'R U OK' Day: Ways to help when someone shares they're struggling

'R U OK' day is near, and in this third year of the pandemic, it's likely we'll know someone who is not okay.

Even if it's daunting, it is important to ask those close to us how they are and learn how to broaden the conversation when it matters.

Ask open-ended questions

Knowing how to ask people about their mental health is crucial. 'R U OK' is an excellent way to get us thinking and talking about mental health. However, it is not my preferred question when asking someone how they are.

Closed questions which can be answered with a simple yes/no, or questions which lead someone to a certain response are not great conversation openers.

Instead, I prefer to ask an open-ended question such as "how have you been feeling lately?"

Pay attention to how they're going

It's helpful to understand the signs which might suggest someone isn't travelling very well.

These signs may be difficult to notice, but the most common observable change is in how someone engages with the world such as withdrawal from social events or absenteeism at work. Other common signs of distress are a change in mood or energy levels, tearfulness, fatigue, distraction, or poor concentration.

Remember that some people are good at masking distress, so also check in with your happy friends, your extroverted colleagues, and those who seem to have it together.

Check in often

It's essential to make a habit of checking in with people regularly.

By asking people how they are openly, curiously and regularly, you can normalise conversations about mental health and wellbeing and make it easier for people to tell you when they have been struggling.

It is unlikely that someone will honestly respond to a question from someone they don't know very well or if they sense the question is tokenistic. So, before you ask, it's helpful to think about whether there's enough closeness and trust to support a conversation like this.

How to ask the more difficult questions

Sometimes, you might notice that someone has been struggling and might want to ask them a more direct question about their wellbeing and mental health. This will depend on the context and type of relationship.

For close friends or personal relationships, asking sensitively and directly can be helpful.

I usually recommend saying something like, "I've noticed that you have looked really tired lately and I saw you crying yesterday. I want to check in and see how you are going and how I can support you?"

In other contexts, such as with work colleagues or someone you don't know too well, this may be too intrusive. You can still signal care to them by saying something like, "You're looking tired/sad/distracted — I'm here to talk if you need".

Or you might feel more comfortable mentioning what you have noticed to someone closer to them who can check in properly.

What to do once you've asked

Knowing what to do once someone has disclosed that they are not coping is essential.

You could start by saying something like "thank you for your honesty in sharing that".

Depending on what they have shared, there might be a number of ways you can support them.

There will be some instances where professional help is essential. For example, when there is serious mental health distress such as suicidal thoughts, self-harm, depression, psychosis, or severe anxiety. In these instances, supporting someone to book an appointment with their GP or psychologist, or to contact a crisis helpline is vital.

At other times people may feel bad but may not be in serious distress. You might be able to have open conversations about what might be helpful, such as a regular text check-in or making a plan to catch up IRL soon. It's important to avoid cliches such as "chin up, it'll be fine".

There might be other avenues of support you can help them access, such as confidential counselling offered by workplaces for free through employee assistance programs (EAPs).

Finally, educating yourself about mental health is essential, which can include things like a mental health first aid course.

Dr Ahona Guha, DPsych, is a clinical and forensic psychologist in Melbourne, Australia. She writes about a range of psychology topics at Psychology Today. You can find her on Twitter and Instagram.