Signs of mental illness and what to do

Mental illness directly affects one in five Australians at some stage in their lives It may seem like this person is on drugs, or that they are just being difficult. But there’s a chance that they have a mental illness. Mental illness is more common than you may think. Lack of awareness often results in misinterpretation of body language, apparent verbal abuse and can worsen a situation. It is important to know then when you may be faced with a person who is in the midst of psychosis.

Signs and indicators of mental illness

• Agitation
• Being overly loud
• Vacant or seemingly preoccupied (‘spaced out’)
• Pacing
• Inappropriately dressed (eg wearing a coat and a beanie when it’s 35 degrees)
• Withdrawn
• Paralysed or stuck to the same spot for a long time
• Displaying signs of paranoia.

All these can be warning signs that a person is unwell. When approached, it may be difficult for the person to focus. If the person is delusional or experiencing hallucinations, or if the person is feeling paranoid, it is vital to remember that their ability to focus on you and what you are saying, and their ability to respond, may be severely restricted.

People who are experiencing acute symptoms have a lot going on in their mind already, therefore it is important to decrease stimulation

• Stay calm
• Talk quietly
• Keep surrounding noise (radios, intercoms) to a minimum
• Keep surrounding environments calm
• Reduce the number of people
• Give the person time. Slow down. Be patient. People who are experiencing acute symptoms of mental illness may be fearful
• Avoid any initial feelings you have of control/authority/demand/anger
• Do not intimidate
• Be quietly confident yourself
• Avoid confrontation by creating situations in which you are doing things alongside that person
• An example of this is to sit next to them rather than in front of them, walk alongside instead of in front or behind, sit in an open area with little stimulation. People experiencing acute psychotic symptoms (loss of touch with reality) believe that their delusions or hallucinations are real
• Avoid disputing their sense of reality. You can’t reason with a delusion
• Do not encourage or inflame paranoia
• Validate their feelings, eg ‘It must be frightening for you…’. This will build trust and avoid useless arguments. People experiencing acute symptoms are often unable to think clearly
• Avoid too much discussion about the situation – in most cases each person’s realities are different
• Explain your position and what you are obliged to do to assist
• Explain calmly and confidently if you are not able to comply with a request by the person
• Explain what you are going to do and ask them to sit down quietly
• Keep it to the ‘now’ situation
• Communicate each step you are taking. When that is done ‘Now, you wanted me to call your friend…’
• Ask if there is someone the person would like you to contact to help the situation. It can be helpful for you to speak to that person to get more information and tips about handling the situation
• Take ‘small steps’ to solve the immediate problem; don’t attempt too much.

Don’t take it personally

• It’s not about you.
• If you are extremely worried about the person call your local crisis team
• Tell them the person’s name (if possible), describe the behaviour and what the person is saying. They will make an assessment as to whether they will attend
• In the meantime ask them to assist you to manage the situation by offering advice over the phone
• If the person is violent (although people with mental illness are more likely to hurt themselves than other people) tell the crisis team about this. They should then attend with the police.

Outside of crisis times

If this is an ongoing situation you are dealing with:

• Proactively establish formal lines of communication with your local crisis response or on-call team and police to understand what they consider to be the best course of action in certain situations that you encounter and in what circumstances they would expect to be called. It also means that when you do contact them in a crisis situation they are familiar with your situation.

For further information on mental illness please visit the following websites:

Mental Illness Fellowship Victoria
www.mifellowship.org

Mental Health Services Website (Vic)
www.health.vic.gov.au/mentalhealth

National Alliance of the Mentally Ill (NAMI) (USA)
www.nami.org

Mental Health Council of Australia
www.mhca.com.au

SANE Australia
www.sane.org

Beyond Blue
www.beyondblue.org.au

Mental Illness Fellowship of Victoria fact sheets What can friends and family do to help a person experiencing mental illness?

Collaborating with professionals