Managing a mental health conversation in 7 steps.

Introduction

We all want to help those who are experiencing poor mental health but there’s more to a successful conversation than most people realise. Get it right and you build trust and confidence, get it wrong and you lose credibility and you may make the person feel worse about themselves. Here’s a few tips from our managing mental health course (see our training page) and, although it’s written with managers in mind, it’s applicable to everyone.

Step 1 - Identify

How is the team doing? How are they coping, who’s in need of a wellness chat?

At the end of each week look around the team and see who’s thriving and who’s been surviving. Perhaps they haven’t been their usual self, maybe their timekeeping has changed, or perhaps they aren’t engaging anymore. The starting point is to identify a change in their usual persona or performance.

Step 2 - Approach.

Timing is everything. The conversation can’t be rushed, what you think will be a quick check or performance meeting can turn into a lengthy conversation even a crisis, so make sure you allocate enough time. Make sure you meet in an appropriate place free from distractions and safe for both parties. Before you meet up have some examples of their behaviour ready and any changes you have noticed. Often the person in need of help doesn’t realise it so giving them examples may help them gain some insight.

Step 3 - Use empathy and active listening skills.

Imagine walking in the persons shoes for a while. Be careful not to be judgemental and be aware of your inner bias. Yes it sounds obvious but being aware of your frame of reference, micro aggressions and any prejudice (yes we all have them) can help keep them in check.

Listen for feelings - Yes it’s ok to explore feelings, no it’s not a sign of weakness.

Asking how someone feels and actually considering the response is the first step to identifying risk and the level of intervention needed to help them.

Hopelessness, feeling overwhelmed, angry, sad and lonely are feelings that shouldn’t be ignored. Look out for the meaning behind the use of metaphors such as isolation or detachment from social circles e.g. “ It feels like I’m looking at people down the wrong end of a telescope”.

Step 4 - Assess for crisis.

Sometimes you get clues, disclosures or that ‘gut feeling’ that the person is at risk of harming themselves or others. At this point we may be tempted to ignore our concerns fearing that by confronting the issue any further we will open Pandora’s box, breach confidentiality or make things worse. We may ask them if they are going to “do something stupid” thereby showing judgement, or we may promise to keep things confidential, even though they are at imminent risk. Suicide and self harm are complicated subjects surrounded by myths and stigma which is why managers and peer supporters should be trained in spotting the signs and know how to respond.

If you have a suspicion that suicide is a possibility then ask the person. Use words that are unambiguous such as suicide, killing yourself, dying by suicide. Depending on the response you may need to respond to an immediate threat.

Many people have suicide plans as a way of coping and without the immediate intent of carrying them out but if you identify they are at risk of suicide don’t promise confidentiality.

Stage 5 - Signposting

Hopefully you already know what resources are available at your workplace but if in doubt, or this isn’t a work conversation signpost them to their own doctor or search the web for local resources. You aren’t there to fix the problem but by signposting them to professionals and appropriate support services you have taken the first step to helping them in their recovery.

Stage 6 - Self care

Listening to someone disclosing distressing thoughts, intentions or problems can be emotionally challenging and can trigger unresolved issues in the listener. Its important as a listener to make time for your own self care. It’s also important to set boundaries and not become an ‘emotional crutch’.

Stage 7 - Review

We live on a mental health continuum where we thrive or survive. It’s ever changing depending on life and physical events so always check in again with the person at an agreed time. You may wish to link them up with a Peer Supporter such as a trained Mental Health First Aider.

Conclusion

We will all need support sometime in our life and asking for, and offering it, isn’t always easy. Don’t be afraid to reach out to someone you think might need support, even if it’s just offering an ear for them to process their feelings and concerns and to be heard. Following these steps provides a structure which will help get the most out of the conversation.

For further details on support and training contact us at info@tpswellbeing.com or via our enquiry form.