How to talk to loved ones in mental health crisis.

One in four adults struggles with their mental health, but knowing how to help when loved ones are suffering can be tough too. Yet sometimes all people really need is to be heard. In this exclusive extract from How to Listen, Samaritans’ new guide for these troubled times, you’ll learn to start conversations, listen without judgment, empathise rather than problem-solve, and use gentle encouragement to help others share. Start by saying SHUSH, the acronym Samaritans volunteers use to remind them of the key to good listening.

Show you care

Give the person you are listening to your full, undivided attention. This is a non-verbal way of showing them how much you care. We are constantly dropping clues about what’s going on in our heads, often without realising what signals we are giving.

  • Try sitting at a five o’clock angle to the person you’re supporting.
  • Lean forward slightly to show you are interested in what they are saying.
  • Be aware of any habits you have which might be off-putting, like glancing at your watch or phone.
  • Be careful not to fidget.
  • Keep your arms open and uncrossed.
  • Make eye contact, but remember that excessive eye contact can, to some, come across as threatening, so be mindful of staring. Sit or stand at the same level, so you’re not looking up or down at the person you’re listening to, as this might make you both feel uncomfortable.
  • Try not to let your mood or how you’re feeling show in your body language.

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Have patience

It may take several attempts before someone is ready to open up. Effective listening is about showing compassion and creating trust, and patience is key. They shouldn’t feel rushed or they won’t feel it’s a safe environment. If they’ve paused in their response, wait: they may not have finished speaking. It might take them some time to articulate what they’re feeling.

Don’t interrupt or cut in. If someone pauses, count to five in your head. This will help give them space to think and time to elaborate further if needed. It also shows you are thinking about what they are saying, which will hopefully give them the confidence they need to keep talking.

Use open questions

Opening up about a problem can be difficult. Someone might start by telling you about a smaller, separate issue they may have been having, or talk about what they’re going through, but initially downplay how they’re really feeling. They might not even know what the heart of the problem is until they have explored it with you. Often people do want to talk, but will wait until someone asks how they are.

Questions that invite someone to elaborate rather than just giving a “yes” or “no” answer are the most useful. Try asking them: “How are you feeling today?”, and then following with, “Tell me more about that”.

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Inviting them to elaborate or asking questions that cannot be answered monosyllabically will give them the chance to tell you more. These questions don’t impose a viewpoint or imply any judgment. They require the other person to pause, think and reflect, and then hopefully expand.

Ask: “When did you realise you felt this way?”, “Where did that happen?”, “What else happened?” or “What do you think is making you feel this way?” and “How did that feel?”

Be careful with “why” questions, as they can sometimes suggest judgment and make people feel defensive. Try saying: “What made you choose that?” or “What were you thinking about at the time?” instead.

With active listening, although you do some talking, you’re really acting as a sounding board. Whatever you say shouldn’t influence what people have to say. It should just help them to talk.

Say it back

Check you have understood, but don’t interrupt or offer a solution. Repeating something back is a good way to reassure someone they have your undivided attention. You can check to see that you’re hearing what they want you to, not putting your own interpretation on to the conversation.

It is also an opportunity to ask if you have understood properly. It shows you are listening intently and trying to understand what they are feeling from their point of view, rather than your own. Mirroring the language, they are using demonstrates that you care about what they are saying and gives them a chance to reflect on what they have said, which can lead to further exploration of a thought or idea.

Have courage

Do not be put off by a negative response and don’t be afraid of any silences. You do not have to fill the gaps in your conversation. Sometimes it can feel intrusive or counterintuitive to ask someone how they feel. But you will be surprised by how often   people are willing to talk, and how, sometimes, being asked how they feel is exactly what somebody needs to be able to share.