How can I support my loved one’s mental health recovery when they live in a different state?

You may wish to take a look at Family Caregiver Alliance’s Handbook for Long-Distance Caregivers, which provides tips and strategies for caregiving from afar.

Other helpful tips for supporting a loved one’s mental health recovery when they live in a different state are included below.

Research crisis services in your loved one’s area

Get familiar with resources in your loved one’s area that could be helpful in a crisis.

Research Mobile Crisis Units or Mobile Crisis Teams (MCUs/MCTs) that may be able to travel to your loved one and complete an onsite evaluation in the event of a mental health crisis.
Look for psychiatric stabilization facilities, psychiatric urgent care facilities, or even peer respite facilities your loved one may be able to visit when they need help and support in a crisis.
Locate the emergency department closest to your loved one.
Locate the non-emergency police number in your loved one’s city or township.

Consider having your loved one write down the numbers and addresses for these resources on a fridge whiteboard, their phone, or another place that is easily accessible. Be sure to save them for your easy reference, too.

For help finding local crisis services in your area, dial 2-1-1.

Work together with your loved one to create a crisis plan

Help your loved one come up with an easy and straightforward plan they can follow in a crisis. Some questions to ask them may include:

What starts happening when you don’t feel good? What do you notice? (E.g., has paranoid thoughts, stops sleeping, stops eating, misses work, etc.)
What can you do when you start to notice those things happening? (E.g., take my medicine, call my doctor, go to a support group, go to a respite center)
Who can you call for help when you need it? (E.g., my doctor, the 988 Suicide & Crisis Lifeline, family members, friends, etc.)
What starts happening when you have an emergency? What do you notice? (E.g., has thoughts of hurting self, hears voices telling them to hurt others, etc.)
Where can you go in an emergency? (E.g., psychiatric urgent care, emergency department, etc.)

Consider making a copy of your loved one’s crisis plan for them and for you. Encourage them to keep their copy somewhere safe and accessible so it’s helpful when they need it.

Build a support team

Try building a team of people who can help support your loved one. Explore with your loved one whether there is a trusted person in the area that you both can rely on. Small things like checking in with your loved one, eating lunch together once a month, or letting you know if your loved one looks like they’re having a hard time can be a huge help.

If there are not many friends or family in your loved one’s area, other people can still offer support from a distance. Consider asking family members to check-in regularly with your loved one or schedule a virtual movie night to spend quality time with them.

Encourage your loved one’s autonomy

It’s normal to want to check in with your loved one all the time to make sure they’re OK. You may have feelings about their beliefs and choices. You might have the urge to tell them what you think they should do.

In most cases where there are no safety concerns, it’s best to support your loved one’s autonomy by being curious and supportive. Messing up is human, and you can be there to offer your support when they do feel like they've made a mistake.

Help your loved one connect with local support and resources

Encourage your loved one to do activities they like and connect with others when they can. Here are some things your loved one might do for meaningful activity:

Maintain part-time or full-time employment, if possible
Participate in a skills training or job training program
Become a member of a clubhouse
Attend support groups with other people that live with a mental health condition
Join community clubs or groups focused on a specific interest (e.g., gaming, gardening, food, sports, etc.)
Visit the local library
Volunteer in their community

In addition to hosting support groups your loved one can attend, local NAMI Affiliate and State Organizations are knowledgeable about local resources that could support your loved one’s safety and well-being.

Consider helping your loved one get connected to their local NAMI, a local clubhouse, and other local organizations that could help them find support and resources when they need it.

Schedule a weekly video chat to help with planning and coordination

Consider scheduling a weekly video chat with your loved one to help them manage upcoming tasks and appointments.

Here are some ideas to help you support your loved one with planning and coordination:

Explore apps and tools that can help your loved one stay organized and keep you in the loop (e.g., virtual task lists, a shared virtual calendar that sends your loved one reminders about their upcoming appointments)
Explore options for scheduling transportation to appointments in advance (E.g., Medicaid/Medicare provided transportation, scheduling a pickup on a rideshare app, etc.)
Help your loved one plan something to look forward to after their appointments to increase the chance that they will remember and attend

Consider participating in your loved one’s treatment

If your loved one is open to it, consider asking them to sign a release of information (ROI) so you may receive information about their treatment.

You can explore the option of joining sessions virtually to be a supportive presence for your loved one and to learn of any challenges they may be having with their treatment.

Help your loved one complete a Psychiatric Advanced Directive (PAD)

A Psychiatric Advance Directive (PAD) is a document that allows a person with mental illness to state their preferences for treatment in advance of a crisis, including who can receive information about their care.

In some states, PADs include an option to appoint a health care power of attorney, allowing the appointee to make healthcare decisions for their loved one if the loved one can't make decisions on their own because of their illness’s impact.

Twenty-five states currently have laws that allow PADs.  You can find more information about which states permit PADs and how to write these documents at www.nrc-pad.org.

Show your support when, where, and how you can

Consider calling, texting, or video chatting just to check in and offer a listening ear. Letters and care packages are thoughtful gifts that give your loved one something to look forward to. Remember that it means a lot for you to just show up for your loved one when, where, and how you can.

Be kind to yourself

It can be a relief not to be involved in the daily ins and outs of caregiving when you live in a different state. It can also bring feelings like worry, fear, and guilt. Sometimes it’s helpful to remind yourself that these are all normal feelings to have.

Remember that you are doing the best you can to support your loved one. Give yourself permission to focus on your own well-being and be sure to seek support yourself if you need it.

Hours of operation: Monday-Friday, 10 a.m. – 10 p.m. EST

Call: 800-950-NAMI (6264)

Text: 62640

Email: helpline@nami.org

Website: www.nami.org/help