In the last article, we looked at what difficulties you may encounter when talking to the person. We looked at exercising patients, being accepting of responses, being as supportive as possible, and not interrupting, criticising, expressing frustration or being hostile or sarcastic.
This article will look at encouraging the person to seek professional help, some self-help strategies, if the person doesn’t want help and if there is risk of harm top the person or others.
SHOULD I ENCOURAGE THE PERSON TO SEEK PROFESSIONAL HELP?
It is important that you be able to recognise when to encourage the person to seek professional help. Professional help is warranted when depression lasts for weeks and affects a person’s functioning in daily life. Do not assume the person’s depression will just go away, because treating depression early is important to getting the best outcomes. It is also important that you do not lie or make excuses for the person’s behaviour, as this may delay getting assistance. Seek immediate professional help if the person is experiencing hallucinations or delusions.
You should have some general knowledge about the types of treatment that can be helpful for depression. You should also know about what services are available in the person’s local area and the local pathways to professional help, e.g. referral from a GP in order to see a specialist. These may vary depending on the person’s cultural background or religious beliefs.
Discuss the benefits of seeking professional help and ask the person whether they think it would benefit them. Talk about professional help seeking in a way that normalises it, e.g. talk about it as a natural action to take, explain that mental health problems are common and treatable. Avoid labelling the person’s behaviours or feelings as symptoms of depression when talking to them about seeking help. If they feel they do need help, discuss the locally available options and encourage them to use these. If the person needs it, offer to help them seek assistance.
If the person decides to seek professional help, encourage the person to make a list of questions to discuss with the health professional at their first appointment. If the person would like you to support them by accompanying them to a doctor’s appointment, you must not take over completely because a person with depression needs to make their own decisions as much as possible.
Depression is often not recognised by health professionals and it may take some time to get a diagnosis and find a healthcare provider with whom the person is able to establish a good relationship. Encourage the person not to give up seeking appropriate professional help.
WHAT ABOUT SELF-HELP STRATEGIES?
People who are depressed frequently use self-help strategies. Some of these are supported by scientific evidence as effective, such as regular physical activity. The person’s ability and desire to use self-help strategies will depend on their interests and the severity of their depression. Therefore, you should not be too forceful when encouraging the person to use self-help strategies.
Before suggesting self-help strategies, ask the person what they are currently doing or what they have done in the past that they found helpful. If they have successfully used self-help strategies in the past, encourage them to use these.
SELF-CARE?
If the person’s behaviour is having a negative effect on you, recognise your own feelings and deal with these separately. It can be helpful to find someone to talk to about what has happened. If you do talk to someone, don’t share the name of the person you helped, or any personal details that might make them identifiable to the person you choose to share with.
It can also be good to do things that improve your own mood or mental health after helping the person. Activities that are known to be helpful for improving mood and reducing anxiety include eating well, keeping regular sleep habits, practicing relaxation techniques (e.g. progressive muscle relaxation), being physically active, talking to supportive people, letting other people know how you are feeling, scheduling enjoyable activities (particularly those that give a sense of achievement), and doing other things you know have been helpful in the past.
If the person is interested in self-help strategies, discuss with them a range of strategies that might be helpful and encourage them to use the ones that are most appropriate. You can also encourage them to consult reputable sources about what is most likely to be helpful, e.g. a health department sponsored website.
WHAT IF THE PERSON DOESN’T WANT HELP?
It is important that you understand the barriers to seeking treatment for depression. If the person does not want to seek professional help, find out if there are specific reasons why this is the case. For example, the person may feel like no one can really help, or they might be concerned about finances, not having a doctor they like or that they might be sent to hospital. These reasons may be based on mistaken beliefs, or you may be able to help the person overcome their worry about seeking help. If the person still doesn’t want help after you have explored their reasons with them, let them know that if they change their mind in the future about seeking help they can contact you.
You must respect the person’s right not to seek help at all times, unless you believe they are at risk of harming themselves or others. Do not push the person into seeking professional help before they are ready. Never use deception, coercion or threats to ensure professional help is received. If you try to force or pressure the person into seeking help it could turn them off seeking help altogether.
WHAT IF THERE IS RISK OF HARM TO THE PERSON OR OTHERS?
If the person is at risk of harming themselves or others, you should consider the safety of all involved, and take any necessary protective action, e.g. call an ambulance, emergency services, or mental health crisis team. Ask the person to take steps to get help (e.g. see a GP) and involve them in decisions about who else should be told about the risk of harm.
