How to Start “The Conversation”

Telling a loved one that you’re worried about their mental health may seem like a tricky conversation. But it’s very important and can be as easy as checking in with that person to let them know you care about them and that they are not alone. That conversation could even save someone’s life. We asked several Integral Care therapists to weigh in with tips on starting the conversation.


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Check in with yourself before starting a conversation with a loved one to make sure you are in a healthy place to be present, vulnerable, and engaged. This is key to a creating a safe space for both you and that important person in your life. When you’re ready, choose a time and place that’s comfortable and confidential. That might be a morning walk in the park or a cup of tea on your front porch. Start with an open-ended question or share an observation about a change in their behavior to help start the conversation.


  • “With everything going on lately, you’ve been on my mind. I just wanted to check in to see how you are doing.”
  • “I just wanted to check in and am wondering how you are.”
  • “Work has been pretty hectic for me recently. How have things been for you?”

In these moments, we may be focused on what the “right” or “best” response is but one of the most supportive things we can do for someone we care about is to create a safe space to:

  • Help them pause and reflect
  • Let them know you care
  • Listen and affirm what they have to share

Remember, the goal of this conversation is not to “fix” your loved one. Instead of advice, you can say: “Thank you for sharing this with me. What can I do to support you?”

It is also important to be mindful that certain cultural stigmas may keep someone from talking about their mental health. If this might be the case for your friend, take steps to learn about these issues.  One of the most powerful ways to overcome stigma and shame is to talk about it.


Loved ones might be scared to ask for help or not ready to open up. If that happens, let them know that you’d like to check in with them later. If you’re worried about their safety, share your concern with them and offer to connect them to professional help.

While there is no one size fits all answer, one of the first steps you can take is to meet that loved one where they are. We must approach with compassion and sensitivity, while being open to the fact that they may not be ready to have the discussion. Opening up about our own mental health can be difficult, so approaching a loved one about theirs can be even more challenging.


You could begin the conversation with expressing your care for that person and then bring up some of your observations related to their mood, behaviors, and feelings. It’s important that we remember it’s not our job to diagnose them or to give them a lecture about what they should or shouldn’t be doing. Instead, have an open dialogue with them where you talk about what you’ve noticed.

You might notice signs like isolation or social withdrawal, intense mood swings, difficulty concentrating, increased alcohol consumption, loss of interest in activities they once enjoyed, irritability, sleep problems or changes in weight or appetite. This is not a complete list. Sometimes, you’ll noticed a combination of things that happen at the same time.


Here’s just one example of a conversation starter: “Hey man, just wanted to reach out and say I appreciate you and I love you! I’ve noticed you seemed a bit down lately and you’re staying in your room most of the day. Has something been bothering you lately that you feel comfortable talking about? If not, that’s okay. Just know that I’m here if you ever want to talk.”


If you’re worried about your friend’s immediate safety, call your local mental health crisis helpline or 911. Stay with them until help arrives.

One of the difficult problems people sometimes face is how to talk to a loved one about mental health concerns. Unfortunately, concerns about a loved one’s mental health are often voiced (or shouted) when mental health issues are flaring and emotions are high on all sides.


Instead, try to pick a time when things feel calmer and not in the middle of an intense event or flare-up. Also, choose a place where the person feels safe. A good opener might simply be to say that you are concerned that the person seems to be having a hard time and that you want to know if you can help in some way. If you’re worried about their safety, ask if the person has thought about hurting themself or others.


Here are some tips for the conversation.

  • Avoid taking a confrontational or critical tone, which can often lead to someone being defensive and shutting down.
  • Ask how the person is feeling, what they need, and what you can do to help them.
  • Ask what the friend or family member thinks the problem is.
  • If the person is having experiences that seem hard to understand or unusual, don’t debate them.
  • Ask how these experiences are making them feel.
  • Show your concern, look them in the eye, and tell them you support them.

Sometimes, offering to set up an appointment with a mental health organization, or even the family doctor, is best.  A third party who is informed can talk about the issues in depth with the person, while providing a feeling of privacy and respect. If they’re not ready to talk, let them know that you’ll be there for them when they’re ready. Or offer to help find someone they can talk with when they are ready.


Families and friends who have a loved one with serious mental health symptoms often struggle with the problems by themselves for quite some time, which leads to impatience and fatigue. Offering to find help for the person in a loving, respectful, and nonjudgmental way can start a journey toward recovery for everyone. It’s also important for you to get support from others so that you don’t feel that you are doing this all on your own. Finally, learn about mental health issues, so that you feel more informed and less overwhelmed.

One of the most important elements of the conversation are good listening skills. Check out these helpful hints to improve your listening skills from Aaron Evans, LPC, Mental Health First Aid Program Manager.

For free 24/7 emotional support, call Integral Care at 512-472-4357.
Visit NAMI Central Texas to check out support groups for adults, family members, and more.