How to help someone make decisions about their mental health

Making decisions about mental health is hard. Helping a loved one make these decisions can take a huge load off their shoulders. But if you’re not on the same page, you can end up making things even more complicated. By keeping a few things in mind, you can become a more effective caregiver and make sure you’re really helping.

Things to remember

First, you’re there to help. You’re not there to make decisions for them. Mental health treatments work best when the person being treated is on board. Forcing a treatment on someone who doesn’t want it is usually not very effective, and could even make things worse. (And even if it helps their mental health, it will probably hurt your relationship.)

Second, put yourself in their shoes. As a caregiver, you have a different perspective. You might be more focused on the aspects of mental illness you can see, like self-harm or other destructive behaviors. Meanwhile, your loved one is probably more focused on how they feel. Sometimes changing a behavior helps a person feel better, but not always—and even if it does, it might not be obvious to them at first.

Always think about what the decisions you make together will mean for them. For example, if you’re looking into a medication, they’re the one who will have to take it every day and deal with the side-effects. If you’re talking about therapy, they’re the one who will have to open up to a stranger about their deepest, darkest thoughts and feelings.

The decision-making process

With that in mind, let’s look at how you can help make these decisions, step-by-step.

• Get on the same page. Ask your loved one about their hopes and goals. What treatment options are they open to? Why or why not? What do they have in mind when they imagine recovery? What sacrifices are they going to have to make?
• Set short-term and long-term goals. When someone is first starting treatment, recovery can seem completely out of reach. Break things down into smaller, more manageable goals. Make sure they’re achievable and measurable. They can be as simple as going outside at least once a day, or getting out of bed at a certain time. Accomplishing simple things like these can build momentum in the recovery process.
• Keep them accountable. Once you’ve helped them set goals, check in with them about their progress. Be gentle about it—don’t act like a taskmaster or make them feel guilty if they haven’t accomplished their goals. Falling short isn’t a sign of failure—it’s a sign that the plan needs some kind of adjustment. The important thing isn’t how quickly your loved one is recovering—it’s that you’re helping them move in the right direction.
• Be flexible. The path to recovery isn’t linear. Priorities change, life happens, and you’ll need to make adjustments along the way. Set open-ended goals: try a lot of different things to see what helps and what doesn’t, and don’t be afraid to drop something that doesn’t seem to be helping (preferably with the help of a medical professional).
• Remember your place. Your goal is to provide support, not to take charge. Your loved one will be more successful in their recovery when they have a sense of control and are actively involved. And their idea of recovery may be different from yours.
• Prepare for times of crisis. Make sure you plan for what to do if they reach a point of crisis. Consider what will happen if they are unable to make decisions for themselves.