How to start a conversation with your friend about their mental health: An expert’s guide

Talking about your mental health has never been more important. But whilst you might be incredibly open about what’s going on in your head, it can be difficult to get your mates to do the same.

Mental healthcare in England is now a “national emergency” according to NHS bosses, with services still “overwhelmed” and unable to cope with the large post-Covid surge in people needing help. Students are particularly effected, with 69 per cent having suffered with a mental health illness and only 12 per cent satisfied with how their university handles the issue. So, it’s important to check in on your mates.

However checking in on someone isn’t always the easiest thing to do. Maybe you’re a fresher, who has only formed surface level relationships with your flatmates and don’t know how to bring up your concerns for that flatmate you hardly speak to. Or perhaps your friendship circle just doesn’t talk about their feelings – it’s all beers, nights out and rugby. Or you just simply feel awkward and have no clue how to get the words out you’re concerned about a friend.

The Tab spoke to two mental health professionals to get their advice on how you can approach a friend you’re worried about or simply want to start a dialogue around mental health with. It’s equally important to remember to look after your mental health whilst supporting struggling friends, our experts revealed their tips on how best to cope:

It’s important to know when to have that conversation

Usually when living in your uni flat or house with a small group of people, you become incredibly close and are able to pick up on in changes in your friends’ moods.

Psychotherapist and spokesperson for UK Council for Psychotherapy, Noel Bell, says it’s important to remember everyone goes through struggles, anxieties and stress. However this is not necessarily a measure of poor mental health. For example when you’re busy in essay mode, you’re more likely to be stressed and worn out, but after you submit it you’re generally much calmer and in a happier mind set.

Noel says after the particularly stressful event has passed and someone is still exhibiting “worrying signs” then this is the “time to pay more attention to someone’s mental health”.

What are the signs you should be watching out for in someone you’re worried about?

Psychologist Dr Tara Quinn-Cirillo says: “Changes in behaviour may be a sign that someone may be experiencing a difficult time emotionally.”

According to Dr Quinn-Cirillo, these behaviour changes could be anything such as someone becoming withdrawn, quieter, experiencing mood swings and anger problems.

Generally behaving out of character will also indicate that something could be going on with a friend and a lack of interest in things they used to enjoy is another thing to watch out for.

Equally someone using drugs or alcohol as a way to cope, a change in sleep pattern and not initiating conversations with people they used to can all be things to keep an eye on, says Dr Quinn-Cirillo.

Noel Bell suggests a deterioration in their physical appearance and a messier house is something you might observe. Confused thinking and an inability to concentrate are also classic signs of someone struggling with their mental health.

How to broach the subject of mental health to someone you’re worried about

Noel Bell suggests an open and honest conversation about your concerns is a good to way to broach the subject of your friends’ mental health. Tell them your only motive “is out of concern for their welfare.”

Whereas for Dr Quinn-Cirillo she suggests a simple “how are you doing?” conversation can be a great opening for a deeper discussion of someone’s mental health.

How should I act in the conversation?

It’s often hard to know how to react when a friend tells you something that’s upsetting them, you never quite know what to say or how to say it.

Dr Quinn-Cirillo offers some really good advice for this problem. She suggests using simple verbal responses to show them you’ve heard them, such as “okay” and using your body language to show that you’re supportive. Sitting with them and “letting them know you are right with them” even if it’s not easy to hear what they’re saying could be enormously helpful.

One of the biggest pieces of advice Dr Quinn-Cirillo offers is validating your friends’ experiences. She suggests saying: “‘I can see why that would make you sad/anxious’ rather than ‘don’t worry about that, it’s not worth getting sad/anxious about’.”

Even if you don’t agree with what they’re saying, it’s still important to validate what they’re going through.

How can I help my friend more?

Both Dr Quinn-Cirillo and Noel Bell emphasise the power of talking and how even just having that one conversation could lead to someone seeking professional help.

And Dr Quinn-Cirillo suggests that if appropriate you should encourage your friend to speak to their family, tutor, a student counsellor or their GP.

For Noel there are a number of seemingly small actions you can take that will actually have a big impact in potentially helping a friend. He suggests regularly checking in on them, offer to run errands, accompany them to an appointment and even just going for a walk or watching a film together.

These simple actions can actually make “conversations concerning self-care and mental well-being easier and can come about more naturally when doing things together.”

Remember it’s still important to look after your own mental health

When you want to help a friend you can almost be so consumed in it that you forget to look after yourself. In order to maintain your own mental health, encourage them to seek professional help and Dr Quinn-Cirillo emphasises: “It can be a lot to manage by yourself if you are supporting a friend and it is ok to acknowledge this”.

She also suggests if you are increasingly concerned there may be times when you could “need to step outside of a friendship and seek help on their behalf.”

Finally Noel Bell stresses the importance of not trying to rescue your friends. He says: “You don’t want to rescue them, however. Rescuing is when you take on their problems and assume responsibility and thereby negatively impact on your own well-being.”

Reassure your friend they made the right decision by confiding in you, accompany them to appointments if possible and show them that you care.

If you or someone you know has been affected by this story, please speak to someone or contact Samaritans on 116 123 at any time. You can also contact Anxiety UK on 03444 775 774, Mind on 0300 123 3393, and Calm (Campaign against living miserably, for men aged 15 to 35) on 0800 58 58 58.

The Tab’s You Matter campaign is putting a focus on student mental health right now. If you’ve got a story you’d like to tell us – whether it’s difficulties with getting uni support, or anything you think we should hear, get in touch in confidence by emailing [email protected]

You matter.

Read more from The Tab’s You Matter campaign:

•I tried to book uni counselling for a week but was told ‘come back tomorrow’ every day

•Adults’ response to student mental health shows how out of touch they are

•I’d rather drop out of university than have to self-isolate in halls again