Prince Harry has a knack for dropping eloquent mental health truths, and his interview this week on Dax Shepard’s Armchair Expert podcast is no exception.
In the episode, the two discussed their fear of sharing past traumas or mental health difficulties with others. Shepard said that he worried his peers would call him “attention-seeking” or tell him to “stop being a baby.”
Harry replied that the phrase “you need help,” which is often employed as a joke or insult, is another damaging reaction. That’s because it implies “I don’t know how to deal with this, you’re unhinged or you’re not particularly well – go and seek help,” he explained.
“Rule No. 1 is that when you actually want or feel as though someone needs help, telling them to their face ‘you need help’ is probably the best way for them to go ‘uh no – no I don’t,’” Harry said.
“Any single one of us – wherever we are, wherever we come from – will always try to find some way to be able to mask the actual feeling,” he continued. “That was a huge part of the beginning of my life. I rejected it, I said there was nothing wrong with me. I’m fine.”
He’s absolutely right. We’ve made progress as a society, but that doesn’t erase past decades of mental health stigma (which still persists in some ways). Telling someone they need mental health help has often been used in a derogatory way – particularly when someone is being what others consider “problematic.”
Saying “you need help” turns a process that would actually be beneficial into the absolute last thing anyone would want to do. It implies that you’re beyond personal care and only a therapist can “fix” you.
In reality, people living with mental health conditions need both professional and social support. Research shows that loved ones play an integral role in our mental health: One study showed people with depression who have poor social support have worse symptoms and recovery. That same study suggested that people with anxiety disorders, bipolar disorder or schizophrenia may also have similar outcomes.
Another study found that social support is a significant protective factor against postpartum depression. Other evidence states that a lack of social support is associated with an increased likelihood of developing post-traumatic stress disorder following a traumatic event.
Now, of course, there are many cases in which a person might say “you need help” more seriously. It might be a well-intentioned or compassionate observation. That’s fine! Your concern is needed! But there are ways to make that statement sound more caring and less dismissive.
Below are a few options to try the next time you find yourself in this situation.
Ask an open-ended question that acknowledges mental health issues.
“My favourite way to get into these conversations is to lead with normalising it and then get into open-ended questions,” said Jessica Gold, an assistant professor in the department of psychiatry at the Washington University School of Medicine in St. Louis. “Like, ‘This pandemic has been really hard on me mentally, what has it been like for you?’ And see where the conversation goes.”
Say, “I noticed _____ and I wanted to check in.”
Gold said this isn’t necessarily her first option, but it is one method you can try.
“I always try to lead with non-accusatory statements where possible, trying really hard to say things that don’t point out something someone may see as a ‘fault,’” she said.
You don’t want to make them feel like they look bad, but rather compassionately bring up your concerns. For example, “I noticed you’ve been a little down and haven’t been playing piano much recently, so I wanted to check in.”
You can also ask them how they want you to check in.
Do they prefer a text every so often? What kind of questions actually help them open up? Would they rather you ask about symptoms or distract them from what’s going on for a little while?
“I think it is important to ask people how they want to be checked in with,” Gold said. For example, people who are well-meaning “often say things like ‘Are you eating?’ to the people with eating disorders or ask about symptoms of depression or anxiety. People understand why you are checking on them, but it is important to try to do it on their terms.”
Ask, “Would you like me to help you find a professional to speak to?”
Think someone genuinely needs help? Offer to search for someone with them.
“Help people navigate the mental health system. The mental health system is inherently broken, but it is also not designed to be very helpful for people with actual mental health disorders,” Gold said.
“For example, you have to call a bunch of therapists and see if they have openings, and maybe follow up,” Gold continued. “Depression decreases your motivation and activation energy and anxiety makes talking to people on the phone hard. It can help tremendously for friends and family to help get you where you need to go ― look up therapists, or hospitals if that is what they need, even manage the emails and communication initially. But, you should ask if they want help with it before you just do it, of course.”
Therapy isn’t a dirty word or something to be shamed, Gold stressed. “It doesn’t mean something is ‘wrong’ with me, it means I made a choice to support myself more, to make my life more balanced.”
And if you are making jokes or snide comments about someone’s mental health, know that it says way more about you than it does about them. Be kind and open when someone is vulnerable around you. No one is asking you to be perfect ― just asking you not to be a jerk.