When one of your friends is hurting, it can be hard to know what to do. It's important to remember that your compassion can go a long way.

IMPORTANT: If you or someone else you know is in immediate danger or crisis, please call 988 or 911. When in doubt, please talk to a trusted adult to review symptoms and experiences – like a parent, school counselor or physician.

On this page, you can find helpful resources that provide support in determining what you should and shouldn't say to friends in crisis, and what to expect when a friend is dealing with a mental illness.

REMINDER: It is not your responsibility to diagnose or treat a friend struggling with a mental illness. If you find yourself unsure of what to do, always talk to a trusted adult.

Keep in mind that your compassion can go a long way when supporting a friend. Listening, providing a supportive ear, and affirming your love, care and desire to understand are all important parts of any conversation. When you reach out to a friend who you think may be struggling, be sure to find a good time and space for it, whenever possible – you may want to avoid bringing it up in a public place, for example – and make sure you're clear that it's just you and not several people expressing concern to make sure they don't feel ganged up on or self conscious.

You can bring up things you've seen – "I've noticed you've been quieter than usual" – or ask open-ended questions like "How have you been lately?". Active Minds has a video about a technique -- Validate, Appreciate, Refer (V-A-R) – which details how to have a conversation with someone who is struggling with mental health challenges. VAR recommends using phrases like "that must be really hard to deal with," "I'm so glad you told me," and "I think it might be helpful to talk to someone – can I go with you?" which communicate your support without judgment.

Some things you want to avoid include pressuring someone to talk more, diagnosing them, or offering unsolicited advice. If you have something to share from your own experience, you may want to ask before sharing, using phrases like: "I have some thoughts to share, but sometimes other opinions aren't helpful. How are you feeling right now? Would that be helpful, or should I wait for another time?"

Keep in mind that it's not uncommon to feel frustrated or emotional or to encounter awkwardness or irritability. Some people may be resistant to help or not know how to respond. People may not be ready to talk about what they're experiencing, and that's okay, too. You can always express that you are there for them, and ask permission to check in now and again.

Active Minds has written information on what to expect when offering help and how to support someone during different types of treatment (during counseling, during outpatient, during recovery, in the hospital).

You may hear people casually self-diagnose themselves with mental illness or use a mental illness to describe their behavior. People who are organized might call their behavior "OCD" or may refer to a mood swing as "bipolar." People who are experiencing stress or symptoms of mental illness may also use language they see in online articles or videos without understanding what that language truly means.

When you're concerned about a friend and reaching out to support them, keep in mind that the language you use matters. Terms like "OCD," "bipolar," and "depression" are more than just words – they are real conditions that people struggle with. Using these words casually may make a person struggling with mental illness feel like what they are going through is unimportant, or prevent someone experiencing everyday stress from feeling comfortable talking about their experiences. Again, avoid diagnosing anyone, and, if your friend brings up a diagnosis, use active listening skills like the VAR technique to stay present and attentive to what they tell you.

IMPORTANT: If you or a friend are in immediate danger or crisis, please call 911 or 988. 988 is the Suicide & Crisis Lifeline. Trust is important, but if your friend ever talks about hurting themselves or others, it is important for their safety and the safety of others that you reach out to an expert. Your friend may be angry or upset with you, but reaching out in moments like this could save their life.

If you would like to connect to a peer support service that provides information, resources, and support to friends of someone with a mental health challenge, you may want to reach out to the National Alliance on Mental Illness (NAMI) HelpLine. It's available Monday - Friday from 10am to 10pm. You can call 1-800-950-NAMI (6264), text 62640, chat at nami.org/help or email helpline@nami.org.

Other options:

2NDFLOOR

• You can call or text.
• How: Call or text 888-222-2228. For hearing impaired callers, 2NDFLOOR can be reached at the following TTY number: 732-264-1703.
• When: 24/7.

Crisis Text Line

• You can text, chat, or message on WhatsApp.
• How: Text HOME to 741741 to reach a volunteer Crisis Counselor or visit here.
• When: 24/7.

IMPORTANT REMINDER: When in doubt, please talk to a trusted adult to review symptoms and experiences – like a school counselor or physician.