Mental Health—Helpful Question sets

Approach 

• Open conversation 
• Consider your own judgements 
• Right me/place? 
• Be sensitive/mindful of personal space 
• Respect privacy unless there is a risk of harm to self or others 

Assess for crisis 

• Watch for warning signs 
• Suicidal crisis? 
• Self‐harm? 
• Panic Attack? 
• Traumatic event? 
• Severe psychotic state? 
• Medical Emergency 

Assist with crisis 

• Ensure own personal safety 
• Ensure the person is not left alone if an immediate crisis 
• Seek immediate emergency help in doubt 
• Inform external helpers of the situation and mental health needs 
• Encourage the person to talk 
• Don’t give advice, argue, deny their feelings/experience 
• Reassure help is available and can be found 
• Stay calm—it’s infectious 
• Physical first aid for medical emergencies 

•  Set aside any judgements you hold 
• Listen without interrupting 
• Ask appropriate clarifying questions 
• Reflect back on what the person has said, use minimal prompts (’Mmm’, ’Ah’ etc.) 
• Silence can be supportive 
• Open body language 
• Comfortable eye contact 
• Don’t invade their space 
• Don’t be critical, argue or get frustrated 
• Don’t offer glib advice (e.g. ’Cheer up’) 
• Avoid confrontation unless necessary in a crisis 
• Remember, you can acknowledge emotional experience without agreeing with concerning actions and/or pretending delusions/hallucinations are real. 

• Treat the person with respect and dignity 
• Please don’t blame them for their difficulties (mental health issues are real and they’re coping as best as they can) 
• Have realistic expectations for them (any behaviour change takes me; they’re not weak or lazy) 
• Offer consistent emotional support and understanding 
• Give hope for recovery (effective treatments are available) 
• Give practical help, but don’t try to take over and solve all problems; instead, support new coping strategies 
• Give high-quality info relevant to their condition 
• Where the risk to self or others exists, don’t keep a secret, but try to consult the person before sharing any details 

•  This can be a difficult step to take, but vital, so help the person make a decision— early intervention aids recovery 
• Discuss a wide range of options: GPs, counsellors, psychologists, psychiatrists, NHS — IAPT, Early Intervention in Psychosis, Crisis Resolution, Community Mental Health Teams, inpatient, voluntary sector—e.g. Mind, helplines 
• GP first port of call is 999 in crisis 
• Medication & psychological treatments are both important, balancing side effects and negotiating with professionals 

What if the person doesn’t want help? 

• Explore reasons why (costs, fears, negative experience?) 
• Tell the person you’ll support if they change their mind 
• Respect the person’s right not to seek help unless they are a risk to themselves or others 
• If the person is very unwell, seek help on their behalf; try to involve them as much as possible 
• Never threaten with forced treatment—legalities are complex, seek advice 

• Family/friends can play key roles and can help by listening, encouraging and providing practical and emotional support 
• Support groups and informal befriending services can validate experiences, reduce isolation and provide peer learning for self‐help 
• Voluntary and community sector support 
• Self‐help strategies can help and give people a sense of regaining control of their lives and doing something positive. Includes: books/leaflets, groups, computerised packages, websites, or apps, often cognitive‐behavioural based 
• Wellbeing strategies (5 ways to Wellbeing, 10 Keys to Happier Living) 
• Complementary therapies, e.g. mindfulness, massage therapy, yoga, relaxation strategies, nutrition, exercise, creativity, avoiding alcohol /drugs 
• Wellness Recovery Action planning