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EDUCATION - KEY TOPIC

Life as a Supporter

How to Have Conversations About Mental Health with a Loved One

It takes bravery to bring up mental health topics like addiction with loved ones, and love and wisdom to bring it up well. Ask questions to understand, instead of making assumptions about someone’s behavior or current state. Treat the individual with dignity, acknowledging their power to make their own choices. Express hope for the future, including opportunities to find greater connection and health in life. Recovery happens for millions of Americans each year. For supporters and individuals struggling with addiction, stories can stir hope. Wisdom from additional resources or professionals trained in these conversations may be needed.

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Building Trust in Conversation

Talking about mental health issues like addiction with a loved one can be a challenging and delicate process. Individuals struggling with a mental health challenge likely already feel some shame, whether it’s conscious or sub-conscious, and these conversations can hit a painful nerve. These talks can range from “formal” sit-downs to more “informal” check-ins about someone’s well-being and health. Talking about such personal topics is best when close relationships are established. There can be great value in involving a third party counselor or interventionist, if possible, as well as individuals whom the person knows and trust. Building and communicating trust with the person needing help is important, although there may be times where that is not possible, due to the severity of an addiction.

Multiple Approaches

There are many approaches for handling these conversations. People respond differently to feedback, particularly around topics which may feel painful. Some individuals may deny a specific problem, even when they know that something is wrong. Remember, it’s about building trust and helping move the individual toward help more than having them agree with your assessment. Here are some thoughts on how to navigate these conversations, again recognizing that these conversations, like recovery, are not one-size-fits-all:

Do your homework before. Look into resources that provide guidance on these types of conversations. Reaching out to a counselor or interventionist for help can be valuable if possible, even if they’re not involved in the process directly. Read to understand how addiction and mental health challenges affect the brain.  Understanding the science, and the medical condition that can develop, can stir empathy.
Lead with love. Express your genuine care for the person. If someone’s behavior makes you afraid, or anxious, or angry, seek a place of rest and peace before having the conversation, or involve others that will be able to communicate from a place of love. Medicine goes down a lot more smoothly with a bit of sugar. Even if using, individuals struggling with an addiction or other challenge can still read motives, and the perception of being controlled can contribute to an unhealthy conversation.
Involve someone who is trusted and safe for the person. Have a person who is trusted by the individual, or to whom the individual has reached out in the past, lead the conversation. It’s important that this person also feels comfortable and prepared. Avoid times, as possible, where the individual may be feeling particularly stressed or tired.
Ask questions. Don’t make assumptions about their behavior, or try to label it. Ask about their wellness, and how they’re perceiving or seeing their own lives and behavior. Be careful to avoid assumptions about their condition. The U.S. Department of Health & Human Services has a great list of questions that can help guide these conversations.
If addressing behavior, use specific examples and “I” language in communicating the problem. Using “I” language that expresses how you experienced the situation helps enable communication for information, not judgment. For example, instead of saying,  “Your drinking problem is destroying our family, and making you untrustworthy,” focus on how it affects you: “When you drink, I do not feel comfortable trusting you, and I see how others in our family have expressed their concern. For example…”
Recognize their value and ability to make choices. We can’t force others to change; however, we can extend the invitation to help people find their next step, and introduce consequences if they are unwilling to change. Even for family members that you love, you are not required to enable them, or to support choices that endanger yourself or others.
Have possible next steps prepared. Suggest practical, tangible steps to take if there’s an openness to help, such as talking to a counselor, going to a support group, or finding a treatment center. Have several possible steps prepared, with varying degrees of effort or time required, in case they’re not willing to take the one that you would think.
Participate with them. If the individual agrees to take a next step, offer to join them, or help facilitate their taking of the step. Attend an NA or AA meeting, drive them to the counselor’s office, help them look for treatment options. Participating in a new recovery experience may feel uncomfortable for you, but it can greatly increase the chances of the individual taking that step and moving forward.
Express hope. Identify something that you can honor or respect in that person, and remind them of their underlying value. Shame and guilt are powerful factors that individuals are likely already experiencing, even if they don’t show it. Hope and love can create the motivation to step through the same, guilt, or fear to get help.

As you’re planning for and then having these conversations, keep in mind what you are trying to accomplish. Is it to genuinely check in and understand more, because you’re unsure of the situation? Or, do you have stronger evidence of a significant problem? Your approach can vary based on what you are aiming to accomplish in that specific challenge. Friends and family play an important role in recovery. If you think an individual may be suicidal, you can contact the National Suicide Prevention Hotline.

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