How to Help Someone You Care About Get Psychiatric Care

How do I bring it up?

Pick a time and place where the person feels safe and comfortable, not in the middle of an argument or in front of others. Say what you have noticed and that you care, then stop and listen. Watch their reactions, and slow down if they seem confused or upset.

These are examples of wording, adapted from federal guidance for family and friends. Use your own voice.

• I have been worried about you. Can we talk about what you are going through? If not with me, who would you be comfortable talking to?
• It seems like you are having a hard time. How can I help you find help?
• Who or what has helped you with something like this before?
• I am concerned about your safety. Have you thought about harming yourself or others?

What should I avoid saying?

Most people who say the wrong thing are frightened, not unkind. Try to speak from your own view instead of telling someone what they are doing wrong. Remember that nobody chooses these symptoms. If they say something hurtful, listen for the emotion behind the words rather than getting into an argument.

Please also avoid diagnosing them. You may be right that something is wrong, but a label can end the conversation before it starts, and only an evaluation can sort out what is going on.

What practical help can I offer?

Specific offers are easier to accept than, let me know if you need anything. Ask which of these would help, and take no for an answer. Keep inviting them to the things you normally do together, without being overbearing, even if they keep saying no.

• Sit with them while they look up providers or call their insurance. Our guide to checking benefits lists what to ask.
• Help with a request form or stay with them while they make the call, if they want that.
• Give a ride, help with childcare, or take over a task that is getting in the way.
• Go with them, take notes if asked, and step out when they want time alone with the provider.
• Check in afterward: how did that go, and what would help next?

What can I do if the person is an adult?

You can support and encourage an adult, but you cannot make their treatment decisions for them. They may not choose what you would prefer. Accepting that their decision is theirs treats them with dignity, and can make them more willing to stay with the plan they chose.

Providers generally cannot talk with family members about an adult patient without that person's permission. Ask the person to arrange that if they are willing. If you have a safety concern, you can ask us whether and how you can share it with us. With a patient under 18, a parent or guardian must be present at appointments here, and we see patients ages 5 to 65.

If medication is part of their care, offer reminders carefully, because daily prodding can feel insulting to an adult. Ask what they would prefer. Medication decisions are made after an evaluation, not every medication can be prescribed at every kind of visit, and some may require an in-person visit. We explain what applies to the patient, and medication management describes how follow-up works. Encourage them to talk with their prescriber before stopping or changing anything.

What if they refuse help?

It may take more than one conversation, and a no today is not the end of it. If there is no immediate safety concern, stay in contact, ask what they are afraid of, and try again later. Sometimes a smaller step feels easier, such as seeing a primary care provider first.

With psychosis, a person may have difficulty recognizing what is real, so they may honestly not believe that anything is wrong. Arguing about a belief is unlikely to help. You can talk instead about what they do feel, such as being unable to sleep or feeling afraid, and offer help with that.

You may also need support for yourself. Stress is easier to handle when you regularly talk with people who understand, and peer-led support groups exist for family members. You can contact the 988 Lifeline for help if a friend is struggling, even if they will not call themselves.

What are the warning signs of psychosis?

A person's behavior will often change before psychosis develops. Possible warning signs include the ones below. If you notice these and they begin to intensify or do not go away, help the person reach a health care provider promptly. Early treatment often means better recovery, and studies show it is common for people to have symptoms for more than a year before they receive treatment.

If someone has clearly lost touch with reality, for example hearing voices telling them to do something, or if they seem frightened, confused or at risk, do not wait for a routine appointment. Treat it as urgent and use the crisis contacts in the next section.

• Suspiciousness, paranoid ideas or uneasiness with others
• Trouble thinking clearly or logically, or confused speech
• Withdrawing socially and spending much more time alone
• Unusual or overly intense ideas, strange feelings, or a lack of feelings
• Decline in self-care or personal hygiene
• Sleep disruption, or a sudden drop in grades or job performance
• Difficulty telling reality from fantasy

When does safety make it urgent?

Warning signs of suicide include talking about wanting to die, great guilt or shame, or being a burden. They also include feeling empty, hopeless or trapped, making a plan or researching ways to die, saying goodbye, giving away important items, and using drugs or alcohol more often. Get help as soon as possible, particularly if the behavior is new or has increased.

If you are worried, ask directly and matter-of-factly. Listen without debating whether their feelings are right or wrong, and do not offer glib reassurance. Do not promise to keep it a secret. Remove means such as weapons or pills if you safely can, and stay close.

If someone is in crisis, call or text 988, or call 911 if there is immediate danger, even if the person objects. DanShalom Behavioral Clinic is not an emergency service, and our website, email and text line are not monitored for emergencies. Our crisis resources page lists more places to turn.

How can DanShalom Behavioral Clinic help?

We are an outpatient practice with an office in Sugar Land, and we offer secure video for people physically in Texas, Idaho, Arizona or Maryland at the time of the visit. Conditions we list include psychosis and depression. Ask us whether we are a good fit for what is happening. We can help arrange a higher level of care when it is needed, and with permission we can coordinate with other providers.

Our insurance and fees page lists plans by state. Once the person agrees, what happens after a request explains each step, so you can tell them what to expect.