How can I have a caring conversation with my loved one about getting help?

Many caregivers work to find the right balance between giving their loved one non-judgmental support and pushing them to get the help they need. If you’ve noticed some things that make you think your loved one might benefit from mental health help, you might be wondering how to talk with them in a way that doesn’t make them feel judged or upset.

Family, friends, and caregivers play an important part in a loved one’s mental health treatment and recovery. Your care and concern can make a world of difference. We hope these tips will help you have a caring conversation with your loved one about getting help with their mental health.

Start with Self-Compassion

It’s only human to feel worried if your loved one experiences things like low mood, angry outbursts, or seeing and hearing things that others don’t. You might also feel scared, uncertain, or frustrated by your loved one’s symptoms and behaviors.

Start with self-compassion by noticing what you’re feeling and reminding yourself that anyone would feel this way if they were in your shoes. Acknowledging these feelings makes them less likely to take over. That way, you can stay focused on what your loved one is going through and how you can be there to support them.

Find a Good Time and Space to Talk

Conversations about mental health can be hard. Try to find a low-stress time and place to talk. Consider starting the conversation over the breakfast table, after you’ve sat down to watch a show together, or when taking a nice walk in the park.

A non-judgmental way to start the conversation is to simply share what you’ve noticed about your loved one’s feelings and behaviors. Then, ask them how they’re doing. For example:

“I noticed that you are eating and sleeping a lot less lately. How are you doing?”
“It seems like it's been really hard to get out of bed and go to class these past few weeks. How have you been doing?”
“I heard you say that your friends have been plotting against you. Would you like to talk about it?”

Focus on the Person, Not the Symptoms

Sometimes, your loved one might say things that are confusing or difficult to respond to. They might see or hear things that aren’t there (hallucinations), express false beliefs that aren’t based in reality (delusions), or share feelings of hopelessness that feel hard to answer in a validating way.

You can be helpful by focusing on your loved one, their emotional reality, and the impact of their symptoms instead of on their specific beliefs.

For example:

Loved One: “I’m the chosen one. I’ve been called upon to cross the Atlantic and spread the real, actual truth to the world.”
- Response: “I’m not sure what to make of what you’re saying, but I can see how much it’s affecting you. How are you doing with all of this?”
Loved One: “I’m completely worthless. People like me don’t deserve help. I’m meant to feel depressed forever.”
- Response: “I can hear how much pain you’re in right now. I’m so sorry you're going through this. I’m glad I can be here with you.”

Offer Options for Getting Treatment & Support

It’s OK to be honest with your loved one about your concerns for their well-being. Reassure them that help is available. If you’re willing to support them in getting the help they need, let them know that, too.

Try using a compassionate, genuine, and non-confrontational tone. Offer options to help them get started. For example:

“I can see how excited you are, and I’m here to support you. I’m also worried that this big plan came together while you weren’t eating or sleeping. Perhaps talking to a doctor or psychiatrist about this before you make any big decisions would be helpful. Are you open to that? I can help you make the call and even go with you to your appointment.”
“I’m so sorry you’re going through this, but you don’t have to do it alone. Your college has a counseling center, and I think it might be helpful to make an appointment with them. Could I help you look online to learn more about that process?”
“You’re not alone in this. I’d like to help you reach out for some support with what you’re going through. Would you be willing to call your insurance together and ask for a list of therapists you could talk to?”
“Your life is important, and I’m here to help. Can we call the crisis hotline together? They can help us understand more about what you’re going through and give us some ideas to make sure you stay safe and connect to help. I’ll be right here with you.”
“I hear you saying you don’t want to talk to a therapist right now, and I get it. I want to be honest about my concern for you, and I think getting professional help is important. You don’t have to go through this alone. If you ever change your mind, I’m here to help you take that next step.”
“I understand therapy doesn’t feel like it would be helpful to you right now, and I don’t want you to be alone in this. Would you be open to joining a peer support group with other people who are going through something similar?”

Ask How You Can Help

Mental health treatment is important, but there are other ways to support your loved one and help them start the process of accepting help.

When mental health symptoms flare up, everyday tasks and responsibilities can feel impossible. Asking how you can help lets your loved one know that you’re there to support them. For example:

“Can I help you stock up on some groceries this week? Do you need a ride to the store?”
“Would it help if I got up with you the next few mornings to have breakfast together before you go to class?”
“Would you like me to be there with you the next time you talk to your friends?”
“I’m here for you. How can I be helpful while you're going through this?”

Learn How to Partner

Try to partner on things your loved one cares about to encourage their participation in treatment. While they might not have the same concerns as you do, it’s possible that mental health symptoms have affected their activities, health, and relationships in ways they deeply care about.

For example, if your loved one can’t sleep because of their mental health symptoms, and they’re bothered by sleepiness and low energy, they may be willing to talk to a doctor about their sleep concerns. That conversation could lead to a referral to a psychiatrist or a discussion about mental health medication.

Partnering with your loved one is just one aspect of The LEAP Method, which stands for Listen, Empathize, Agree, and Partner. The LEAP Method was created by Dr. Xavier Amador to help families improve their communication with loved ones who have serious mental illness. This approach helps families focus on using empathy, reflective listening, and the motivations of their loved one to build strong relationships and encourage voluntary participation in mental health treatment over time.

The LEAP approach is a great tool for having caring conversations with loved ones who don’t know they’re experiencing symptoms of mental illness. Check out the resources below to learn more.

“I Am Not Sick I Don’t Need Help” is a book by Dr. Xavier Amador that discusses how family members and allies of those with serious mental illness can use The LEAP Method to help partner in the person’s recovery. Portions of the book are accessible to the public on our website. The full book is available for purchase at online booksellers in English and Spanish. 
The LEAP Institute is a for-profit organization whose mission is to spread the word about the LEAP approach. Their website contains free LEAP videos where you can get an idea of how this communication strategy works in practice.
NAMI’s Ask the Expert Webinar: How To Help Someone With Mental Illness Accept Treatment - Dr. Amador describes how the symptom anosognosia impacts people’s abilities to recognize that they are ill. He discusses how to use LEAP to focus on a supportive relationship and encourage a loved one’s treatment participation over time.

Communicating in a Crisis

In their 2017 NAMI blog, “Caregivers: When to Push and When to Show Extra Compassion,” Stephanie and Andrew Downing write, “I often walk the narrow, unforgiving line of when to push and when to administer a large helping of mercy. Though challenging people to improve their quality of life is risky, if we don’t, those who are struggling may continue to struggle”.

You can use the same compassionate, non-judgmental communication strategies described above when interacting with your loved one in a crisis. However, you may also need to help your loved one get urgent support by contacting the 988 Suicide and Crisis Lifeline, visiting their local emergency department, or finding other local mental health crisis services together.

If your loved one is unable or unwilling to seek care on their own in a crisis, consider options like Mobile Crisis Teams (MCTs)/Mobile Crisis Units (MCUs) or police intervention from a Crisis Intervention Team (CIT) officer, if these services are available in your loved one’s community.

For more information on emergency treatment options and communicating with your loved one during a mental health crisis, please visit NAMI’s Navigating a Mental Health Crisis Guide.

Focus on What’s in Your Control

You’ll be in the best position to support your loved one’s long-term recovery if you take care of yourself along the way.

Even if you take all the steps above, it’s possible your loved one could still feel too uncomfortable, stigmatized, or symptomatic to hear your concerns or accept professional help. Know that your willingness to be there, to be honest about your concerns, and to support your loved one as best as possible still makes a world of difference.

You can take care of yourself by focusing on what’s in your control – your own physical and mental wellness, opportunities for fun and joy, your own social support system, and doing what you can to have a positive relationship with your loved one.

You may find the following NAMI HelpLine Knowledge Articles helpful for focusing on what’s in your control as a friend, family member, or caregiver:

Let Love Lead

You might not know everything about your loved one’s experience or how to help them, but you know that you love them and you want them to be well.

When things get difficult, remind yourself to let love lead the conversation. Even when we don’t say or do the perfect thing, our loved ones can often tell when we come from a place of care and concern rather than a place of fear or judgment.

Leading with love leaves the door open; your loved one knows you care about them and their well-being, and they know you’re there to offer help and support when they’re ready to accept it.

We are so glad you found this information. NAMI HelpLine offers a Family Caregiver Service. It brings together family caregivers with shared experiences and equips HelpLine Specialists with knowledge and insights into what helps. If you are a family caregiver and would like support from a peer, we encourage you to call the NAMI Family Caregiver HelpLine at 800-950-NAMI (6264) or send a text to 62640. We are available Monday through Friday, from 10:00 am to 10:00 pm EST.

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