RU OK? What to say if they’re not ok

Are you prepared to ask someone “Are you okay?” and for them to respond with “no, not really.”

Lots of caring people want to do right by their friends, family, colleagues, neighbours, the barista at the local cafe but have no idea what to do if suddenly finding themselves in this situation.

Do you immediately try and ask a million questions about what’s wrong, why do they feel that way and how can you fix it for them?

Before you know it, you have turned into their interrogator. 

Or do you have more of a tendency to say a few comforting words, such as “it will get better”, “what are you so worried about”, or “it’s not that bad, life will turn around in no time” or “chin up.”

All of a sudden, you have potentially invalidated how they feel.

Leaning into these difficult and often very personal conversations can be challenging, but also provide an opportunity for personal growth, deepening of relationships, and heartfelt connection.

But how do you do it with compassion, care, empathy, and sensitivity, and how do you not take on the responsibility of fixing their problems or taking on the burden as your own?

First and foremost, recognise your own capacity to be with the person in the moment.

You may have asked quite innocently how someone is going and you get an unexpected reply.

What if you can’t talk right now, but want to?

Here is the possibility that you’re short on time, have a lot of pressures you are currently juggling, not be in an appropriate space or not in the correct frame of mind to truly engage in this conversation.

Having some go-to sentences or statements can be helpful for these situations.

I’m sorry to hear that you are struggling.  If you would like to, I can make myself available (at x time) to talk about this further.

Or

I had no idea this was happening for you but I’m glad you reached out.  As you are important to me, I’d like to give you my full attention and take the time to listen.  Can we make a date/time to have a cup of tea/lunch/chat?

What if you’re not the right person for them to speak to – not now, not ever

If you don’t feel comfortable and or you’re not the right person for them to talk to, it is helpful to think about how you can be supportive and guide the person to someone who is in a better position to help.

The following statements may be of interest to you.

I’m sorry you’re feeling this way, that sounds really hard.  Who do you have in your life that can best support you with this?

Or

That sounds tough, I’m glad you feel comfortable enough to share this with me.  I’m sorry I’m not in the position to be able to support you directly with this right now but want to ensure you have the care you need.  Can I help put you in touch with someone who can?  (then have support numbers on hand, or encourage them to speak to family/friend/health professional – see below).

What if you can and are willing to chat about this more deeply

“I’m sorry you’re having a hard time.  I’m here to listen if you would like to go into it further?”

Or 

“Wow, that sounds rough.  Would you like to tell me more about it?”

These statements are a safe and empathetic way to open the conversation up a little more.

Often people just need someone to sit with us and be there in the moment when we are having a hard day, week, or situation that we are working our way through.

It’s not always about problem-solving, finding someone or something to blame, or referring them onto a health professional.

Sometimes listening and being open to just being supportive can be enough.

You don’t necessarily have to agree or disagree with them about their stress, thoughts, or feelings either, just acknowledging how they feel and listening to their struggle/concern can be reassuring and helpful.

It’s important to recognise, the person you’re talking with may or may not have the same moral compass, religious belief, cultural approach, or political affiliation as you.

This is okay and just allowing them to be who they are, or finding their own path can be appropriate and helpful.

Just opening up and chatting about their fears, emotions or stressors is enough to feel better about it.

As they say, a problem shared is a problem halved.

Asking open-ended questions, rather than questions that are either a yes / no answer can help keep the flow of conversation going and help provide clarity or opportunity to express their concerns.

It can be appropriate to ask if they would like any specific help.

What you may automatically think of as helpful, may not be received as help, but rather a distraction or a burden.

Statements such as “is there anything you can think of that I can help you with?” or “what would you find helpful at the moment?”  may be useful.

Is this person’s (or someone else’s) safety at risk?

What if the person you’re chatting with discloses they are having thoughts of harming themselves or others?

This can be a very confronting situation.

Some common fears are, if I ask or say something about suicide, are they more likely to do it?

The answer is a definite no.

You asking if they are thinking about suicide, ending their life, or dying does not increase the risk of them going ahead with it.

In fact, talking about it and them having the opportunity to get help is more likely to reduce their risk.

So if you think someone is at risk of hurting themselves, this could be for a huge number or reasons (such as destructive, or out-of-character behaviour, making jokes / flippant comments about suicide, experiencing significant distress) don’t be afraid to ask.

How to ask if someone is at risk of suicide

Often being direct when asking this type of question is best.

Ways to ask could include:

“I know you have been having a hard time recently, have you had any thoughts about hurting yourself or suicide?”

“Have you been thinking about death and dying recently, particularly suicide?”

“Do you think you are at risk of suiciding?”

What else do you need to know if they are at risk of suicide?

Key questions to ask and increase the risk include:

Do you have a plan on how you would do it?

Have you taken any action to put this into place? (have they acquired medication, a weapon or made a will or provisions for their family)

Do you have a time frame in mind?

The other determining factor is are they intending to go thru with it.

The more specific, detailed, and planned they are, the higher the risk.

If someone is in immediate danger, call 000 and ask for ambulance.

People who have high risk should not be left alone until further assistance is available.

Ensuring someone is safe

If someone is making plans, but they are not in immediate danger, they may require further professional support services.

You do not need to handle this on your own.

If someone wants you to keep it a secret, it’s best, to be honest and say that you care for them deeply enough to ensure more support is in place for them.

It may be appropriate to assist them in making an appointment with their GP or mental health professional such as a psychologist or psychiatrist if they have one.

Alternatively, if someone is reporting risk of harming themselves or having significant mental health distress and may require a hospital, you can seek the assistance of the CATT (Crisis Assessment and Treatment Team).

The outer eastern service is managed by Eastern Health and can be contacted on 1300 721 927.

Additional family and friend support can also be helpful, especially if the person is not able to get any immediate professional care.

A list of contact numbers, including support 24-hour hotlines can also be useful, in case they escalate, feel isolated, or want to chat when others are unavailable.

Service providers include:

Suicide Call Back Service: 1300659467

Beyond Blue: 1300224636

Lifeline: 131114

Kids Help Line: 1800551800

Resources for Carers:

Carers Australia: 1800422737

Mind Australia: 1300554660

If you are interested in more specific information or training on Mental Health First Aid, you can find out more information here.

People who are struggling with their emotional wellbeing can have differing needs at different times and what may be right at one time can change, or be different from person to person.

Keeping yourself safe and supported while caring for others is also incredibly important and it is worthwhile recognising your limitations and seeking your own support as needed.

People who don’t have a mental health condition can still benefit from mental health support.

A psychologist or mental health expert can help people develop tools and strategies to deal with and manage stress over time.

In fact, many health care professionals, who spend their careers taking care of others regularly engage in something called “clinical supervision”. 

This is to ensure the health and wellbeing of the carer and to decompress and discuss difficult cases or situations with another health worker.

Ensuring your mental wellbeing, or seeking out support services does not make you weak, lesser than, or sick. 

In fact, it is often the preventative care that keeps us safe and well for the longer term.

We would love to hear your thoughts on RUOK day, what to do if they’re not okay, and any feedback about any services you have engaged with.