How to start a conversation about mental health

When Jordan Snook started this site in 2020, his advice was simple: “the best thing to do is have a normal conversation with someone.” Not a lecture, not a program. Just a real, face-to-face talk. He believed that every honest conversation makes mental health a little less frightening to talk about, and that the people we take time with are “more likely to open up to you about more serious issues.” This guide turns that advice into practical steps.

If you or someone you’re talking with is in danger right now, stop here and go to Get help now, or call or text 988.

Why does talking about mental health matter?

Mental health problems are common. In 2022, about 23% of U.S. adults, roughly 59 million people, had a mental illness, and only about half of them got treatment in the past year, according to the National Institute of Mental Health. Many people stay quiet because everyone around them stays quiet. Jordan put it this way: people avoid the subject “because others avoid it as well.”

SAMHSA says friends and family “can make all the difference in a person’s recovery.” A conversation won’t fix everything, and it isn’t meant to. It tells someone they are not alone and that it’s safe to say what is really going on. That is how stigma loses its grip, one ordinary conversation at a time.

How do I start a conversation about mental health?

You don’t need training or perfect words. A few things make it easier:

• Pick the right moment. Somewhere private and fairly quiet: a walk, a drive, a kitchen table, a coffee. The Jed Foundation suggests avoiding loud, crowded places and not bringing other people along, so your friend doesn’t feel ganged up on.
• Go face to face if you can. Jordan noticed how much our phones pull us away from the people in front of us. In person is best, then a phone or video call. A text makes it easy to reply “I’m fine” and move on.
• Put your phone away. Make eye contact, or sit side by side if that feels less intense. Show them you have time.
• Start with what you’ve noticed and that you care. Be specific and gentle, and make it clear it’s your impression, not a verdict.

What can I say? Example phrases

These come from, or are adapted from, the Jed Foundation and SAMHSA:

• “You don’t seem like yourself lately. How are you really doing?”
• “Hey, I miss you. Can we hang out this week?”
• “It concerned me when you said you can’t sleep. Do you want to talk about it?”
• “I’ve been worried about you. Can we talk about what you’re going through? If not, who would you feel comfortable talking to?”
• “I care about you and I want to listen. What do you want me to know about how you’re feeling?”
• “Who or what has helped you with something like this before?”
• “It seems like you’re going through a hard time. How can I help you find some support?”

If you’re the one who is struggling, you can use the same honesty: “I’ve been having a rough time and I’d like to talk. Do you have a few minutes?” It helps to say what you need, whether that is “just listen” or “help me figure out who to see.”

What should I avoid saying?

Most hurtful comments come from good intentions and nerves. Try to avoid:

• Minimizing: “Everyone gets stressed.” “It’s not that bad.” “Others have it worse.”
• Quick fixes: “Just think positive.” “Go for a run, you’ll feel better.”
• Spiritual shortcuts: “You just need to pray more.” Prayer matters deeply, but suggesting that struggling means weak faith adds shame. Faith and professional care work together.
• Other people’s opinions: “Everyone has noticed something’s off with you.” It can feel like an ambush.
• Diagnosing: “I think you’re bipolar.” You can describe what you see without labeling it.
• Making it about you: A short “I’ve been there too” can help, but bring the focus back to them.

How do I listen well?

Listening is most of the work. Scripture says it plainly:

“So, then, my beloved brothers, let every man be swift to hear, slow to speak, and slow to anger.” — James 1:19 (WEB)

• Listen for the feelings, not only the facts. “That sounds exhausting” often helps more than advice.
• Don’t interrupt or argue. You don’t need to agree with every thought to accept that the feeling is real.
• Be comfortable with silence. Pauses give people room to find words.
• Ask, don’t assume. “What would help right now?” is better than guessing.
• Don’t promise to keep secrets that involve danger. If someone’s safety is at risk, getting help comes first.

What if they mention suicide or hurting themselves?

Take it seriously and stay calm. Ask directly: “Are you thinking about suicide?” NIMH says that asking does not increase suicidal thoughts or behavior. If the answer is yes, stay with them and help them call or text 988, or call 911 if they are in immediate danger. Our guide to the warning signs of suicide walks through what to do, and Get help now lists every crisis line.

How do I follow up after the first conversation?

The first talk is a beginning. Afterwards:

• Check in again in a day or two, with a text, a call or a visit. Keep your word if you promised to.
• Keep inviting them to normal things. SAMHSA encourages including people in your plans “without being overbearing.”
• Offer practical help finding a counselor, making a doctor’s appointment, or going with them.
• Remind them help works. Mental health problems can be treated, and many people get better.

If they weren’t ready to talk, that’s okay. You’ve shown the door is open. See how to help a friend who is struggling for what to do next.

Where can I learn more?

• Understanding depression and understanding anxiety
• Talking to your parents about mental health, for teens
• Mental health stigma in the church
• After a suicide loss
• Our frequently asked questions