February 2nd, 2017

Etiquette for Mental Health Announcements

[Administrivia note: I wrote this at the end of December, but am only now posting it. I kept thinking I was going to find something better and replace or revise this, but I haven't. If you know of a resource with better advice on this topic, please share!]

Has your friend, family member or coworker recently announced that they spent some time in an inpatient mental health facility? Have they explained recent changes in demeanor or behavior as being the result of a "meds adjustment"? Have they had to take time off, because of a mental health crisis? It can be very difficult to know how to respond to these announcements. Depending on your relationship to the person making the announcement, we might have very strong feelings of our own about that person's recent demeanor and actions. We might feel a much stronger sense of connection to them as a result of this announcement -- and that stronger sense of connection might or might not be wanted.

If you can find some advice in a book or online about how to respond to this sort of announcement, please tell me! I've done a little looking around and found many interesting things but, alas, nothing apropos. Here are some suggestions.

First, consider as quickly as you can the time and place. The person making the announcement may have had to really work hard to get to the point of telling you or anyone else. They may have picked a really unfortunate time and place for the announcement, and they may have trouble limiting the details conveyed to ones that are appropriate to the time and place. Help them out with this. "What you are telling me sounds like very sensitive information that is not appropriate to this time and place." If you are very clever, and have an alternative location and some time to devote to this conversation, "Let's step into this office, where we can talk for 20 minutes." Don't offer to talk as long as they need to talk. That might make it even harder for them to sustain focus and result in them exhausting themselves.

Second, validate that it was probably not easy for them to tell you what they are telling you. "I recognize that this information can be extremely difficult to share."

Third, clearly convey that you actually heard what they said. Repeat back the salient portion in as close to their words as possible. "I hear that you recently spent time in an inpatient facility/had a meds adjustment/experienced a mental health crisis/are newly diagnosed with X personality disorder, etc."

Fourth, convey YOUR response. If a friend that you had been hoping would share finally has, "I appreciate your trust and willingness to share this with me." If a coworker, "Thank you for taking the time and effort to share this information with me." If you really don't want any more like this, "Please know that there is no need on my side for you to share any more details with me." If they are really not stopping, you can escalate to holding your hands up in a stop gesture and say, "I am very uncomfortable with this conversation and I am going to step away from it now." Hints may not work, and attempts to use social pressure and similar techniques to stop the flow are more likely to be misinterpreted than this very bald statement. If you do this, don't soften it by promising to come back to it later, while hoping they don't. Offering hope in this situation is not kind to them, but only cruel.

Fifth, affirm the nature of the relationship that you want going forward. "I love you dearly, and this really helps me to better understand you." "Being able to work with you is important to me, and having this information will make it easier for me to coordinate with you." "I will continue to treat you with the respect and professionalism that I treat everyone here at [location]." While it might be difficult, now is not the time for comments along the line of, "Well, that sure explains a lot." It might be hard, but save that for a private, confidential conversation with someone from your own support network. Everyone will be much happier if you save any remarks about how you relate the announcement to the person's recent behavior or demeanor until after you have had some time to think about it.

Wrap it up in a sincere appreciation for the effort they put into it: "Again, I know that talking about this is often very difficult, and I appreciate that you are trying so hard to make sure I understand."

If you want to offer support and assistance, make it clear that you are asking for them to clearly _ask_ for what they need -- you are not going to guess, and while it can be an unconditional offer to listen to specific requests, it should NOT be an unconditional offer to do anything that is requested. "Please let me know if there is something specific I can do to support or assist you with this. I will do what I can."

If you frequently use a generic well-wishing statement, and have used it before with this person, such as "My thoughts are with you" or "I will pray for you" or something similar, feel free to tack that onto the end. But if you've never used such language before, now is not the time to start. If your history with this person includes physical touch -- handshakes, backslaps, social hugging -- and you feel so inclined, that is okay as long as you don't override any resistance on the part of the person making the disclosure. Be sensitive to non-verbal hesitation, in particular. This is NOT the time to offer physical comfort to someone who you have never touched before.

Thursday's Activities Include: A.'s half day, no play therapy, basketball, dinner at Julie's

I had a nice conversation with J at noon today. My walking partner M. works on Thursday morning, so we visit in the afternoon. Because it was A.'s half day, she was home, and because A. has had a bad cold, we stayed in and played iPad games. Also, I canceled her play therapy because, aforementioned cold. She did go to school today and made it through the entire (half) day. So there's that.

T. wanted to go to a basketball game at his school. This is the teachers and students game he participated in last year. Apparently, they let him try to shoot a couple baskets this year and he got at least one and won a t-shirt. His school is so awesome. His sitter brought him, and R. traded off a little after 7 so he was there to see T. sink a ball. Good times happen unexpectedly.

A. and I went to Julie's Place for dinner. We had a waitress we hadn't seen in a long time. She was in a bad car accident years ago, and it took a long time for her to be able to walk again, much less work. I was so happy to see her again, but what a horrific thing to have happen. I'm glad modern health care got her back up and walking again and that she was able to access that health care.

I downloaded Mickey's Typing Adventure on the Mac, because A. wants to learn how to time. Basically, if you remember your old typing or keyboarding class, pretty much the same idea, only instead of one of those books that hangs off the edge of the table, the screen is split in pieces, one part shows the text you are to type, another part shows animated hands positioned correctly and with a highlighted finger. It's pretty awesome, altho a bit long-winded in the style of Myst-era personal computer gaming. T. is apparently too old for Mickey, so I may have to find him a different typing game, but I did send email to his teacher to see if maybe she could sell him on it.