A Caucasian mother talking with mixed-race son while both sit on a bed

Speaking up can be the first step in helping someone navigate their mental health journey

Asking if someone you love is okay can be an uncomfortable question, especially if you’re concerned the answer might be no. But noticing the signs early and starting a thoughtful conversation can make a meaningful difference in someone’s life.

Tessa Cosand, LPCC, NCC, Clinical Therapist II at Loma Linda University Behavioral Health, says that mental health concerns often don’t announce themselves loudly, but show up in subtle changes.

“Knowing what to look for and how to respond can help you step in with care and confidence,” Cosand says. 

While ‘mental health’ is a broad term, it typically encompasses a range of challenges, including:

  • Depression, which may present as hopelessness, low energy, isolation, or negative self-perception

  • Anxiety, including restlessness

  • Substance use

  • Grief or trauma

  • Eating disorders

  • Self-harm or suicidal thoughts

When to intervene

There’s no perfect moment to step in, but there are clear warning signs that someone may be struggling. Some common red flags include:

  • Decline in self-care or hygiene

  • Frequently arriving late to work or not showing up at all

  • A noticeable drop in performance or motivation

  • Withdrawing from family, friends, or activities they once enjoyed

  • Spending excessive time alone or sleeping much more than usual

  • Sudden mood changes or emotional distress

  • Isolation, particularly when someone who was once engaged begins pulling away

It’s important to note that the severity of the issue matters. 

“Someone experiencing mild anxiety may need support and therapy, while someone engaging in substance abuse, self-harm, or expressing suicidal ideation requires more immediate intervention,” Cosand says. 

A Caucasian mother and daughter talk over breakfast

Starting the conversation

Timing and tone are everything.

Choose a private, comfortable setting when your loved one is calm and open to a conversation. Avoid trying to talk when time is limited, there are distractions, or you or your loved one is already feeling overwhelmed. 

Cosand also emphasizes that the most important step is stating your intention clearly, using open-ended, curiosity-driven questions that focus on specific observations rather than assumptions. 

“The goal with the conversation should be connection, not judgment.”

Below are a few options for starting the conversation:

  • I care about you, and I’ve noticed you haven’t seemed like yourself lately.

  • My goal isn’t to judge you. I want to understand what you’re going through.

  • Would you be willing to share how you’ve been feeling?

  • What’s been the hardest thing for you lately?

  • I’ve noticed you’ve been spending more time alone.

  • I’ve seen that you’ve seemed more tired and withdrawn.

Remember: a productive conversation means listening to your loved one rather than lecturing. To do this, practice patience and avoid interrupting. 

Are group interventions productive?

While group interventions can be effective in some cases, especially with severe substance use, Cosand says that most people respond better to a one-on-one conversation.

“Being confronted by a room full of concerned loved ones can feel overwhelming or frightening,” Cosand warns. “Often, a close friend, spouse, or family member is the best person to initiate the first conversation.”

What if they don’t want help?

Some people acknowledge they need help but don’t take the next step. In these cases, explore the pros and cons with them. 

“Offer practical support, such as helping them find a therapist or even going with them to an intake appointment. If there is no immediate safety risk, it’s important to respect their autonomy,” Cosand says.

It's also okay to continue checking in without pressure. Gentle persistence can be more effective than force.

Talking to children and teens can require a different approach

Children and teenagers often don’t recognize the changes happening within them as they approach and navigate puberty. 

They experience changes in social behavior, sleeping patterns, mood, and physical development, which can amplify their feelings and cause additional stress. These changes often make it difficult to identify when something more significant is happening, such as a mental health concern. They may also struggle with labeling emotions, which is why it’s important to be more direct when motivating them to seek support. 

Parents need to take a more active role in supporting their child and potentially seeking professional help if the issue is severe.

When starting the conversation, Cosand suggests focusing on connection and not persuasion. 

“If you want your child to open up, approach the conversation using ‘I’ statements while asking questions from a sense of curiosity.” 

Some “I” statements can include:

  • I’ve noticed you’ve been withdrawing more lately.

  • I’m concerned because your mood seems different.

  • I’ve noticed that your energy is lower than it usually is.

If you believe your child might benefit from therapy, schedule an assessment or call us at 909-558-9113.

For information on additional behavioral health services, including substance use programs, outpatient services, adult programs, and eating disorder programs, call us at 909-558-9112.