how family and friends can help
by Sally Burningham
Mental health problems are widespread and nothing to be ashamed of. We have all either experienced them ourselves or know someone who has. If someone close to you has problems, try to be as open about it as you can without upsetting the person affected, but certainly don't avoid or ignore it.
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You're likely to feel very anxious and uncertain about what to do for the best. However, the important thing to remember is that it's not up to you to find solutions. Just being there and listening or offering support is the best kind of help you can give.
You can relieve some of your stress by finding out where to turn for information and advice. However, don't forget that different psychological or emotional problems may require different approaches, and that each person is an individual who reacts to their own situation in a very personal way. This means that you will need to use your own judgement and experience of what seems to work in deciding what kind of support to give.
Finally, offering support to someone who is mentally distressed can be both emotionally and physically draining. It is important that you look after yourself if you are to continue to help and lead your own life as well.
seeking help
It sometimes happens that it gradually dawns on you that a friend or relative needs help. They may have been very upset or withdrawn for some time without apparent reason. Their behaviour or attitudes may have changed in a distressing way. Or they may not be able to cope with tasks or relationships at home or work. What do you do?
Problems are much easier to deal with in their early stages. Rather than waiting for a crisis, try to persuade the person to see their GP or to seek other help as soon as you're aware that something is wrong. If the person refuses to seek help, you could ask for advice yourself – from your GP or an appropriate organisation – on how to deal with the situation.
In an emergency, the best course might be to call an ambulance or take the person to the nearest hospital accident and emergency department.
coming to terms
It can be shocking and upsetting when someone close to you is diagnosed with a mental illness or some other form of mental distress. However, this can be followed by a sense of relief, as a diagnosis helps to make sense of behaviour that is hard to understand.
Although some treatments do work quickly for some people, you need to be prepared: recovery can be a slow, up-and-down process. Try not to become discouraged. Your help is valuable, even though you might not see much sign of progress. You may find it easier to cope if you can lower your expectations and take each day as it comes.
Some forms of mental illness – for example, schizophrenia – can sometimes cause long-term changes in a person's personality and behaviour. If that is the case, you may need to work through feelings of grief and loss for the friend or relative you once knew before you can accept the person as they are now.
ways of helping
finding out about the problem The more you understand about how a particular condition can affect your friend or relative, the more confident you will feel about offering help.
- Many organisations give information, advice and support to friends and relatives, as well as providing helpful publications or websites.
- The health professionals involved should be prepared to talk to members of the affected person's family about their condition and ways of providing help. If the person is your relative, arrange an appointment with their doctor – either their GP or the consultant if the person is in hospital.
- People who have experienced similar problems – or who have been close to someone who has – often have very sensible and down-to-earth advice to give. Many organisations are able to put you in touch with a local group or an individual you can talk to.
listening People who are distressed are often relieved to talk about their feelings. You can help them by listening carefully without offering advice or making judgements.
Someone in this sort of state is not really looking for logical answers to their questions. What they need is reassurance that you understand how they feel. It may seem to you that you are doing very little, but giving someone your time and support is often the most helpful thing you can do.
physical contact Sometimes people may not feel like talking or you may not know what to say. Physical contact may be the best thing here.
Although they may not be able to respond, many people who are distressed crave physical affection and find such gestures comforting. Just sitting holding the person's hand or putting your arm round them may be the best way of showing that you care.
However, in some cases, people may want more distance, not less, or touching may simply be inappropriate. You'll have to use your judgement and your knowledge of your past relationship with the person before deciding what is the right thing to do.
practical help You can show your support by offering practical help, such as doing some shopping or cooking a meal. But it is important to find out first what your friend or relative really wants you to do. Otherwise they may think that you are trying to take over. It may be that helping them to fill in a tricky form or make a phone call is quite acceptable, while cleaning the house makes them feel even more inadequate.
encouraging independence It is always difficult to get the right balance between offering support and encouraging independence. Although it may be quicker and easier to do everything for your friend or relative, it is not really helpful, except when they are acutely distressed. Try to give them just enough support to enable them to manage, and then withdraw gradually as they begin to improve. You can make it clear that you are always there if they need you.
tips
- Don't worry if you sometimes get it wrong. You can sometimes only learn the right approach through trial and error.
- Don't over-stretch yourself if you have lots of other commitments. Just being with someone for an hour from time to time or making a weekly phone call is often enough to reassure them that they do matter. Many people, when they recover, say gestures like these were a lifeline when they were ill.
- Try not to feel too responsible. You can give someone every encouragement, but you can't solve their problems or force them to get help if they don't want to. And you have your own life to lead.
- People often function far more slowly if they have mental health problems, often taking four or five times longer than usual to complete minor tasks. Encourage them to do things at their own pace and praise any small achievements.
- Try not to collude with your friend or relative if they are talking or behaving in a strange way. You can say you understand how they feel, but you should add that that is not the way you see the situation.
- Keep telephone numbers of relevant professionals (including emergency out-of-hours numbers) close at hand in case you are worried or a crisis occurs. You may need advice or immediate assistance.
taking care of yourself
Make sure that you have support for yourself. You may have a lot of quite difficult emotions to cope with on top of worries about your friend or relative. Talking to someone about your own feelings and anxieties can make all the difference.
Stand back and detach yourself a little from your friend or relative, however close your relationship. Otherwise you may be hurt by their words or behaviour and so be less able to cope. People who are mentally distressed are usually so weighed down with their own problems that they have no energy to consider anyone else. They might blame you or criticise you unfairly, seem quite uncaring or unresponsive to any gestures of affection or become angry or hostile for no good reason. It's important to realise that this behaviour is part of their distress – try not to take it personally. But you will need plenty of reassurance and support from other friends or relatives yourself.
If you are the main support for someone with a mental health problem, you may find that the worry is always at the back of your mind. Hard as it seems, it is important to make sure you have time for yourself and your own needs. Otherwise, you will become exhausted. Doing something that interests you or that you enjoy is a good way of recharging your batteries.
It's easy to feel isolated and vulnerable if you're the only one offering support. Try to share the load among other friends and relatives so that no single person feels too responsible. Also encourage the affected person to make full use of all the services available.
You may find you have a lot of uncomfortable feelings – resentment, anger, irritation – particularly if you have been supporting someone for a long time with little or no thanks. Sometimes, as the person starts to recover, these feelings bubble up more strongly – as if you have held them in check until then. Although it rarely helps to express your feelings to the person concerned, who is too wrapped up in with their own problems, it's important not to bottle them up. Talk to someone you trust or find an outlet for your tensions such as exercise or relaxation.
help and info
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organisations
Depression Alliance
35 Westminster Bridge Road
London SE1 7JB
Tel: 0845 123 23 20
E-mail: information@depressionalliance.org
Website: www.depressionalliance.org
National network of self-help groups for people experiencing depression. Offers a newsletter, national pen friend scheme and correspondence service with advice, guidance, support and fellowship to people experiencing depression, and their carers. Produces booklets and leaflets on various aspects of depression.
First Steps to Freedom
1 Taylor Close
Kenilworth CV8 2LW
Helpline: 0845 120 2916 (every day 10am-10pm)
Tel: 01926 864473
E-mail: info@first-steps.org
Website: www.first-steps.org
A confidential helpline for people suffering from general anxiety, panic attacks, phobias, obsessive compulsive disorder, anorexia and bulimia, and their carers. Offers counselling, listening, advice, support and information.
Mental Health Foundation
Sea Containers House
20 Upper Ground
London SE1 9QB
Tel: 020 7803 1100
E-mail: mhf@mhf.org.uk
Website: www.mentalhealth.org.uk
Working to improve the support available for people with mental health problems and people with learning disabilities. Offers information and literature on all aspects of mental health, including where to get help, information about specific mental health problems, treatments and rights.
Mind (National Association for Mental Health)
15-19 Broadway
London E15 4BQ
Mind Infoline: 0845 766 0163 (Mon-Fri 9.15am-4.15pm)
Tel: 020 8519 2122
E-mail: contact@mind.org.uk
Website: www.mind.org.uk
Campaigns for better mental health services in England and Wales, through its national office, regional offices and network of over 200 local branches, some of which also provide services. Publishes a range of helpful books and leaflets. Contact them for details of your nearest local group and for more information.
National Schizophrenia Fellowship (Scotland)
Claremont House
130 East Claremont Street
Edinburgh EH7 4LB
Tel: 0131 557 8969
E-mail: info@nsfscot.org.uk
Website: www.nsfscot.org.uk
A member led organisation that works to improve the well being and quality of life of those affected by schizophrenia and other mental illnesses, including families and carers. Provides community-based services, information/education and promotes greater understanding of schizophrenia.
Northern Ireland Association for Mental Health (NIAMH)
Central Office
80 University Street
Belfast BT7 1HE
Tel: 028 9032 8474
Website: www.niamh.co.uk
Northern Ireland equivalent of MIND. You can write in for general advice on mental health matters and details of local services, including self-help groups and you can download factsheets on a wide range of mental health topics from the website.
Rethink
30 Tabernacle Street
London EC2A 4DD
Tel: 0845 456 0455 (general enquiries) (Mon-Fri 9am-5pm)
National Advice Line: 020 8974 6814 (Mon-Fri 10am-3pm)
E-mail: advice@rethink.org
Websites: www.rethink.org or www.rethink.org/at-ease (for young people)
Dedicated to improving the lives of anyone affected by severe mental illness, by providing information, advice and advocacy services, raising awareness of mental health issues, and challenging the attitudes that create stigma. Website has sections on employment, money, benefits and legal rights.
Samaritans
c/o Chris
PO Box 90 90
Stirling FK8 2SA
Helpline: 08457 90 90 90 (24 hours)
E-mail: jo@samaritans.org
Website: www.samaritans.org.uk
The Samaritans exists to provide confidential emotional support to any person, irrespective of race, creed, age or status who is in emotional distress or at risk of suicide; 24 hours a day. Can be contacted by e-mail, telephone, writing, or by visiting one of over 200 local branches (details are on the website).
SANE
Cityside House
40 Adler Street
London E1 1EE
SANELINE: 0845 767 8000 (every day 12pm-2am)
E-mail: london@sane.org.uk (admin queries only)
Website: www.sane.org.uk
SANELINE is a national mental health helpline providing information and support for people with mental health problems, and those who support them. They can provide information on illnesses and symptoms, local and national mental health services, medication, treatments and therapies.
Scottish Association for Mental Health (SAMH)
15 Carlton Court
Glasgow G5 9JP
Tel: 0141 568 7000 (information service)
E-mail: enquire@samh.org.uk
Website: www.samh.org.uk
Scottish equivalent of MIND offering information and advice on a wide range of mental health topics, including legal advice and publications. Campaigns for better services and provides some mental health services.
YoungMinds
102-108 Clerkenwell Road
London EC1M 5SA
Tel: 020 7336 8445 (for info and publications)
Parents Information Service: 0800 018 2138 (Mon and Fri 10am-1pm; Tues-Thurs 1-4pm)
E-mail: enquiries@youngminds.org.uk
Website: www.youngminds.org.uk
National charity committed to improving the mental health of all children and young people. Campaigns for better provision of child and adolescent mental health services. Provides information to anyone with concerns about the mental health or emotional well-being of a child or young person, as well as leaflets on mental health issues, and details of local and national advice services.
websites
Anxiety Disorder Education Program
www.nimh.nih.gov/publicat/anxiety.cfm
Has information about panic attacks, phobias and other anxiety disorders and treatments, plus links and contacts. Part of US National Institutes of Health website.
Mental Help Net
www.mhnet.org
Website offering information on a wide range of mental health topics.
One in a Hundred
www.janssen-cilag.co.uk/1in100
A resource brought produced by Janssen-Cilag Ltd, aimed at people with schizophrenia and their friends and families. Offers information on support groups, facts, medication and causes of schizophrenia. An information pack can be applied for online. The pack provides facts about schizophrenia, details of a range of treatments, and a list of questions to help individuals and their families have a discussion with their doctor about the best treatment options for them.
Self-Harm: Look beyond the scars
www.nch.org.uk/selfharm
Frequently asked questions, information and resources about self-harm, especially for children and young people who are self-harming, or for their families and friends.
YCNet
www.youngcarers.net
A place where young carers (under 18) can go for help, information and support. They can email a question directly or check out the messages boards or go to the only moderated chatroom specifically for young carers. Also includes lots of information on coping strategies for young carers as well as advice for professionals, such as teachers, who are in contact with young carers.
reading
Anxiety, Phobias and Panic Attacks: Your questions answered by Elaine Sheehan (Vega Books, 2002) |
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Dealing with Depression by Kathy Nairn and Gerrilyn Smith (The Women's Press, 2001) |
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I Am Not Sick I Don't Need Help! by Xavier Amador and Anna-Lica Johanson (Vida pr, 2000) |
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Living with Mental Illness: A book for relatives and friends by Elizabeth Kuipers and Paul Bebbington (Souvenir Press Ltd, 2004) |
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Obsessive Compulsive Disorder: New help for the family by Herbert Gravitz and James Broatch (Partners Publising Group, 1998) |
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The Scarred Soul: Understanding and Ending Self-inflicted Violence by Tracy Alderman (New Harbinger Publications, 1997) |
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(July 2001, resources updated January 2005)
