Disclosing mental health problems: Remember to listen

How to listen to someone with a mental health problem

Listening skills. Tips and guidance for these are everywhere. Unfortunately, when one or both people are feeling uncomfortable about a conversation, our capacity to retain a listening game-plan is reduced. If we are to provide listening guidelines, they need to be unambiguously simple. If I were the boss of the world, I would post these instructions:

  1. Resist Problem-Solving. Unless specifically asked (or there are safety concerns), don't automatically leap to problem-solver mode. Many are driven to take concrete actions in response to a person's distress. This urge often reflects our own desire to feel useful and effective. We need to ask ourselves 'What does this person need most from me at this moment?' NOT 'How can I feel like I've solved this person's predicament?'

  2. Gently Gather Information. Active listening skills involve many components (pay attention, encourage disclosure, reflect, summarise). I find this can be stripped down to one element; gather information about the speaker's experiences with compassionate curiosity. If you are doing this well, you probably will be paying attention, asking questions, and checking your understanding. Ask about what it's like to be that person in that situation with that difficulty. Think fact-finder, not advice-giver. Example questions could include 'How has that issue affected you day-to-day?' and 'What has been the reaction of others?'.

  3. Validate. Validating painful experiences is often far more valuable than a listener assumes. "I am sorry you are going through this", "I can see why you would be feeling this way", "You've got a very challenging situation to manage". Statements that 'name' and 'normalise' distress are usually helpful. If someone with mental health challenges is fearful of negative evaluation, validating responses (provided they are genuine) are conversational gold dust.

  4. Ask. Finally, you can signal on-going support by asking "What can I do next to be helpful?" This step can be as beneficial for the listener as the person who is struggling. Supporters often feel stuck, unintentionally freezing when someone is distressed. This behaviour can be interpreted as a lack of interested or an uncaring attitude, reducing the chances of speaking up in future. If the answer is "I don't know", that may not be a problem. Simply make it clear you are available if a request comes your way down the track.

There we go; Resist, Gather, Validate, Ask. Hopefully, a clear and straightforward approach to listening to a person struggling with mental health issues. 

Remember that effective listening also involves an effort to identify your own sources of discomfort in these conversations. And why wouldn't you feel uncomfortable? This is challenging stuff, so don't be too self-critical if you struggle to feel at ease. For instance, you may be wary of difficult emotions (e.g., low mood, anger) or have a limited understanding of mental health difficulties. You may want to take some action to address these barriers (e.g., seek reputable information on common psychological problems). But sometimes, having more frequent conversations about mental (ill)health in itself can help. People will talk more about mental health issues if their disclosure experiences are positive. Therefore, mental health campaigns must emphasise listening as much as talking.

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