Awareness campaigns such as Time to Talk Day encourage us to reach out for help if we’re struggling, and to be there for others who reach out to us. I’ve discussed some of the reasons people may not want to talk, but what about when they do? You might feel confident talking with a friend or loved one about their mental health, but what about someone you hardly know at all? In this post I share how I approach such requests, because it can be very different from talking about mental health with people I know.
Little or No Backstory
The most obvious difference is that I only know what the person has chosen to share with me. With a friend or loved one there’s a history and a relationship to draw on. A friend will choose to talk to me based on their trust in our relationship and in me personally. When someone approaches me out of the blue there’s very little to provide that broader context.
In the workplace I might be contacted in my role as a Mental Health First Aider. The person is necessarily a colleague but rarely someone I’ve worked with previously or closely. They work for the same organisation but could be based anywhere in the country. They may have heard my name mentioned by others, seen my e-mail signature which mentions my role as a Mental Health First Aider, or chosen me from the organisation’s list of MHFAs.
Outside work, the person might have found me through social media, our book, or this blog. Occasionally, I might have been suggested by a mutual friend. However it happens, they are approaching me based on their perception of my personality, knowledge, and experience. It helps if I know how or why they chose me, but that’s less important than the fact that they did, and their belief that I can help in some way.
ALGEE: The Mental Health First Aid Framework
Workplace conversations are conducted within the Mental Health First Aid framework, but I also find it useful when responding to other requests for help and advice. Known by its acronym ALGEE, the MHFA action plan has five steps which can be used in any order.
A: Approach, assess for risk of suicide or harm.
L: Listen nonjudgmentally.
G: Give reassurance and information.
E: Encourage appropriate professional help.
E: Encourage self-help and other support strategies.
You can find more detail about the ALGEE action plan on the Mental Health First Aid website. The MHFA framework reminds me to pay attention to my responsibilities regarding safeguarding and escalation in the case of suspected crisis situations, and to maintain healthy boundaries.
The Initial Approach
With friends, mental health topics tend to arise naturally during regular conversation, whether that’s face-to-face, in chat, or on a voice or video call. If it’s more urgent, a text or message along the lines of “Something’s happened, can we talk?” will be enough.
It’s different with people I don’t know personally. In the workplace, the request is usually by e-mail or Teams chat, asking if I’m free to have a Mental Health First Aid conversation. The initial approach might be from the person concerned or their colleague or manager. There may be a little context or background, but that’s not always the case. We’ll decide a mutually convenient time, and meet face-to-face or via Teams depending on our location and availability. More often than not, I arrive for the meeting or open the call with little idea of what is about to be shared or asked of me.
Outside work, requests from people I don’t know arrive by e-mail or instant message. These tend to be longer and more detailed than workplace approaches. They generally describe the situation the person is in and what kind of help or advice they’re looking for.
Assessing the Urgency of the Request
No matter how it arrives, the first and most important priority is to take the request for assistance seriously. I may not be able to respond immediately but I’ll read the message at the earliest opportunity and assess how urgent it seems to be. If the situation appears urgent or critical, I respond straight away, signposting to relevant services, crisis or support lines.
If it doesn’t appear urgent, I think about when I’ll have time to give it the care and attention it deserves. The person will be looking for a response but it’s better for them to wait a little longer than receive something from me that appears rushed, or dismissive of their situation and concerns. If necessary, I might reply to say I’ll get back to them within the next day or so. That way, they know I’ve received their request and that I’m not going to ignore it.
Responsibility and Respect
I begin by reminding myself it’s both a responsibility and a privilege to be asked for help, advice, or support. I treat the person and their request with respect, recognising the courage it takes to reach out to someone you’ve never met and don’t know at all. Whether I can help them or not, they deserve to feel I’ve taken them and their request seriously.
What Am I Being Asked?
It’s important to assess what I’m being asked to provide. Does this person want someone to hear their story, or are they asking for practical help or advice? I was reminded of this distinction during one workplace Mental Health First Aid conversation. The person told me they were happy to talk about their situation all day, but they were looking for practical help and suggestions, not just someone to listen.
Advice, Information, and Signposting
I’m wary about giving advice, especially on the basis of limited information. Where possible I want to offer something practical, helpful, and positive. That often includes signposting to relevant resources, or suggesting next steps they might take. I’ve written previously about taking and offering advice, including whether I am good at taking my own advice.
If I feel an online resource would be helpful, I’ll take the time to find direct links to the websites or pages. This makes it as simple as possible for the person to check them out and decide if they’re relevant to their situation. Wherever feasible, I suggest support links and resources that are geographically relevant. Hub of Hope is a great starting point for anyone in the UK, offering crisis and support links based on your home location.
Clarity and Focus
It’s important to respond concisely and clearly to the points or questions the person raised, without rambling or going into too much detail. It’s natural to try and fill in the gaps but I resist the temptation to make assumptions or draw conclusions about the person’s situation. I find it helps to focus on the actual words they’ve used in their message or e-mail and proceed on the basis they meant precisely what they said: no more and no less.
In a face-to-face conversation it’s easy to check my understanding or ask them to expand a little on what they’ve said. This is harder where I’ve been approached in an e-mail. Where necessary, I might ask for further information or clarification, or simply state in my reply any conclusions I’ve drawn. This gives them the opportunity to consider my suggestions in context, and where necessary to correct any misundersandings.
Never Diagnose or Suggest Treatment
It might seem obvious but I make no attempt to diagnose the person’s mental health condition or suggest specific treatments. If they disclose that they or the person they’re concerned about has received a clinical diagnosis, it’s reasonable to take that into account, but it’s no part of my role to diagnose or recommend treatment. That’s solely the responsibility of the person’s doctor or clinician, and I would always advise they seek relevant professional advice.
Thank Yous and Follow Ups
I close by thanking them for approaching me, and invite them to follow up with me if they’d like to. I generally receive a reply thanking me for taking time to reply to their request. They sometimes expand a little based on what I said or suggested. On occasion, it’s clear that my suggestions were not as relevant or useful as I’d hoped, but that’s inevitable when working with limited information.
Self-care and Confidentiality
An important lesson from my MHFA training is the importance of considering my own boundaries and wellbeing. It’s rare for me to need support following a mental health conversation but I can draw on the network of Mental Health First Aiders at work, and the wider MHFA community. If necessary, I’d turn to my circle of friends for support. In either case, I take the privacy of the person who approached me for help, and the details of what they shared with me, very seriously. I would only divulge details if I felt the person was at risk.
Links and Resources
If you’re interested in finding out more about becoming a Mental Health First Aider, the websites of Mental Health First Aid England and Mental Health First Aid (US) are a great place to start. For international crisis lines and support organisations, check out our resources page. If you are in the UK, the Hub of Hope website and app can signpost relevant resources local to you.
Over to You
In this article I’ve described how I approach requests for mental health help and support from people I don’t know. Have you ever approached someone you didn’t know for help or advice? How did it go? Have you offered help and support to someone you didn’t previously know? Did you feel confident about being able to help them? Fran and I would love to hear from you, either in the comments below or via our contact page.
Photo by Timon Studler at Unsplash.