How to check on family and friends’ mental health – KENS5.com

SAN ANTONIO If you or a loved one is in immediate danger, call 9-1-1. If you are in a moment of crisis and need someone to talk to, you can call the National Suicide Prevention Hotline at 1-800-273-TALK or text the Crisis Text Line at 741-741. You can also find a web-based chat servicehere. You may want to consider adding these numbers to your phone in case you ever need them in the moment.

If you've ever been concerned about a family member or friend's mental health, you may have wondered about the best way to provide support. Dr. David Roberts, Director of UT-Health San Antonio's Transitional Clinic, says taking action can make all the difference.

"Social connectedness is a huge factor," Roberts said. "If you talk to people that have experienced suicidal thoughts or attempted suicide and gotten through it, social support is something they point to as one of the big factors that gets them through. Very often it can be just small moments, small gestures; 'so-and-so reached out to me, I thought I was in a dark hole by myself and just her reaching out to me made all the difference.'"

Claudia Vargas, a peer policy fellow with the Hogg Foundation who works with groups such as the National Alliance on Mental Illness and SA Clubhouse, a space for mental health recovery, says everyone has mental health, so anyone can have a mental health condition. As someone who's experienced suicidal thoughts and has gotten help, she now advocates for others.

KENS 5 Eyewitness News asked Roberts and Vargas to weigh in on their thoughts about how we can support our friends and family members.

WHAT TO WATCH FOR

Roberts: Theres different ways clinicians and researchers try to assess the risk of suicide. Very few people luckily actually attempt suicide, so the risk factors that are out there- even if someone has these risk factors, theres still a low chance theyll commit suicide- but still there are some that are important.

Obviously if theyre experiencing depression, if they have a history of attempting suicide, if theyve had people in their lives that have attempted or committed suicide, if theyre using drugs or alcohol at a higher risk than they normally do, if they are prone to impulsive behavior, and experiencing any recent loss or disappointment, all of these combined in any sort of combination can be an indicator that someone might be at risk.

Other factors could be withdrawal or saying statements like I feel worthless, or making statements like they dont see a future for themselves. Listening to the words they use can be very helpful as well.

Vargas: I think in general, if somebody is distancing themselves or they seem not like their usual self go ahead and have those kinds of conversations: hey, how are you doing? Is there something thats bothering you, how can I help?

I think everybody is susceptible to having a mental health [crisis]. Everybody has mental health, so anybody can have a mental health condition. There are definitely people that are the spirit of the room, always laughing and cracking jokes- but they can be going through a crisis themselves.

STARTING A CONVERSATION

Roberts: Oftentimes if youre feeling concerned about a family member or a friend, youve seen something or heard something thats different from the way they usually are and youre worried about their safety, if youre worried about depression or suicide. I think the best thing to do if possible is to actually refer to something concrete. Say something like- last week I saw you say, my life is useless. Using that concrete thing to refer to is really helpful and shows them youre paying attention and prevents them from saying, its nothing at all. And then you can say your concerns about that. I heard you say your life is useless- I wonder if youre thinking about hurting yourself, or killing yourself.

One of the most important things to make known publicly: theres this idea that if I ask somebody about suicide, will that put the idea in their head or make them think, oh I should commit suicide- or make them horrified that I would even bring that up. One of the most important things we can do is be comfortable bringing up the question of the suicide. Theres very clear research out there that bringing it up does not at all increase the risk of suicide. In fact, theres some evidence its the opposite. For people thinking about suicide, often they feel ashamed and alone and alienated- like they cant talk with other people about it. By bringing it up and asking them about suicide, they feel like they have somebody to talk about it.

The most important one is- bring it up with them, in a direct way and in a caring way. I think one thing I would like to be sure people understand is- talking about safety and suicide is very important for friends and loved ones. We want to keep people safe if theyre at risk for suicide. But people who are at risk for suicide- their goal very often is not to stay safe, its actually to suffer less. And the research shows clearly that people who are at risk for suicide are trying to stop pain, to escape emotional pain or physical pain- so talking with loved ones about the pain theyre in, validating their suffering and not talking to them in a way that communicates they may be trying to manipulate or get attention thats one misconception, when someone is talking about dying, sometimes we think theyre trying to get attention for that- the research doesnt really support that. Show them that we care and ask if we can help them in any way to reduce the pain.

Vargas: It comes down to intention. You have to be careful about your tone and how you approach it. You dont just go in front of a big group hey, are you doing okay? Just make sure its in private and you ask them if theyre doing well. Sometimes during family holidays people ask, do you have a partner or hows school doing and maybe thats a touchy subject for you at the moment. Just be more careful about the words and tone that you use when asking people how theyre doing.

I think people are scared either to push too far or be too straightforward about certain topics, like suicide. Some people are told and they believe wrongfully that asking, hey, are you feeling suicidal? That if they werent already feeling suicidal, they might go ahead and complete suicide. But its quite the opposite. If you ask someone- hey I feel like youve been off lately, and you mentioned things like, I dont find purpose in life anymore- key words that would tell you someones thinking about suicide- you want to make sure you ask them. Are you thinking about suicide? And can I help you? Because talking about it takes away that stigma and that barrier of talking about it. Just asking will lead to a more since conversation that will lead to more positive results long term.

If they say yes, there are various ways you can go about it. Somebody may be thinking about suicide, but not actively planning to die by suicide. So you want to ask- do they have a plan? Are they thinking about hurting themselves in the next 24 hours? Thats from the crisis counselor background. You mostly just want to listen to whatevers going on, not try to solve the problem- because if youre having suicidal thoughts, chances are one conversation isnt going to make it go away. Listening, and if you know- say hey, heres the crisis text line number, or- Im here for you. How can I be here for you- leaving it open ended for that person to help.

CREATING A "SAFETY," WELLNESS OR "CRISIS RESPONSE PLAN"

Roberts: Theyre used in clinical settings but more and more research shows friends and family members can be helpful doing a suicide safety plan with people. Weve actually started thinking about it as a form of mental health first aid. In the same way that you dont have to be a doctor to do CPR, you dont have to be a doctor to do first aid for someone feeling suicidal. The term suicide safety plan may not be the best term to use, because it sort of implies the person having suicidal thoughts has the goal of being same. But almost by definition- if theyre feeling suicidal, theyre not focused on being safe. What theyre focused on is stopping the emotional suffering or physical suffering, the pain theyre in. So when youre making a plan- try crisis response plan. Its a list for the person that shows, what are your personal risk factors? What are the things that give you a sign youre getting to a crisis stage, where the pain is going to be intolerable. The second thing, is what can you do by yourself to lessen the pain youre in? Three- what can you do to reach out to people for social support? Four, what are the things that have been meaningful to you in the past? Helping the person get in touch with what matters to them in life- pets, children, family, those kinds of things. And finally, emergency resources. When all of these things have not helped you to lessen the pain- can you call 911, can you go to the hospital?

These are helpful because often when someone is suicidal- they get blinders on. We arent thinking reflexively, we cant solve problems well, our thinking gets rigid, dark and present focused. What this does is help them in the moment. They can take a picture of this with their smartphone and when theyre feeling suicidal, and cant think straight- they pull out their crisis response plans, follow the directions, and it gets them through.

Vargas: WRAP is a Wellness Recovery Action Plan. You sit down with a book and it asks you a whole bunch of questions about- what do you need to do to be well? Or, what are some signs that youre not doing so well? So you can catch yourself and say- maybe its been more of a struggle to get up from bed in the last couple weeks. A pre-crisis moment. And you make a list of, when you are in those moments- what are things you can do? Who are people you can reach out to, it also goes over, if youre going through a crisis, whos going to help you? Who do you want to contact, who do you not want to contact? So you already have a plan and can be calm in the moment. (In San Antonio,The Clubhouseoffers free classes for how to fill out a form).

This is for anybody. You dont have to technically be diagnosed and have a mental health condition- but if you have mental health, chances are a plan will be helpful for you. It will be beneficial to you- and those around you.

OTHER HELPFUL RESOURCES:

Suicide Prevention Lifeline

Transitional Care Clinic

National Alliance of Mental Illness

Do you have a suggested resource for us to add to this list? Contact ezucco@kens5.com.

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How to check on family and friends' mental health - KENS5.com