How to Support A Loved One Struggling with Mental Health Issues

There’s no quick fix, but unconditional love and validation go a long way

Most of the time, I feel like the last person who should be handing out advice about parenting a young adult with mental health issues. Our rollercoaster journey with our son has destroyed any foolish preconceptions that unconditional love or positive parenting would guarantee him safe passage to adulthood, or indeed that we would have any control over his happiness.

However, a decade of experience in this unchartered area has opened our eyes to the mental healthcare system and supporting a loved one who struggles. As such, I feel a certain obligation to share with anyone in a similar situation the strategies that have helped us support our son as well as our mental health along the way.

There’s little advice about what to do with kids over the age of eighteen when life doesn’t go to plan.

At times, this journey will make you question both your skills as a parent and your values as a person. Furthermore, with no manuals to guide you through your young adult’s mental health crisis and limited services from the government, the onus is more often than not left on family and friends to support them.

It is a responsibility that places tremendous pressure on the majority of us who have no medical training, especially when the number of young people suffering from mental health issues increases each year. Social media, the long-term damage left by COVID, the powerlessness many of them feel about world events, and the disconnection of those who must move away from close family for employment or cheaper housing, are taking their toll.

Furthermore, the more we understand about conditions like anxiety and depression, the more obvious the vital link between connection and well-being.

“Tough love” is outdated

Fortunately, “tough love” is now looked upon as an archaic strategy to turn around those young people who are “lost”, unmotivated or disillusioned — mainly, because it doesn’t work — but clearly, some great mind believed at some point that punishing someone who is already broken was a good idea.

In my opinion, tough love is all well and good when it’s not your child. Fortunately, it is now generally accepted that there is a big difference between the emerging adult who is a bit “lost” and the kid who has a history of self-harm or an untreated or undiagnosed neurological disorder such as ADHD, Autism or Bipolar Disorder.

It’s impossible to remain objective when your child’s safety is at risk

However, the current strategies to support them that are generally recommended depend on many factors. Most of the time, we have no idea what we’re doing — equal parts terrified of not offering enough support to our son or (worse) “enabling” him. And even when we feel confident that a communication strategy, for example, won’t prove detrimental to his recovery, it’s impossible to know if our words during high-stress moments will act as a trigger.

Truth be told, there’s little advice about what to do with kids over the age of eighteen when life doesn’t go to plan. Furthermore, it’s impossible to remain objective when they are your child and their safety is at risk.

Once they turn 25, most subsidised medical support from the government dries up. And although (for the moment) we have the money for his treatment and to top up the Centrelink payment to meet his basic living costs, many parents do not.

The two biggest problems families face in terms of support are:

Lack of funding

Despite the trickle of additional funding from the state and federal government, our current mental healthcare system is still failing many people despite various commissions into it. Like most commissions, it seems, these require a lot of staffing, money and time, with little obvious return for the average voter or our loved ones on the front line.

Ongoing support — or God forbid a multi-modal approach to treatment! — is woefully inadequate and most of the time it feels as though real support only kicks in at crisis points — which is sadly, often too late.

Thankfully, many agencies are now receiving more funding for kids and teens, but there is little tangible support for adults unless they show up on the government’s radar in some way — if they demonstrate a serious risk of self-harm, if they’re involved in criminal activities, or if they threaten the lives of others — not even then, if we consider the ramifications of the recent, shocking tragedy in Bondi.

I know how lucky we are to have a welfare system like ours, but if your young person is unable to work and support themselves financially because of their mental health, it is almost impossible to get more assistance — financial or medical. And meeting Centrelink’s mutual obligations is impossible for some.

Fear and Stigma

For a multitude of reasons, many people with mental health struggles — and I include substance users under this umbrella — cannot access or even want help. Ingrained fear, poor self-realisation, prior bad experiences, shame and stigma are just some of the reasons the number of homeless and unemployed continues to rise.

Support for adults is often left to parents and close friends

So how can you support your loved one?

Firstly, I would remind you that the way a person chooses to live their life is not for us to judge — even if it is at odds with our personal value system. Furthermore, your judgment is unlikely to change their choices and risks pushing them further away.

Personally, I believe that the love we offer should be “unconditional”. You may not be able to actively support ALL your loved one’s choices — and boundaries are important — but never compromise on the love you offer them. We lose far too many people because they feel disconnected or a burden to their families.

Your values may be tested

As a parent (not a medical professional), I can only write about the decisions we have made in terms of support — with varying degrees of success. And I must reiterate that these have come from years of experience, research, therapy, trial and error. This journey will be a learning process and highly dependent on the needs and mindset of your loved one at any particular time, and how receptive they are to receiving support or moving towards recovery.

You’ll probably make mistakes

We’ve made a lot — enabling* anyone? — but over time, we’ve tried to learn from them and to keep an open mind. For your own sanity, I advise you to accept as early as possible that you may not cure or save your loved one, all you can do is support them on this difficult journey with what’s in your control.

The following are the strategies that have produced the best outcomes for us:

• Acceptance — This one dominated my therapy sessions for some time but it has been an important step forward for our relationships and healing. Radical acceptance, a skill taught in DBT, is the acknowledgement that what you are going through is tough and will require ongoing effort, but for the sake of your own health and your relationship with your loved one, you must accept your situation as your reality until it changes.
• Consistency — They may not thank you for it, but ideally you want to encourage your loved one to develop some routine and structure in their lives. A healthy routine helps reduce their stress and when you are also consistent in your care, you build trust with them.
• Mindfulness — How we react to our loved ones when they are emotionally aroused can make all the difference to the outcome. Staying calm, validating, coming up with suggestions in terms of next steps (if they are open to that) and not being judgmental will all help regulate their emotions.
• Communicating, listening, and validating — Sometimes, all your loved one wants is to be heard. In the past, I was guilty of always trying to find a solution, when simply validating our son’s struggles was probably enough. When you feel like the universe is constantly shitting on you — his words — or you feel like a burden to others, you don’t want solutions, you just want reassurance and to know that someone is in your corner, supporting you. In terms of language to use, NEABPD recommends the following three validating responses: “I know”, “Of course”, and “Me too”.
• Educating ourselves — Learn about your loved one’s specific issues so you understand their symptoms, triggers, and the best treatments. That way, you can offer informed advice and effective support when they are open to it.
• Offering assistance — Reduce their stress by assisting them with day-to-day tasks. For example, you might offer to transport them to their medical appointments, cook or clean for them, or help out with personal administration.
• Using appropriate language — Educate yourself about stigmatising terms like “crazy” or “psycho” and use person-first language that emphasizes the individual, not the condition. Instead of saying “a schizophrenic,” say “a person with schizophrenia.” Words like “should” can feel shaming and triggering to someone who is trying to get better or to adapt to a new situation. Finally, focus on strengths and recovery and avoid blaming language.
• Imposing and respecting boundaries — When you find yourself in emotionally charged situations, it’s easy to lose sight of your own limits and needs. Boundaries benefit both you and your loved one. Again, depending on their state of mind, they may not like them very much, but if you want to continue to support them, you need them. Your boundaries may range from refusing middle-of-the-night calls (unless in an emergency) to no alcohol in your home. They may impose a boundary on talking about their problems at certain times.
• Setting achievable goals — You won’t always move forward, but encouraging your loved one towards goals demonstrates your belief in them. The long-term goal is independence, but this will most likely involve many baby steps. Different needs and different stages of their recovery will require different levels of scaffolding.
• Self-care — Again, this applies to both you and your loved one. Activities that benefit both of you include exercise, therapy, exposure to nature, diet, a new creative interest or even journalling. Support groups are great for information, developing strategies, and meeting others with similar experiences.
• Encouraging treatment — Whenever we’ve faced a setback, we return to a basic triage of care: a meeting with the medical professional they trust (GP or their mental health team); medication — which can provide support before other treatments have a chance to work; and therapy (or even art therapy, for a way to express their feelings). If you have the money, other treatments, from psychotherapy and repetitive transcranial magnetic stimulation (rTMS) to electroconvulsive therapy (ECT), may also help. A “multimodal” approach is believed to be the gold standard for the treatment of many disorders.
• Recognising the signs of crisis — You know your loved one, so if you notice any signs of suicidal ideation or risk they are getting closer to that decision, know your plan for how to handle crisis situations. Ask the right questions. A safety plan may be something to work on together.

In simple terms, love is the bare minimum in terms of support. These disorders are not a choice, and although it’s not always easy to find the patience and love in your heart if you feel abused or your loved one is oppositional, try to remember that they have an illness.

These disorders are not a choice

And it’s not all doom and gloom. In the long term, there are many personal benefits to your support and advocacy. We continue to have a close relationship with our son and the experience has made us more self-aware and compassionate, not to mention it has given us a greater understanding of others and a view of life through a different lens.

And finally, if you are in any doubt about how much support to offer, I believe that in moments of crisis, nothing is too much. *Enabling gets a bad rap, but it is less of a risk than withdrawing from them when they need you most.

Does anyone have any strategies to add to my list?

*We have always struggled with “enabling” and the risks associated with it. Finding the line between support and enabling is so dependent on the personal situation and circumstances of your loved one. Clearly, if their life is at risk, that is not the time to question your level of support. However, with our increasing understanding of the importance of connection for healing and recovery, that line can be easily blurred.