My friend is struggling but won't get help. What should I do?

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Ask the therapist

Q: What do I do if my friend is having mental health problems but they won't get help? It's starting to take a toll on our friendship, and my own mental health.

A: It is clear to me from your asking this question that you care deeply for your friend and simply want what’s best for you both in the long run. Kudos to you for stretching yourself to support them, but let’s figure out a way for it to be beneficial and no longer harmful to the friendship and your mental health.

First, reflect on what is draining you of your mental and emotional energy. Is it the late-night calls they expect of you, or the tiptoeing around their symptoms for fear you might hurt them? Take a moment to be specific about what's affecting you. You want to be clear in your objective, and your friend will appreciate your thoughtfulness.

Next, help point your friend in the direction of getting professional help, but don’t take this on as your job. The delicate balance you have to strike will be gently pushing them, but not so much or so often that it pushes them away from the idea altogether. Help them by asking “what do you want for yourself and what help do you need getting there?”

Take care of yourself by responding in ways that don’t make you the therapist but rather encourages them to get help professionally elsewhere. Something like: “I hear you’re struggling, and you deserve the help of a professional so that the changes you make can be long-term." You can suggest searching for a therapist together, and even offer to accompany them to their first appointment if that helps.

If therapy has been a negative experience for them in the past, or if the idea of starting therapy is daunting, allow them the space to talk about what they're worried about. Ask questions. Be curious. No judgment. Help them figure out what didn’t work before, and try to find a specialist that would be a good fit. Remind them that not all therapists are the same, and that “shopping” for a good fit is actually pretty standard.

Be ready for your friend to potentially be hurt by your boundary-setting. Setting and respecting boundaries is uncomfortable for anyone. But remember, this is for your friendship’s long-term health, and they may thank you for it later.

Finally, try not to take it personally if they don't take your advice. Unfortunately, most people only get help when it gets bad enough.

Wishing you patience from afar, Michelle

Michelle Lozano is an Associate Marriage and Family Therapist and member of the ADAA.

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