Someone is having a nervous breakdown in public. What is the compassionate way to respond?

In a recent episode of the popular TV series “Better Call Saul” (very minor spoilers follow), a character is seen having an emotional breakdown on a bus. As she attempts to casually use public transit services in her community, she finds herself unable to contain her emotions – and so publicly begins to cry. In the background, other passengers awkwardly ignore her, though a single hand is placed over her in a feeble attempt at comfort.

Although “Better Call Saul” is a work of fiction, it’s not uncommon for people struggling with mental health issues to have out-of-control public displays. Indeed, even when someone with a mental illness does not have a literal emotional depression, it is still common to be rejected for not behaving in a socially acceptable way.

Humans are, by nature, compassionate and empathetic creatures: sociologists say we could not have created such complex societies without our predilection for helping each other. And just about everyone at some point has this experience of passing by or observing someone having an emotional breakdown in public.

But we don’t always know what to do for them – or even if there is anything we can do.

“We need to remember that, at their root, mental health issues are health issues,” psychologist Doreen Marshall, Ph.D., vice president of mission engagement, told Salon via email. of the American Foundation for Suicide Prevention. This means they deserve sympathy, especially since they are often “scared and don’t know where to turn for help”.

“They may also feel disconnected from what’s going on around them, have worrisome thoughts, or even be unaware that others are seeing their distress,” Marshall explained. “There is also a public misperception that those with mental health issues can be violent or aggressive towards others, but the reality is that the vast majority of those with mental health issues have never been violent towards others and are more likely to be victims of violence than the perpetrators of violence”.


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As such, “If you witness an episode of public mental health in someone, you can approach them and ask them if they are okay and how you can help them,” Marshall wrote to Salon. . “You need to approach these situations with compassion and care and recognize that the goal is to help the person connect to what they need.”

At the same time, you need to ask yourself if this person is already receiving help. If too many well-meaning people converge on a person in mental health crisis, the one they hope to help might instead feel overwhelmed.

“Only one person should really speak to the person going through the episode – not like five or six,” Kelly Abreu, a mental health worker at Worcester Recovery Center and Hospital and vice president of AFSCME Local 137, told Lounge by email. “Because they [the person going through the episode] is confused as it is, so only one person should talk to this person. And it should be in a tone they can understand. Not fast. You cannot be abrupt. Just ask them, ‘What’s going on? Is there anything I can help you with? »

Of course, you shouldn’t be too hard on the spectators whose main mistake is to be overwhelming in their desire to help. Their attitude stands in stark contrast to what often happens if a person publicly displays poor mental health. Many mistakes can be made, and many of these mistakes stem from the stigma we attach to mental health issues.

“A lot of times, other people don’t want to be around someone who’s going through a mental health episode,” Abreu pointed out. “They’ll isolate them. Or they’ll call the police. It can get out of hand very quickly and make the situation more dangerous. They start yelling at them. That’s not the right thing to do.”

Deshonda Copeland of AFSCME Local 1963, senior living unit specialist at Florida State Hospital in Chattahoochee, pointed out that while there are many ways to help a person, potential allies should avoid to appear confrontational or accusatory.

“When people have mental health issues, there’s [are] different ways to help,” Copeland wrote to Salon. “But you never want to shout or approach a place of frustration or anger. Get to know the problem they are having before you deal with it. A lot of people just need someone to listen to them, talk to them.”

It is also important to understand that people who experience episodes of public mental health are, almost by definition, dealing with a problem that is out of control. While it may be tempting to simply urge them to calm down and rest, this may incorrectly assume that their condition is somehow due to a set of conscious choices. It also wrongly oversimplifies the complex situation we face.

“It’s also hard to say why someone might have a seizure,” Abreu observed. “It could be drug-induced, or sometimes it could even be the result of a medical crisis — like high blood pressure, diabetes, or other ongoing issues. Sometimes these medical issues have psychological symptoms.”

“We have to remember that, at their core, mental health issues are health issues.”

There are also many factors entirely external to the individual in question that can put them in a compromised mental state. There is evidence that depression cannot stem from neurochemical imbalances in the brain, but rather from systemic injustices that wear people down.

“Unfortunately, poverty and discrimination can play a role in getting proper diagnosis and care for mental health issues and accessing adequate care,” Marshall explained. “Although these situations are not solely responsible for the symptoms of mental health problems, they are certainly stressors that can aggravate growing mental health and other health problems, as well as prevent the identification and taking early treatment of mental health problems.

In addition, mental health issues can affect anyone — no one, regardless of background, is immune. This means that regardless of a person’s background, there are ways to have a positive attitude that can work for anyone.

“Some people react like they would react to a relative or a friend,” Copeland suggested. “If they’re having a crisis, approach the situation in a positive way…be their support. A lot of people just need someone to listen to them, talk to them.”

“It’s important to remember that mental health issues don’t discriminate, and people of all races, economic levels, genders and backgrounds can experience mental health issues,” Marshall told Salon. “That’s why it’s important for all of us to educate ourselves about the mental health resources available in our regions, to challenge our notions of who may have mental health issues, and to be prepared to meet those who struggle with support and compassion.”

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