Tips for Interacting with People with Mental Health Disabilities

1. SPEAK DIRECTLY
   Use clear simple communications. Most people, whether or not they have a mental health disability, appreciate it. If someone is having difficulty processing sounds or information, as often occurs in psychiatric disorders, your message is more apt to be clearly understood. Speak directly to the person; do not speak through a companion or service provider.
2. OFFER TO SHAKE HANDS WHEN INTRODUCED
   Always use the same good manners in interacting with a person who has a psychiatric disability that you would use in meeting any other person. Shaking hands is a uniformly acceptable and recognized signal of friendliness in American culture. A lack of simple courtesy is unacceptable to most people, and tends to make everyone uncomfortable.
3. MAKE EYE CONTACT AND BE AWARE OF BODY LANGUAGE
   Like others, people with mental illness sense your discomfort. Look people in the eye when speaking to them. Maintain a relaxed posture.
4. LISTEN ATTENTIVELY
   If a person has difficulty speaking, or speaks in a manner that is difficult for you to understand, listen carefully — then wait for them to finish speaking. If needed, clarify what they have said. Ask short questions that can be answered by a “yes” or a “no” or by nodding the head. Never pretend to understand. Reflect what you have heard, and let the person respond.
5. TREAT ADULTS AS ADULTS
   Always use common courtesy. Do not assume familiarity by using the person’s first name or by touching their shoulder or arm, unless you know the person well enough to do so. Do not patronize, condescend, or threaten. Do not make decisions for the person, or assume their preferences.
6. DO NOT GIVE UNSOLICITED ADVICE OR ASSISTANCE
   If you offer any kind of assistance, wait until the offer is accepted. Then listen to the person’s response and/or ask for suggestions or instructions. Do not panic or summon an ambulance or the police if a person appears to be experiencing a mental health crisis. Calmly ask the person how you can help.
7. DO NOT BLAME THE PERSON
   A person who has a mental illness has a complex, biomedical condition that is sometimes difficult to control, even with proper treatment. A person who is experiencing a mental illness cannot “just shape up” or “pull himself up by the bootstraps.” It is rule, insensitive, and ineffective to tell or expect the person to do so.
8. QUESTIONS THE ACCURACY OF THE MEDIA STEREOTYPES OF MENTAL ILLNESS
   The movies and the media have sensationalized mental illness. In reality, despite the overabundance of “psychotic killers” portrayed in movies and television, studies have shown that people with mental illness are far more likely to be victims of crime than to victimize others. Most people with mental illness never experience symptoms which include violent behavior. As with the general public, about 1% - 5% of all people with mental illness are exceptionally easily provoked to violence. (National Alliance for the Mentally Ill, 1990)
9. RELAX!
   The most important thing to remember in interacting with people who have mental health disabilities is to BE YOURSELF. Do not be embarrassed if you happen to use common expressions that seem to relate to a mental health disability, such as “I’m CRAZY about him” or “This job is driving me NUTS.” ASK the person how he feels about what you have said. Chances are, you get a flippant remark and a laugh in answer.
10. SEE THE PERSON
    Beneath all the symptoms and behaviors someone with a mental illness may exhibit is a PERSON who has many of the same wants, needs, dreams and desires as anyone else. Don’t avoid people with mental health disabilities. If you are fearful or uncomfortable, learn more about mental illness. Kindness, courtesy, and patience usually smooth interactions with all kinds of people, including people who have a mental health disability.

This is the Last and Greatest Commandment: Treat people with mental health disabilities as you would wish to be treated yourself.

Adapted by Mary Lee Stocks, MSW, LISW, from the Ten Commandments of Communicating with People with Disabilities, originally developed by the National Center for Access Unlimited/Chicago and United Cerebral Palsy Associations/Washington, D.C.; and a video and script developed by Irene M. Ward & Associates/Columbus, Ohio, partially supported through Ohio Development Disabilities Planning Council Grant #92-13 (1993)