What should I do if I’m worried about a friend’s mental health?

This is  a re-posting of an article written by Dr Pooky Knightsmith, and is re-published with her kind permission.


The most important thing you can do for your friend is to make time for them and to listen to them.  They need to feel listened to, so get rid of all distractions.  Being given the space and time to talk is a really important first step and something that is hugely supportive right through (and beyond) the recovery journey.

Don’t Judge

More than almost anything, young people with mental health and emotional wellbeing issues such as depression, eating disorders and self-harm tell me that they fear the judgement of others.  They worry that people will over-react, thinking that they are crazy or want to kill themselves.  Or sometimes they worry that people will be dismissive and think that they’re just attention seeking.  A good friend listens without judgement and still sees their friend rather than an unhelpful label (‘anorexic’, ‘self-harmer’ etc), after a friend discloses their concerns to them.

Ask How You Can Help

When someone shares their struggles and concerns with you, the most helpful thing you can ask is ‘how can I help?’  There is no need to dissect the ins and outs of why your friend feels this way, that is the work of a therapist, but as their friend you can talk to them about practical measures you can put in place to support them through each day.  Think about difficulties and barriers which are making each day harder for them.  For example, if they’re struggling with anxiety they may find arriving at school in the morning when it’s really busy makes them feel panicky and out of control.  To relieve this you might arrange to meet them a short walk from the school gates and walk into school with them to provide them some moral support.  Exactly how you can help will vary from person to person and is likely to change over time as well so the best thing to do is to have a discussion with your friend to bounce some ideas about.  You should also try to revisit the topic every now and then.

Seek Support

Depending on the nature of your friend’s concerns, it’s likely you’ll need to encourage them to seek further support as you’ll not be able to manage the problem between you.  Telling a trusted adult e.g at home or school will enable you to access further support – for both of you.  Your friend might be reluctant to share their concerns with anyone else but if you’re worried then it’s important that you don’t go it alone as your friend might be in danger.  Also, you may end up developing wellbeing issues yourself if you take on your friend’s concerns without any additional help.  You can help your friend to feel reassured and more in control of the situation by discussing:

  • WHAT information needs to be passed on – you only need to share enough to access support, not everything they’ve told you.
  • WHO needs to know – think carefully about who you trust to respond appropriately and support you both.
  • HOW you’re going to tell them – does your friend want to do it themselevs, do they want you to do it for them, should you to it together or should you write a letter or email?

Of course, we should always try to seek our friend’s consent before alerting someone to their issues, however, there are some circumstances in which you should tell a trusted adult right away to keep your friend safe and to access support as quickly as possible.  These circumstances include:

  • Self-harm including alcohol or drug misuse
  • Suicidal feelings
  • Difficulties concerning food including bingeing, starving, vomiting or laxative abuse
  • Abuse at home (physical, sexual or emotional)
  • Abuse from a boyfriend or girlfriend (physical, sexual or emotional)
  • Bullying of any type

If you need reassurance before you or your friend talk to someone face to face then you can get good support, anonymously, from the Samaritans or Childline either on the phone or online.

Stick By Them

Finally, stick by your friend, through thick and thin and through ups and downs.  It’s hard being friends with someone who’s facing these kinds of difficulties; you may find your friend pushes you away, stops coming out with you, starts acting differently to the person you made friends with or ignores you completely.  But rest assured that your support will mean a huge amount to them (even if they don’t show it) and will help them through their recovery.  Even just the occasional text message can mean a huge amount to someone who’s struggling to get through each day.

Good luck – your friend is lucky to have you.

Click here to read the original blog posting and/or book @PookyH for school training as she runs student workshops on a range of issues related to mental health and emotional wellbeing.  Regardless of the precise topic, the question that students most often ask me is ‘what should I do if I’m worried a friend has a mental health issue?’

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The Editorial Account of UKEdChat, managed by editor-in-chief Colin Hill, with support from Martin Burrett from the UKEd Magazine. Pedagogy, Resources, Community.

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