You Noticed Something. Now What?

You have noticed that someone is different. Maybe they have withdrawn from friends, seem exhausted, become unusually angry or appear overwhelmed. The changes have continued, and you are beginning to wonder whether something is wrong. There is one fairly important problem: you don't actually know what is happening. That is okay. You do not need to diagnose someone before you can care about them.

Suppose a friend has barely spoken all week. You could ignore it because you are unsure what is happening, or secretly construct seventeen theories about the problem, approximately sixteen of which will probably be wrong. There is a simpler option. Ask them. A normal conversation can be the first step toward support.

ADCA: Starting the Conversation

A simple way to remember what to do is ADCA. Begin with ASK: “How are you doing?” If the automatic answer is “fine,” but you remain concerned, DIG by asking one more caring question: “I've noticed you've been really quiet lately. Do you want to talk?” Dig does not mean investigating someone or trying to uncover their diagnosis.

If you remain worried, move to CONCERNED and simply say it: “I'm concerned about you.” You are telling the person that somebody noticed and cares, not telling them what is wrong. Then comes ACT, which means helping connect them with appropriate support when support is needed. Australian headspace uses a similar Notice, Inquire, Provide approach, while Irish youth resources also emphasize noticing changes, listening and connecting someone with support. (headspace.org.au) (jigsaw.ie)

Caring Does Not Mean Becoming Their Counsellor

If someone tells you they are struggling, listen and take what they say seriously. You do not need perfect advice, and you do not have to solve the problem. You definitely do not need to become a Grade 8 mental-health professional with an office beside the lockers. Your role can be much simpler. Stay connected where it is safe and help bring in someone who can provide appropriate support. That might be a parent, caregiver, teacher, school counsellor, Elder, doctor, coach or another trusted adult. Sometimes someone who is struggling may ask you to keep everything secret. Privacy matters, but there are situations where safety matters more. Being a good friend does not mean carrying a serious situation by yourself. Sometimes being a good friend means involving someone else.

When Concern Goes Up, Support Steps Up

Think about support as a three-level pyramid. At the wide bottom is REACH OUT, where something feels difficult and a person may be overwhelmed, lonely, upset or unsure what to do. Perhaps there has been a friendship problem, family difficulty, disappointment or another stressful event. They may know exactly what happened and simply need connection while dealing with it. Talking with a trusted person is a reasonable place to begin.

The next level is GET SUPPORT. This is where the four markers from the previous post become useful: change, duration, intensity and impact. Something is noticeably different, it is not going away, it is becoming stronger, or it is interfering with sleep, school, relationships, activities or everyday life. A school counsellor, doctor, mental-health professional or another appropriate service can help work out what is happening. You do not need to wait until a problem becomes an emergency before seeking professional support.

Notice what you did not have to do first. You did not diagnose the person, prove that the problem was serious enough or identify the perfect service. You also did not have to decide whether they had depression, anxiety or another condition. Start with a safe person. Appropriate adults and professionals can help determine what comes next.

ACT NOW Is Different

The top of the pyramid is ACT NOW, because safety may be at risk. If someone talks about suicide or wanting to die, talks about harming themselves, has a suicide plan, or you believe they may not be safe, do not try to determine the level of danger yourself. Get a trusted adult involved immediately. At this level, your responsibility is not better assessment. It is action.

If someone is in immediate danger or needs urgent medical help in Canada, call 9-1-1. If you or someone you know is thinking about suicide, Canada's 9-8-8 Suicide Crisis Helpline is available by call or text 24 hours a day. Kids Help Phone also provides 24-hour support for young people across Canada at 1-800-668-6868, or by texting CONNECT to 686868. These services exist because someone facing a serious situation should not have to work through it alone.

Real life will not arrive neatly labelled REACH OUT, GET SUPPORT or ACT NOW. That is why the pyramid is about increasing support, not diagnosing increasing levels of mental illness.

• If you are concerned, involve somebody you trust.
• If you are worried about safety, act.
• You are not expected to determine exactly what is happening inside another person's brain.

The goal is to know what to do with what you have learned.

• Notice when something changes.
• Ask rather than assume.
• Listen instead of diagnosing.
• Connect the person with support when they need it.