For families and carers

Starting the conversation

There is no perfect sentence and waiting for one is how months pass. What works is specific, private, unhurried and free of an agenda.

Name what you've seen, not what you've concluded. "You haven't been out in three weeks and you're not sleeping" is something they can respond to. "I think you're depressed" is a diagnosis they now have to argue with.

Pick a side-by-side moment. Driving, walking, washing up. Difficult conversations are far easier without eye contact, which is why they so often happen in cars.

Ask twice. The first "I'm fine" is reflex. "No, I mean it — how are you actually doing?" is where a lot of real conversations start.

Then stop talking. The silence will feel unbearable and you should let it run. Most people fill it. Resisting the urge to fix, advise or reassure in the first two minutes is the single most useful thing you can do.

Things that don't help, however kindly meant

• "Others have it worse." True, irrelevant, and it teaches them not to tell you again.
• "You've got so much to be grateful for." They know. Guilt about not feeling grateful is often already part of the problem.
• "Have you tried going for a walk?" Exercise genuinely helps. Offered as the first response, it lands as dismissal.
• "Just snap out of it." If snapping out of it were available, they'd have used it.
• "You don't seem depressed." Most people are extremely good at appearing fine. That's the skill, not the evidence.

What does help is unglamorous: turning up, staying, and being unshocked. You do not need the right words. You need to still be there next week.

When the family doesn't believe in it

I grew up around this and I'm not going to be delicate about it. In a lot of African and Caribbean families — and plenty of others — mental illness isn't a medical category at all. It's a spiritual problem, or a discipline problem, or a shameful thing that reflects on the whole family, or evidence that someone has been weak. So it doesn't get named. It gets prayed about, or hidden, or absorbed, until somebody ends up in an ambulance.

A few things I'd say to anyone caught between a relative who needs help and a family that won't hear of it:

You don't need the family's agreement to act. You can call 111, or a helpline, or take someone to a GP, without holding a family meeting first.

Faith and treatment are not opponents. Plenty of people I've worked alongside are devout. Prayer and medication are not competing claims about what is true; nobody is asked to stop believing in order to get better. Framing it that way inside the family often lowers the temperature considerably.

Use the language the family already accepts. "Stress", "exhaustion", "not sleeping", "run down" will get a relative through a GP's door when "depression" will not. That isn't dishonesty — it's meeting people where they are, and the GP will take it from there.

Expect fear of the system, and take it seriously. Black people in Britain are more likely to be detained under the Mental Health Act and more likely to come into mental health services through the police rather than a GP. Families know this, and the reluctance is not irrational. The answer isn't to dismiss the fear — it's that early, voluntary contact through a GP is precisely what makes the coercive route less likely. Getting in early is protective.

Culturally specific services exist, including therapy with Black therapists and in languages other than English.

When they won't get help

This is the hardest position to be in, and there is no technique that reliably fixes it. What tends to help:

• Lower the bar. Not "see a psychiatrist" but "come to the GP with me on Tuesday and just say you're not sleeping."
• Offer to do the logistics. Making a phone call is genuinely hard when you're unwell. Offer to book it, drive them, sit in the waiting room.
• Keep the door open. A refusal today is not permanent. People often accept help on the fourth offer, from the person who kept offering without making it a confrontation.
• Get advice for yourself. SANEline and Mind will talk to you about how to support someone. You do not need their permission for that.

An adult who has capacity has the right to refuse help, and that right is real even when it is agonising to watch. The exception is genuine risk to life — and if you're there, go to help right now.

Looking after yourself

Caring for someone with a mental illness is exhausting in a way that people who haven't done it consistently underestimate. It is also frequently thankless, because the person you're caring for may be angry with you, or unable to acknowledge it, or gone somewhere you can't reach.

You are allowed to be tired. You are allowed to be resentful, and it doesn't make you a bad person. And you are entitled to support in your own right — if you provide regular care, you can ask your local council for a carer's assessment, which is a legal entitlement and not a favour.

The people who last are the ones who accepted early that they couldn't do it alone.

Support for you, not just for them

These will talk to family members and carers about someone else: