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Tips for Families and Other Supporters


How to Communicate with Someone who has a Mental Illness

Supporting someone close to you who has been diagnosed with a serious mental illness is frequently challenging.  Here you can find suggestions for strategies and techniques to help you communicate with someone who has a mental illness.

Be calm. Be non-judgmental. Learn when to walk away.
De-escalation is the goal, but safety is first.

1.  Learn to accept your family member as he/she is NOW. To the greatest extent possible, treat him/her the way you would treat anyone else. Encourage others to do the same. No one likes being treated as if they’re “weird.” Be as matter of fact as you can, and be real.

2.  Demand to be treated with respect. If your family member is rude or abusive, simply say “I don’t ever speak to/treat you like that. It’s not okay for you to talk to/treat me that way.” Maintain as neutral a tone of voice as possible – you are just giving information.

3.  Keep the environment as free from sensory overload as possible. Don’t have the TV, radio, dishwasher, and vacuum all going at the same time. And don’t go to Times Square on New Year’s Eve.

4.  List only one step at a time when giving directions. Wait until that task has been completed to give the second instruction. Keep things as simple as possible. A corollary to this is that our brains process positive instructions more easily than negative ones. It’s better to tell someone what TO do, than what NOT to do. (“Please put the milk back in the fridge” instead of “Don’t leave the milk on the counter.”)

5.  In general, choices are easier than decisions. Fore example, “Would you rather have lasagna or pot roast for dinner?” is less stressful than “What do you want to eat?”

6.  It’s always okay to ask how your person is doing but you must be ready to hear the answer. If your family member suffers from severe depression and you ask if he/she is okay, know how you’ll respond if the answer is “I want to die.” If you telegraph the answer you want to hear, that’s what you’ll get and real communication will shut down. “You’re not hearing voices, are you?” has only one possible answer.

7.  Delusions or auditory and visual hallucinations are reality for the person having them. You can’t “reason” someone out of it. When your loved one tells you things that are clearly delusional, make non-committal responses: “That’s interesting.” “I didn’t know that.” “Huh.”

8.  When dealing with mental illness on  a daily basis, accept that things just are. The more emotionally detached you can be when interacting, the smoother things will go. The simple fact is that we can’t make anyone else do anything. State that there is always a choice, and there is also a consequence for that choice. No investment – you are just giving information.

9.  Use humor. It’ll help both of you.

10. Taking care of yourself is not being selfish. There’s a reason they tell airplane passengers to put their own oxygen masks on before helping those travelling with them. You can’t help anyone if you’re gasping for air.


**Taylor, Kate & Taylor, Creighton (2011). Excerpts from Constructive Techniques for Dealing with the Mentally Ill. Presentation conducted through NAMI Voices of Recovery Speaker’s Bureau.

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- Edward S. Ame


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