R U Not OK?
It’s time to dig deeper than ‘Are you ok?’
Mental health is a phrase that you’d have to try pretty hard to avoid these days.
Thanks to the work of many health experts, charities, celebrity ambassadors, moustached men, fluoro Fridays, awareness weeks and other initiatives, it has become ubiquitous. At the time of writing, it has 9 million posts on Instagram, nearly 1,000 tweets in the past hour and the statistics show that almost half of Australia’s population will experience a mental health disorder at some point in their lifetime.
But if we dig a little deeper, how much do any of us really talk about it? And why is there still such stigma attached to it?
As someone who has experienced anxiety and depression and who has lost a friend to suicide, I believe one of the reasons for this is that we (those with the illness and our loved ones) still don’t know how to talk about it meaningfully. We can start the conversation off, but what happens when you get the ‘stuff and things’?
Even though there are many well-meaning resources out there, the most recent Australian research has shown that almost two thirds of people with mental health disorders have not used services for their mental health problems in the 12 months before the survey. My sense is that the vast majority of people with mental health issues would rather confide in someone they already know and trust, like a friend, colleague or family member before resorting to a stranger or website. Unfortunately, a lot of the people closest to us are just not equipped with the conversation (or listening) skills to provide reassurance.
A brief online survey of national mental health organisations like Lifeline, Beyond Blue and R U OK Day yields a plethora of toolkits, coping kits, forms and quizzes, with top line suggestions for friends and family members. These are all well and good, however I wonder how many people are downloading toolkits in times of crisis.
I spoke to clinical psychologist Dr Elon Gersh, who runs training for Orygen, the National Centre of Excellence in Youth Mental Health, to get some tips for talking when the going gets tough:
When you can’t find the words
Once the ‘Are you ok?’ bit has been asked, the important thing to remember is that the purpose of the conversation isn’t to solve the problem, it’s to share feelings.
“It's really fine not to know what to say. It’s important to remember that it's not your job to fix the situation for the person you're speaking with. Rather, try and focus on just listening to them and trying to understand what it's like to be them” says Gersh.
When someone is anxious or distressed
Oh boy have I been here. Anxiety, worry, or nervousness is a normal feeling that can be managed, but it can be paralysing if it becomes more frequent and left unchecked.
Gersh says the best course of action for anxiety is not to rush:
“Anxiety makes us want to hurry up, when slowing down is usually the best course of action. Provide some reassurance to the person and ask them what works for them. Some people might be fine to "talk through it" and others might need to change the topic for a while”.
When one of you bursts into tears
Tears are totally ok, and can feel great. Personally, if I start crying (I last cried watching Birdbox, FYI), I just want a shoulder to do it on, and maybe a tissue if my mascara starts to look tragic.
Gersh is also in the ‘better out than in’ camp:
“Unfortunately, there is a lot of stigma around crying for some people, especially Aussie men. Crying is a normal human experience and it can be quite cathartic. When someone you are with is crying, give them time to let it out. Avoid judgement, and trying to convince them not to be upset”.
When suicide comes up
Unfortunately, Australians – like most of the Western world - aren’t very good at talking about death. But with suicide the leading cause of death in Australians aged 15-44, we need to get over this.
“Some people worry that asking about suicide might ‘give someone the idea’ or ‘lead them to act on it.’ The research shows the opposite - asking the question is more likely to help someone than harm them. So first, don't be afraid to ask if you have reason to think it might be on their mind. If there are thoughts of suicide, encourage the person to seek professional help”.
For those who aren’t ready to speak to a psychologist or psychiatrist – whether due to time, money or other constraints – your GP can be a great sounding board to start with, as is Lifeline.
If the other person shuts you down or storms off
When anger is the main emotion going on, it’s also important to let it out, and to take the hint if someone doesn’t want to talk:
“There's really no benefit in forcing someone to talk. Tell them you understand they don't want to chat at the moment, and you're around if they change their mind in the future”.
If you're talking to a young person (or are one)
The research has shown that young people aged 16-34 are least likely to use services for their mental health problems, so it’s critical to not only check in with them, but have ‘real’ conversations:
“Young people tend to have a high sensitivity for bullshit - talk directly, honestly, respectfully and authentically. Listen carefully and attentively. It can also be helpful to normalise experiences, either by sharing your own experiences or those of people you've known”, says Gersh.
Although I am not a professional, I do believe we all need to practise talking more about feelings – the bad and the good. No one says the right thing the first time, but saying something is better than saying nothing and may just turn someone’s day – or life - around.
For further information on Dr Elon Gersh, visit Prahrah Psychology Group www.prahranpsychologygroup.com/
Contact Lifeline on 13 11 14 www.lifeline.org.au
 Mental Health Council of Australia, Fact Sheet: Statistics on Mental Health, www.mhaustralia.org
 Australian Bureau of Statistics, 2009-10, Feature article: Mental Health, abs.gov.au
 Australian Bureau of Statistics, 2007 National Survey of Mental Health and Wellbeing: Summary of Results, (4326.0).