With a mental health epidemic across the world it’s important for us to recognise our own limitations before offering support to a friend

According to UK-based charity Mental Health First Aid (MHFA) England 676 million people are affected by mental health issues worldwide.

This phenomenon is particularly prevalent amongst young people; MHFA England report that the proportion of young people aged 15–16 who reported feeling depressed or anxious doubled between the mid-1980s and the mid-2000s.

There is lots of evidence to suggest that minority groups such as members of the LGBTQ+ community as well as ethnic minorities are more likely to suffer from mental health problems.

Half of mental ill health starts by age 15 and 75% develops by age 18. There is therefore an incredible amount of pressure on mental health services to cope with the number of young people reporting symptoms and requiring treatment such as cognitive behavioural therapy, or talk therapy such as counselling.

In the UK, about 20% of young people with mental ill health wait more than six months to receive care from a specialist. Mental health services are under tremendous strain in the UK, the doctors and nurses providing care are doing an amazing job but they don’t have the resources or time to cope with the numbers of young people reporting mental health problems.

Many individuals turn to their friends and family for support before they can be seen by a specialist trained in looking after individuals with mental health problems. It’s important that young people feel that they have a support network to talk to about the symptoms they are experiencing, in an effort to prevent self harm and even, in dire circumstances, suicide.

But as friends of people with mental health problems, we have a responsibility to acknowledge our limits. It is important that we do not shoulder too much of what our friends are going through, however much we empathise with their situation, as otherwise we may end up jeopardising our own mental health in the long run.

Being there for friends with mental health problems is really difficult. It takes a lot of emotional strength, empathy, resilience and sometimes you even suffer abuse or criticism from the person you are trying to help.

But as a friend of a person with mental health issues, there are a few steps you can take to provide the best possible support that avoids compromising your own well-being in the process.

Be an empathetic, active listener

Let your friends know that they can talk to you about the way their mental health problems are affecting their lives. Set aside time for them, and arrange to talk in an open and non-judgemental space with no distractions. Put your phone away and focus on the conversation. A friend may feel more comfortable talking in private than in a public place.

Let them control the conversation, and don’t pressurise them to tell you anything they aren’t ready to talk about. Ask open questions about how they are feeling, and keep your language neutral rather than negative. Try asking ‘How do you feel?’ rather than ‘I can see you are really depressed’.

Repeat what they have said back to them to ensure you have fully understood; this is called active listening and it can make people feel more valued because you are demonstrating that you hear them and they are not alone.

Don’t pressure them, or give a diagnosis: you’re not a doctor

Try and avoid colouring the conversation with your own thoughts or feelings about their symptoms or a possible diagnosis. You’re not a trained medical professional, after all. Instead, encourage them to seek medical help if they haven’t already.

If you find that your friend has already been referred to a mental health professional, but is facing prolonged waiting periods for care then you can practice active listening strategies mentioned above, set clear personal boundaries about appropriate times to contact each other, create distraction free listening spaces, and do small things to help them with basic self care and personal hygiene.

Help them with the ‘small’ things — from clean underwear to a lap around the block

Basic tasks such as eating and showering can often seem insurmountable when someone is in the throes of a depressive episode. If this sounds like something your friend is struggling with then that’s when the need for non-judgement comes in. Say something like ‘I am going to do my laundry this afternoon and I wondered if you wanted to do yours at the same time’, or ‘shall I help you change your bedsheets?’. Don’t say things like ‘you smell’ or ‘you need to do X Y or Z’ — this is confrontational language that will only make them feel worse about their situation.

Sometimes something as tiny as offering to go for a walk around the block can make a world of difference to their day and give them a small victory to hold onto in a time of great difficulty.

Set clear personal boundaries

It’s OK to help a friend with basic tasks but you shouldn’t be their go-to 24/7 every hour of the day. If your friend is suffering with suicidal thoughts then you need to gently guide your friend towards medical help. By doing so, you are making sure that they get the best care possible.

If you go to bed worrying about whether your friend will overdose if you leave their last message unread, you’ll end up compromising your own health. Instead of just leaving a conversation unannounced, try saying ‘I am going to bed now but I would like to talk to you tomorrow about this’. This makes it clear that you recognise that a response is important, but you are setting clear personal boundaries about appropriate times to talk.

Then, give yourself a bit of downtime between leaving the conversation and going to bed. It’s important that you relax and avoid rumination about their situation, or else your own sleep will be negatively impacted.

Look after yourself first

It is only by recognising the limits of your responsibility as their friend in these ways that you will be providing the most effective support in the long run.