Ask the expert: What does good mental health care look like?

Crystal Cederna is a psychologist and researcher who has provided mental health support for thousands of people. As an associate professor in the Charles Stewart Mott Department of Public Health at the Michigan State University College of Human Medicine, Cederna shares suggestions about how people can take care of their mental health and where to turn for help.

What can people do to support their mental health?

Mental health starts with the basics. When people are overwhelmed, stressed or burned out, the first step is often to simplify. This allows time and space to rebuild the mental and physical resources that help people cope and limit how much they need to cope with in the first place.

Some of the most effective daily habits for supporting mental health include the things we do for physical health. Get adequate sleep, stay hydrated and eat nutrient-dense foods. Other ideas include maintaining social connections and routinely making time for activities that refill their wellness buckets. Examples include hobbies, exercise or a spiritual practice. Reducing unnecessary commitments also helps support mental health.

Why do people struggle with mental health?

For any one person at any given time, there are usually many factors leading to mental health difficulties. The risk for mental health problems rises when people don’t tend to self-care, uphold boundaries to protect time for important tasks including rest, or face more stressors than they can handle. When stressed, people also can experience a decline in creative problem-solving, their ability to manage strong emotions, and coping with everyday life events and stressors. Often when stressed, people isolate or withdraw from others, limiting chances for meaningful connections, help and support. They may miss out on some of the basics too, like adequate sleep, hydration and healthy food intake.

Many people are juggling chronic stress from work, parenting, caregiving, finances, exposure to traumatic events, and local and world events all at once. These factors create a perfect storm and lead to a sense of being overwhelmed, overburdened, overscheduled and stressed.

Frankly, the word burnout comes to mind. Burnout can affect parents, workers, caregivers, kids and teens alike. Ongoing stress can wear down a person’s ability to cope and increases the risk for anxiety, depression and emotional exhaustion.

What are common signs that you may need help?

One of the biggest warning signs that someone may need mental health support is a lasting and significant change from their usual behavior or emotional state that causes problems or is very bothersome.

Other signs include:

• Feeling anxious, sad or irritable most of the time
• Sleep or appetite changes
• Withdrawing from friends or activities
• Trouble functioning at work, socially or at school
• Increased conflict in, or withdrawal from relationships
• Feelings of guilt, hopelessness or overwhelm
• Responses to stressors that are extreme for the situation

With children and teens, parents should look for changes in mood, academics, friendships, appetite, sleep or socialization. What separates depression from the typical teenage moodiness is an abrupt and noticeable change from what’s normal for this teen that lasts several days to a couple of weeks.

What should someone do if simplifying and self-care are not enough?

When symptoms are really troubling or begin interfering with daily life, relationships, work or school, professional support is helpful.

I encourage people to reach out before they are in severe distress or problems stack up. Therapy benefits everyone because it meets you where you are and boosts your health and wellness from there. Early support can prevent problems from becoming more serious and taking longer to treat.

Where can people go for help?

There are many options. Primary care doctors can offer supportive resources and help with medication when that is an appropriate option. People can also directly contact a licensed therapist, psychologist or counselor. One of the most common things people learn quickly after starting therapy is that everyone experiences challenges, but they’re so much easier to navigate with the help of an objective mental health expert in your corner.

Here are additional resources and suggestions:

• Google your county’s name and ‘community mental health.’ Every county has an agency that helps people locate local mental health services.
• Call 211, a free service available in the U.S. and Canada. They’ll ask for your ZIP code, your insurance type (if any) and connect you with local mental health providers.
• Call or text 988, the Suicide and Crisis Lifeline, available anytime. You do not need to be in a crisis to call. You might just need someone to talk to in the moment.
• Phone a friend and ask for recommendations or ask your social media connections.

After getting names of suggested providers, make sure they are licensed and experienced in the area(s) where help is needed. A licensed provider has had the appropriate education, training and clinical experience to support and boost your mental health while treating any conditions you’re facing. In the absence of a license and appropriate experience, you may be getting well-intended advice, but it may not be evidence- or science-informed, and that could be harmful.

What if someone feels resistant to getting help?

For some folks, there are personal factors behind a hesitancy to get help (e.g., ‘I knew someone who knew someone that had a [less than great] experience’). Some people don’t get mental health support because they’re not ready to examine what’s going on, they believe it’s not okay to ask for help, or they think they should be able to ‘handle it’ on their own. But humans are not made to live in isolation — it takes a village.

It can be uncomfortable to share your story with someone you’ve just met, and it takes courage to make that first phone call to schedule the appointment. But once people get in the door, most are grateful they did. Many say they wonder why they waited so long.

Is treatment effective?

Yes, mental health treatments are highly effective for many people and many conditions.

Cognitive behavioral therapy, or CBT, helps people notice and change unhelpful patterns in their thoughts, feelings and behaviors. These parts are connected and interact, so when you make changes in one area, it leads to improvements in the others. CBT is used to treat many mental health conditions, including anxiety, depression and more. It looks a little different based on the condition but has the same goal of reducing troubling symptoms and their impact on everyday life.

For some conditions, medications are the most effective treatment approach, either alone or combined with therapy. A mental health professional can help sort out which treatment approach is best for you.

Regardless of the type of problem to be addressed, the earlier people seek support, the easier mental health concerns are to treat or manage.

How can family members or friends support someone who may be struggling?

These conversations can be tough but there are several ways to facilitate an open conversation.

First, set the stage. Approach the conversation gently and without judgment. Minimize distractions. Make it a side-by-side partner conversation rather than a front-facing conversation. Take a walk or a drive.

Start the conversation by pointing out changes you’ve noticed. You could say, ‘Hey, I noticed a few things are different about you lately. The things that I’m seeing are, [fill in the blank with what you’ve noticed]. What’s going on? Are you noticing this too?’

Avoid making assumptions, stay curious and keep creating spaces for others to share. Follow up a response with, ‘Tell me more about that.’

When we ask, ‘Why?’ it often leads to defensiveness and that’s not what we’re seeking here. So, use, ‘Tell me more.’ Then quietly listen without judgement.

The role of the concerned person isn’t to be a fixer. It’s to be a listener and make sure the other person knows they’re being heard.

And, it doesn't hurt to say, ‘I’m coming from a place of care, love and concern. I love you. I know you, and I’m seeing something different than I’m used to seeing. I just want to check in and see if you’re doing okay.’

What’s the most important message people should take away?

There are three things people should know.

First, mental health struggles are common and there are treatments that work.

Next, it’s important to tend to mental health by prioritizing connection, taking good care of ourselves every day and reducing unnecessary sources of stress including overscheduling. Plan a schedule that’s a little less full. Challenge societal norms and pressures that come with grind culture. Separate essential from nonessential tasks. Do the dishes or laundry really have to be done before bed? Does the house need to be cleaned right away? Does your child really need to be in three sports this season? Can one be enough? Care for your mental health by eliminating things that are elective or putting them off until time allows.

Last, but not least, we need to watch out for each other. Check in with friends and loved ones regularly. If you notice that something seems off, ask about it. Everything may be fine, but your caring question might be the opening that person needs to start talking