In the time of COVID-19, many people are experiencing severe psychological distress. Life during a pandemic can create mental health struggles for anyone, but can be particularly harmful for those with pre-existing mental health conditions. If you are worried about a friend, the strategies below can help.
1. Listen and Affirm
It is natural to want to find solutions to a friend’s pain immediately. However, one of the most important things you can give someone is a listening ear.
Ask open-ended questions about how they are feeling, what has made them feel that way and how long they have been experiencing difficult emotions. Try to get comfortable with pauses; it can be hard for people in distress to answer questions quickly. Remind them how much they mean to you, and affirm the good things they do. Don’t compare their pain to your pain or to other people’s problems — this conversation is about your friend, not anyone else.
In urgent situations, when your friend has discussed thoughts of suicide or self-harm, listening can be hard to do. However, listening is just as essential, if not more important, when someone is in crisis. You can’t de-escalate a crisis that you do not understand.
2. Help Them Brainstorm Coping Strategies
If your friend is not looking for coping strategies, and simply wants to talk about their feelings, respect that preference. If they are open to suggestions, keep in mind that coping strategies look different for everyone, and they know their own needs best.
Some people find comfort in meditation, while fast-paced activities like running clear other people’s heads. If your friend is struggling to come up with a list of coping strategies, here is a list with some options that could help you start a discussion.
No matter what your friend’s interests, the brain ultimately exists inside a body, and taking care of your physical health is generally a good approach to improving mental wellness. The CDC recommends deep breaths, balanced meals, regular exercise and avoiding excessive alcohol and drug use.
3. Identify Resources That Your Friend Feels Comfortable With
As well-intentioned as you are, you are most likely not a psychologist, social worker or therapist. One of the most important things you can do for someone is help them find resources that work for them so that they can get professional help. For those looking for resources for eating disorders, abuse, anxiety and depression, these links can be good starting points.
Counseling is often a good general resource that can help individuals find further resources. The open counseling database can help you find low-cost options, while the Woebot can offer free chatbot-based therapy that can be useful if your friend cannot pay for therapy at all. While in-person access to counseling during COVID-19 can feel risky, many providers are offering phone and video-based therapy.
Your friend may fear calling 911. The psychological health care industry is currently grappling with how to extricate itself from an emergency system that sends the police to those in psychological need, putting people of color disproportionately at risk for mistreatment. While some cities, including Eugene, Oregon, are experimenting with alternatives to sending police to people in need of a wellness check, this is not true everywhere.
While there are no perfect solutions to assist someone who is at risk of harming themselves, some crisis hotlines are less likely than others to refer someone to 911. The Trans Lifeline will never call 911 without a caller’s consent. The Black Emotional and Mental Health Project has a directory of mobile crisis teams across the U.S., which can offer an alternative to calling the police, although some teams are required by local law to notify law enforcement.
While the Crisis Text Line (which I volunteer for) does sometimes call 911 in extreme cases, they do offer the benefit of counseling via text, making assistance available to those who cannot make a private phone call. You can access the National Lifeline by calling 988, and the counselor on the line will do their best to make a safety plan with the caller. However, like the Crisis Text Line, the National Lifeline will sometimes call 911 if a caller is unable to work toward a safety plan.
Sometimes, those in psychological distress have their stress stemming from financial issues, housing insecurity or unsafe relationships. While psychological assistance resources are still valuable, these people need more than counseling services — they need material support. The counselors on the 211 line can help your friend find local social services resources.
4. Make A Short Term Plan
Plans should be driven by your friend’s needs and specific circumstances. For someone struggling with isolation, a plan could be coming up with a list of friends and family to call regularly. Registering for counseling and finding a support group is often a good general purpose plan that can help your friend process their difficult emotions.
Planning grows more complicated, but more essential, in cases of potential immediate physical danger. This worksheet from the National Suicide Helpline can help guide your safety planning process. An essential recommendation on this worksheet is making the environment safe, which generally means removing the intended method of suicide from someone’s environment.
If reducing access to the intended method of suicide is not possible, a promise to call a crisis line if they feel suicidal could be a helpful plan. Someone experiencing serious suicidal thoughts should seek counseling as soon as possible, but an immediate safety plan that keeps them secure is an essential first step.
Seek Support For Yourself
Providing emotional support can be difficult and draining. Just as you have assisted your friend in finding coping mechanisms and identifying resources, consider finding your own coping mechanisms and resources. Your well-being is essential, both because you matter and because you will be unable to provide help if you burn out. I wish you luck as you take care of not only others, but also yourself.