After my presentations, I’m frequently asked how to respond to an employee, friend or family member who says they are okay when there is evidence that they are not. This is a very difficult question since often there aren’t easy answers. At this point, I want to remind everyone that my response is not based on any medical training, but my response is based on multiple resources. I have referred to the following resources: Mental Health America (, Jed Foundation (, Substance Abuse and Mental Health Services Administration (, Fort Behavioral Health (, Summit Pathways (, Mental Health First Aid USA (, and I Am Not Sick I Don’t Need Help by Xavier Amador.

Have you ever had a physical ailment and you postpone seeking medical treatment thinking things might improve over time? Once you have sought treatment, however, you haven’t felt any shame or much hesitancy to share your medical prognosis with a fellow employee, friend or family member. On the other hand, with mental illnesses and substance use disorders, stigma and shame are often significant barriers to seeking treatment.

Additional barriers include a lack of: mental health facilities, substance use treatment facilities, psychiatrists and psychologists. On occasion the correct diagnosis of a mental illness can be difficult since often co-occurring illnesses exist. Another barrier to seeking treatment is that a person living with these illnesses will blame themself for their illness and that they are unable to manage their illness. These factors will also slow the process of recovery or the ability to manage the illness.

  • What might be some reasons as to why a fellow employee, friend or family member doesn’t want to open up and tell you what is really going on with them? Please consider the following:
  • They might feel that they can or should be able to handle the situation on their own without any outside help.
  • They are fearful of losing their job.
  • They don’t want to burden you with their situation.
  • They aren’t sure that you are able to understand what they are going through.
  • They are afraid of what you and others will think of them.

It is important to remember that your first invitation to talk with your fellow employee, friend or family member might be rejected. Respect their decision and let them know that you are there for them when they are ready to talk. Consider the following when there is acceptance to talk:

  • Identify an appropriate time and place which will be private with limited distractions.
  • Start the conversation from a place of concern and support. Let them know that they are not alone, and you are there for them.
  • Describe the reasons for your concern in specific terms.
  • Listen and acknowledge their feelings without any judgement. It is important to listen how and why they feel the way that they do.
  • Resist the urge to fix or give advice. Offer advice only when it is asked for.
  • Provide reassurance that mental and/or substance use disorder issues are treatable illnesses.
  • Be aware of available resources and help them connect with those resources.
  • Be patient.

Being well informed regarding mental illnesses and substance use disorder will enable you to be more effective in helping your fellow employee, friend of family member. The National Alliance on Mental Illness ( and Substance Abuse and Mental Health Services Administration ( are excellent sources of information. It is also important that you practice self-care by taking care of yourself. Finally, as with many physical and mental illnesses, relapses are very possible.