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How to support someone living with mental illness

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Tatiana Wyse, Noemia Cerqueira, and Sandra Li,
(L to R) Tatiana Wyse, Noemia Cerqueira, and Sandra Li, Clinicians in UHN’s Community Mental Health Program at Toronto Western Hospital, share advice on how to support someone living with mental illness (Photo: UHN)

Today is Bell Let's Talk Day, an annual opportunity for Canadians to engage in a national discussion to raise awareness about mental health.

In Canada, one in every three Canadians cope with a mental illness at some point in their life, making it likely that, if not affected directly, we may all experience mental illness indirectly through a friend or loved one. So what can we do to help?

Across UHN, there are 21 clinics associated with mental health. UHN News sat down with Noemia Cerqueira, Sandra Li and Tatiana Wyse – clinicians with clinics in Toronto Western Hospital's Community Mental Health Program – to discuss how you can support someone who is living with a mental illness.

What should I do?

If you think someone you know might be suffering from a mental illness, the first step is to get them assessed by their family doctor.

"Our clinic receives many calls from the community, from concerned family members who have noticed a change of behaviour in a loved one and they really want to understand what is going on," says Noemia, a clinician with Portuguese Mental Health and Addiction Services.

"Without seeing the patient, we can only tell them what resources and options are available. The best way to start the process is to have the person assessed by a family physician who can refer them if necessary.

"However, if something more serious is happening and the person is in crisis, you should call 911."

In cases where the individual is unwilling to visit a doctor, resources are available in many communities for caregivers of people struggling with mental health issues.

"There are family support groups that provide psychoeducation, resources, and support to family members, helping them better support the person with mental health concerns, and take care of themselves as they may be in the caregiver role," says Sandra from the Asian Initiative in Mental Health (AIM) team.

Don’t know what to say? Here are some suggestions on how to speak to someone coping with a mental health issue.

WHAT HELPSWHAT HURTS
​I know you have a real illness and that’s what causes these thoughts and feelings.It’s all in your head.
​​I may not be able to understand exactly how you feel, but I care about you and want to help.​​​We all go through times like this.
You are important to me. Your life is important to me.You have too much to live for – why do you want to die?
Tell me what I can do now to help you.What do you want me to do? I can’t do anything about your situation.
You might not believe it now, but the way you’re feeling will change.Just snap out of it. Look on the bright side.
You are not alone in this. I’m here for you.You’ll be fine. Stop worrying.​
​​​Talk to me. I’m listening.Here’s my advice…
​​I am here for you. We will get through this together.What’s wrong with you? Shouldn’t you be better by now?

Education and listening

Education is a big piece when it comes to understanding someone's mental illness and occurs at many stages of a person's journey – from recognizing when the person is at risk of a crisis and how to respond, to understanding the side effects of medication.

The more informed you are about your loved one's issue and needs, the better equipped you are to be supportive.​

A patient's consent is needed before healthcare providers discuss a patient's issue with anyone else, but education for patients' loved ones is important. Joint sessions with the patient and his/her family members that are facilitated by a clinician can help foster greater understanding and better patient care.

"Talking with the family can help raise awareness about prejudice and break away from the stigma connected to mental illness," says Tatiana, who works with the Spanish Mental Health Program. "Stigma can play a huge role in the relationship and how the patient interacts with their family.

"Once we start to provide education on awareness of this stigma, we always see a shift in how the patient and family relate to each other."

Self-care

Living with or trying to support someone who is dealing with a mental health issue can take a toll on the person trying to help. It's important to practice our own self-care and have appropriate boundaries around what we can and can't do for someone.

"Family members care about the patient so much that they can get so anxious and worried that it affects their own mental health and ability to help the patient," Sandra says. "The instinct is to want to help, which is natural. But it's important that you listen and understand the patient rather than try to fix them.

"Help the patient access resources and professional help instead of trying to change the patient on your own since that may cause a patient to shut off even more."

Tatiana adds: "Family members often want fast solutions and recommendations on what they can do.

"It's better to be an empathic listener and help them access resources. Preventing caregiver burnout also helps prevent mental illness from spreading in a family which can sometimes happen."

Acceptance, patience and realistic expectations​

Once a loved one is receiving treatment, it's important to not only accept their diagnosis but also be patient and have realistic expectations about someone's recovery. Recovery might not always mean the patient is symptom free, and can involve many changes to a person's lifestyle and how they cope with certain feelings.

"Sometimes – especially when the illness involves a type of psychosis – family members don't want to admit their loved one has mental illness." Sandra says. "By the time a patient reaches us, they may already have difficulty functioning and need family support in compliance to medication and daily activities.

"So if the family doesn't accept the fact that the patient is sick, they may encourage them to stop their medication, receiving psychotherapy, or seeing a specialist once the patient appears to have passed the crisis stage. We see a lot of relapses in patients' conditions as a result of that."

It's also important to remember that when a patient first receives treatment, they may seem "better" but might still need ongoing management of their illness for months or even years. Continued engagement between the family and care team ensures higher rate of success.

"Patients usually come for treatment when they are at their worst, after trying to cope over a long period of time," explains Noemia. "So we need to remind families that it took this long for the patient to get to treatment, and it's going to take much longer for them to get better because there are many pieces to treatment aside from just medication and therapy."

Tatiana adds: "It's not easy for families to deal with the fact that this is a chronic illness or that it will affect a person's ability to perform regular duties or even retain a job. Families want to keep the hope going and we want to give them hope, but the expectations have to be realistic.

"We have to find the right formula for patients – figure out how the person can manage on a day-to-day basis and also have a good care plan in place that supports them."

For more information on resources available to family or friends looking for support for someone with mental illness please visit the resources below:

Mental Health Helpline 1-866-531-2600 ​

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