need them to cope
• Frequent crying, or showing uncontrollable agitation or anger
• Not sleeping well or sleeping a lot
• Giving away possessions or making plans for after their death
• Increased engagement in high risk behaviours such as reckless driving, dangerous sports or activities

Physical Signs

Have they talked about or showed the following signs:

• Thinking about suicide or wanting to die, even if it seems like they're joking
• Hearing voices, especially voices that tell them to harm themselves or others
• Saying that they don't care about the future or that nothing matters
• Saying goodbye or saying that they'll miss you
• Feeling disconnected from their body or being physically numb
• Feeling like they are not wanted or needed by others

Talking With a Friend

Start by telling your friend what you have noticed or what is concerning you.

"I have noticed you don’t seem to be sleeping much, and you’re skipping meals. Is everything okay?"

• Suggest going for dinner or a coffee if this is the kind of thing you normally do together. If they are not interested in your usual activities, suggest something new or ask what they would like to do.
• If you struggle or have struggled with your mental health, you could share your experience and create a safe space for your friend to share their experience as well. If they open up to you, listen to their experience and validate their feelings, without inserting your experience into the conversation.
• If your friend confirms that their experience might be mental health related, reassure them that you want to support them through their struggle. Additionally, you can ask if there is a doctor, counsellor, or community/ spiritual advisor that they could confide in and seek help from as well.

What NOT to say

37% of Ontario students report experiencing an elevated level of stress or pressure in their lives.

x “Just relax.”

x “You’ll get over it.”

x “It’s all in your head.”

x “Have you tried spending more time outside?”

These comments could come across as judgmental or dismissive, despite your intent. Instead, focus on how you can show your friend that you are someone they can trust.

Talking With a Colleague

Find an appropriate and private time to approach your colleague. Tell them what you’ve noticed and why you’re concerned. 

"Has something happened recently that you need support with? I’m here to listen if you need to talk."

• Even if your colleague does not think there is a problem, your question will create space to start a conversation.
• If they are open to chatting with you, suggest that you meet outside of work, like at a nearby coffee shop, so there will be no chance of being interrupted or of another colleague listening to your conversation.
• Spend that time listening, without jumping in to problem-solve or diagnose. It is more likely that you will be able to help if your colleague trusts that you are doing this because you care. 

What NOT to say

52% of Canadians report feeling burned out because of their jobs in the past year.

x “I know exactly how you feel.”

x “Maybe you just need a day off.” 

x “We’ve all got a heavy workload.” 

Don’t assume you know what the problem is, or that you experience workplace stress the same way your co-worker does. Out of character behaviour may signify early symptoms of mental illness or other kinds of stress. 

Talking With Your Child

Ask how they are doing casually to create a safe space for conversation. Be specific about what you’ve noticed and what you’re concerned about, without being accusatory or judgmental.

"You’ve seemed down a lot lately. Is there anything that’s bothering you that you want to talk about?"

• Reassure them that no matter what they are going through, you will always love them and care for them unconditionally.
• If they’re ready to talk to you, be compassionate and don’t assume you know what they’re feeling or thinking. Instead, ask if they’d like you to help or take any action on what they’ve shared.
• Support doesn’t always mean talking, it can also be about making time for them and establishing a bond that will hopefully create trust for when it’s time to have hard conversations.
• Families can visit the CAMH Family Resource Centre to find support, education and information about mental illness and addictions.

What NOT to say

70% of mental health problems begin during childhood or adolescence.

x “Snap out of it.”

x “You don’t even know what real stress is, you’ll see when you’re older.”

x “I went through the same thing when I was your age, you just have to get over it.”

Statements like this may make them feel judged for feeling the way they do, or for not being able to make themselves feel better. They may not be well-received by a child or teen who is trying to establish their own identity, and may begin to foster feelings of resentment or mistrust towards you. 

What's next?

If the person confirms that their experience might be mental health related, reassure them that you want to support them through their struggle. Additionally, you can ask if there is a doctor, counsellor, or community/ spiritual advisor that they could confide in and seek help from as well.