Blog: How to start a conversation about mental health

To mark Time to Talk Day, MFT client and regular blog contributor Chris reflects on why we often don’t dare starting a mental health conversation. Chris shares his tips on establishing trust and healthy boundaries when talking about how we feel so both parties leave the conversation feeling better for having had it.

Chris writes:

“Hey, How are you?”

“Fine thanks”.

It’s the start of almost every conversation ever, but the response, “fine thanks” seems to be said instinctively, without even thinking, it conveys no meaning. It was such a promising start, and kind of someone to ask the question, but too often we fear “are they really interested in my problems?”. No-one wants to be ‘that person’ that is always whingeing about this problem or that. Some people ask the question just out of courtesy – they don’t really want an answer, let alone are they interested in listening to it. So how can you tell if the person asking is genuinely interested or is just trying to be polite before moving things on? And is this really the time and place to express how I really am feeling? Far to often there’s other seemingly more pressing matters at hand.

But sometimes not only is it important to share with others our true feelings, it’s needed to help maintain a healthy mindset. I, for one, know the damage ‘bottling things up’ can do, invariably making a big problem out of something small. The right conversation, at the right time, can easily defuse what could otherwise become a dangerous spiral of negative thoughts constantly cycling around in our heads making us feel angry, frustrated and distracted from life.

So how do we start these sorts of conversations? Once we’ve started, how do we make sure both people feel safe opening up? Not only that, how does the listener protect themselves from the other person’s struggle so both leave the conversation feeling better for having had it?

Let’s start with asking twice. Ask twice has become the mantra for mental health conversations to get beyond the initial reflex action “I’m fine”.  “Are you sure”? “Is there anything you’d like to talk about”? “Can I help with anything?”.

But, surely there’s more to it? Asking twice reaffirms interest; it moves the question out of ‘courtesy’ territory and makes it clear that the person asking has a genuine interest in how you are. And if you’ve got a headache, a cold or some other fairly superficial physical condition you’re more likely to say something other than “fine thanks”.

However, for deep and meaningful conversations about mental health, asking twice is simply not enough. While the world is becoming more educated and informed about wellbeing and mental health topics and the benefits of bringing them to the fore, there remains an underlying element of stigma that still goes along with any mental health condition. This makes it difficult for the people on both sides of a mental health conversation to get started. Even if you notice that the behaviour of a friend or colleague has changed, how likely are you to say anything to them? You’d more than likely worry you’d cause offence and think it’s best not to go there. Equally, for the person struggling it’s unlikely they’re going to want to openly admit that they are struggling to cope (although they may well be waiting for someone to notice and genuinely ask how they are). Everyone wants to look like they’re a success and capable on the outside. This happens in all aspects of life, but no-where is this seen more so than in the workplace. Everyone is busy, and you don’t want to be the one letting the side down.

My own difficulties at work started when I never said ‘no’ to taking on extra work. It didn’t matter what it was, somehow, I thought, I’d find a way of getting it done. I was career building; I wanted to be noticed; I wanted my team to grow; I wanted a promotion. I know now that the strategy was of course flawed, but I suspect it’s a common one. It was the start of a spiral that saw me getting more stressed and anxious. I was worried about failing – not getting things done to the required standard. Yet, in all honesty, I’d set myself up for nothing other than a spectacular failure. But, more than anything I didn’t want to show it or admit it to anyone. The outside perception needed to be one of being capable, calm and in control. I had been burning the candle at both ends and was facing burn-out. More than anything I needed a mental health conversation, but before that could be had someone had to notice. My own story is explored more in this blog. But, I can’t help wondering if my story would have taken a different route if someone had not only noticed, but also had the courage to say something. I suspect people around me had noticed a change in my behaviours. They may well have discussed these changes between themselves. However, starting a conversation about feelings, behaviours and mental health is just not something that people are good at; least of all men.

To break down these barriers we need to normalise conversations about mental health. We need to feel ‘safe’ having a conversations about not coping, negative thoughts and needing help. That’s where initiatives like Time to Talk Day can really help. It invites people to have a conversation about mental health ‘for no particular reason’. The door is open and a conversation about ‘how you really are’ can be had if for no other reason than it’s ‘Time to Talk Day’. There doesn’t need to be anything obviously wrong; you don’t need to feel weird about it.

So, we’ve decided we’re going to have a conversation with someone about mental health. How do we actually do it? Well, it’s just the same as any other conversation. It’s as simple as that. That said, I’ve noticed people find it much easier discussing a physical condition; be it a broken leg, diabetes or the flu. I think there’s possibly a couple of reasons for this.

1)     Will I make it worse?

2)     Trust

I think one fear people hold about talking to someone about mental health is that they’ll say something that will make it worse. However what you may forget is what we’re talking about here is an illness. In the same way as your words won’t make someone’s broken leg worse, there’s nothing you can say that will make their mental health illness worse. Sure, you can be insensitive, but by ‘showing an interest’ in someone who may feel otherwise stigmatised and isolated you’ve a 99% chance making things better. You know your friends and colleagues; trust yourself to work out what to say. Sometimes a bit of a joke and banter is exactly what’s needed.

To overcome the inherent stigma we’ve discussed, there needs to be a greater level of trust between two parties to create a safe space for a mental health conversation. The person being asked generally has two questions in their mind that stop them opening up. “If I admit to myself as struggling with mental health, does that make me weak?” (self stigma), and also “will this person I’m talking to think of me any differently if they know the truth?” (externalised stigma). Building trust is not easy or quick. However, there are strategies that can be used to help people feel more comfortable.

1)     Share something personal.

2)     Listen, be inquisitive.

A quick way to build trust with someone else is to offer up something personal about oneself early in the conversation. The ace card is to pick something that could make you vulnerable, to be judged or treated differently by the other person. By offering something up about yourself you’re extending trust to the other person to treat you sensitively. If you’ve got your own story about mental health or wellbeing that you can start the conversation with, that’ll certainly help put the other person at ease. The other person may well then volunteer their own story as a way to reconcile your own tale.

From there, you just need to show genuine interest in the other person. Ask open questions like “tell me more” and trust in the conversation will build. And there you have it; you’re having a conversation about mental health.

It’s great to have got that far with someone, but for you, it doesn’t end there. Please don’t forget about your own self care in the process. Discussions about mental health can be wide ranging, dramatic and sometimes painful.  You can only help someone else all the time you’re taking good care of your own mental health and know your limits. In my own experience I’ve found myself developing a ‘saviour complex’ when asking about the mental health of others. I go beyond being a good listener – not only do I get so deeply involved in someone else’s problems that I also convince myself that I can solve them. I leave the conversation feeling drained. The positive energy that I went into the conversation with is gone. I’m left carrying a sackful of negative energy that I don’t need nor want. The difficulties discussed in the conversation are often deep and entrenched. To ‘solve’ them finds me taking on the burden and, in the process, my own peace of mind gets taken. My own brain cycles outside of the conversation and becomes focused on that other person and their troubles. My own mental state deteriorates, I’m of little use to anyone else.

This doesn’t have to be the case. I’ve matured in my approach and I’ve learned that other people’s problems are just that, other people’s problems. Unless there is something specific that the other person asks you to do, you’re not there to solve their problems for them. Your role is to be a good listener and help them work towards their own solutions. Even just letting the other person talk, open up and feel valued provides a significant cathartic benefit which will help them more than you can believe. I’ve learned that when leaving the conversation I can ‘leave the energy at the door’ too. This means I have to notice what negative energy I may have picked up through the conversation, bundle it up as a ‘package’ in my mind and park it at the door when I leave. It stays in the room as I walk away. This allows me to move on with my day without being overly impacted by the conversation I’ve just had.

Having a conversation about mental health really doesn’t need to be hard. The words are just the same as any other conversation; just be aware that to help someone open up you need to demonstrate that the other person can trust you. So, be prepared to open up a little about yourself in order to grease the wheels to get the conversation moving. And when you’re done, remember to do something nice to take care of yourself too.

Show your friends and colleagues that you’re there for them. It’s Time to Talk Day on Thursday 3 February 2022, the nation’s biggest mental health conversation. Where will your conversation take you?”

Want to celebrate Time to Talk Day with us?

Time to Talk Day will take place on Thursday 1 February 2024. Happening every year, it’s a day for friends, families, communities, and workplaces to come together to talk about mental health, listen to each other and change lives.

To mark the occasion, throughout next week, we will share some blogs and tips on social media so make sure to follow up on Facebook, Twitter, Instagram or LinkedIn so you can join the conversation too!

As part of our End Stigma Surrey campaign, we’re also holding some informal pop up events on Thursday 1 February to get people to open up about their mental health. Please do come and have a natter!

09.30 – 11.30
Leatherhead Community Hub and Foodbank
Kingston Road, Leatherhead, KT22 7PX

13.00 – 15.00
The Horton, Epsom: Arts and Heritage Centre
Haven Way, Epsom, KT19 8NP

16.00 – 17.30
GP Hub Bourne Hall, Primary Care Network
Bourne Hall Health Centre, Ewell
Chessington Road, Ewell, KT17 1TG

Help us tackle stigma in Surrey!

As part of our End Stigma Surrey campaign, we would like to hear from people with experience of mental health issues (either direct or indirect e.g., as a carer, family member, friend), about any stigma or discrimination they have experienced, or may experience.

The survey takes about 10-15 minutes to complete, remains anonymous and is open until 11 February.

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