conversation mental health crisis

How to talk to someone when you’re worried about their mental health

December 2, 2019

With end-of-semester exams sandwiched between Thanksgiving and Christmas, December is a challenge for any student struggling with depression or anxiety.

The CU Denver counseling center reports that from October 2018 to October 2019, crisis walk-ins are up 40%. The good news is more students are reaching out for help, but counselors are seeing more students in distress. Of the 40% of students who presented in crisis the past year, 42% met the criteria of being actively suicidal. It’s a mental health crisis reflected nationwide.

Over the past 10 years, anxiety and depression has doubled among college-aged students. Our campus feels it more than most: research shows the students most at risk for suicide are ethnic minorities, women, veterans and LGBTQ students—60% of CU Denver’s student body.

That’s why it’s important you know what to say—or where to direct your friends—if someone comes to you for help.

“When students have a hard time, they’re more likely to talk to their peers than faculty or staff,” says Kristin Kushmider, PhD, assistant vice chancellor of Health, Wellness, Advocacy and Support for Student Success. “Even if your friend doesn’t bring it up, students know their friends better than faculty and staff ever will. It’s important they trust their intuition. If something feels wrong, talk to your friend.”

Of course, most people aren’t trained to have those conversations. Luckily, resources like the Jed Foundation and Mental Health First Aid have a few strategies to make that first conversation a little easier.

If your friend comes to you

  • Reassure your friend. If you think your friend is spinning out, reassure them that they’re not alone. Let them know it’s possible to feel better.
  • Don’t judge, be patient and try to really listen. You don’t need to know the answers or give advice. And if they can’t find the words, it’s okay to sit with them in silence.
  • Always empathize with what they’re feeling, not with the story they’re telling themselves.
  • Ask open-ended questions, and don’t be patronizing by saying things like, “You have a lot to live for.”
  • Ask “are you thinking about killing yourself?” If they say yes, follow up with: “Do you have a plan?” “Have you decided when you’re going to do it?” “Have you collected the things you need to carry it out?”
  • If your friend has a plan, offer to call a hotline like the National Suicide Prevention Lifeline, and stay with them. You can also offer to find other help, such as a peer-support group or a mental health provider, and to go along to the appointment. If things escalate—if, say, your friend has a weapon—you can call 911 and request a crisis intervention team, a special police unit trained to de-escalate a mental health emergency (the Denver Police Department now pairs officers with behavioral health clinicians on its Crisis Intervention Response Unit).

If you start the conversation

  • Let your friend know you’re concerned because of what you’ve observed. Start most of your sentences with “I,” such as “I’m worried about you because…” or “I noticed you’ve been skipping classes.”
  • Make sure they know you will support them and that help is there when they are ready.
  • Repeat the steps in the “If your friend comes to you” section.

If they don’t want to talk

  • Say, “It’s okay if you don’t want to talk to me, but I would feel better if you would talk to someone.” Offer resources like the CU Denver Counseling Center.
  • Get advice about the situation from someone you trust and be specific about your concerns.
  • Tell a teacher, counselor, parent, or other trusted adult about your concerns and ask them to help.
  • Again, when a person is a danger to himself or others, get help as soon as possible. It is best handled by trained professionals such as emergency services, the counseling center, campus police, or a family doctor.

Who you should call:

CU Denver Counseling Center
Tivoli 454 (4th floor)
Mon – Thurs: 10 a.m – 4 p.m.
Fri: 11 a.m. – 2 p.m.
Emergency after hours number for CU Denver students: 303-615-9911

Colorado Crisis Services
Online chat services are available from 4 p.m. to 12 a.m. daily.
You can reach a crisis counselor 24/7 at 1-844-493-TALK (8255)

National Suicide Prevention Lifeline
24/7: 1-800-273-8255
Lifeline Chat