For a Friend

Are you concerned about a friend? Are you wondering if you should talk to your friend about your concerns? If so, are you not sure what to say?

Friends are often among the first people to learn someone may be struggling emotionally. For example, friends or roommates may be very direct in sharing information with you about how they are feeling. Sometimes, friends may say everything is okay but you notice changes or behaviors that suggest they may be having a difficult time. These are difficult situations to navigate and can often feel overwhelming. Below is some information to help you determine when to be concerned and how to help a friend get help.

Signs that someone may be in distress

Academic Repeated absences from classes Missing deadlines/not completing assignments Deterioration in quality of academic work Disruptive behavior in class (e.g., angry remarks, frequent interruptions)	Physical Deterioration of physical appearance Looking disheveled/not attending to personal hygiene Excessive fatigue Visible changes in weight
Personal/Interpersonal Frequent crying spells Social isolation/withdrawal Unprovoked anger or hostility Sad or anxious mood Significant confusion and/or bizarre statements	Safety/Risk Indicators Written or verbal statement expressing suicidal thoughts or thoughts of harming others Giving away of prized possessions History of suicidal thoughts or attempts Self-injuries or self-destructive behaviors Concerns about alcohol or other drug use

What Can You Do?

Talk to your friend
A direct expression of concern to your friend is an appropriate course of action if:
1. You feel comfortable doing so
2. Your friend is not in a serious mental health crisis (e.g., where immediate professional help is needed to address safety concerns or other extreme circumstances)
If you choose to speak with your friend, below are some tips to guide your discussion:
- Identify the right time and place. Make sure you find a private space and choose a time when you both can be uninterrupted and focused on the conversation.
- Do not promise confidentiality/secrets. Depending on what your friend discloses, you may have to alert professionals to make sure your friend and others remain safe. Although you cannot promise to keep anything a secret, you can promise to respect your friend’s privacy by only sharing information with professionals or others who can help if needed.
- Focus on the behaviors. Everyone can experience some discomfort when hearing feedback about themselves. The most effective way to decrease someone’s sensitivity and, at times, defensiveness in such situations is to: 1) focus on their behavior not their personality, and 2) avoid making interpretations about why they are engaging in the behavior. For example, it is better to say “I am concerned about you because I noticed you have not gone to class in a couple of weeks and you are sleeping a lot” rather than “I think you might be depressed.”
- Avoid judgment. Regardless of the situation or the circumstances, nobody likes to feel judged. You may have opinions about your friend’s behavior, but remember that the behavior reflects their struggle to cope effectively with stress or difficult emotions. Make an effort to be aware of your opinions and keep these private.
- Listen. Listening is more than just hearing what someone says-it is about someone feeling heard. General listening skills such as speaking softly, not interrupting, maintaining eye contact, reflecting back what you are hearing, clarifying, and being patient can be very helpful. Remember that silence can be golden and it provides someone with the opportunity to share more. So try to resist the temptation to fill in the silence if there are brief lapses in conversation.
- Suggest helpful resources. After you have given your friend space and time to respond to your concerns and share their reactions and feelings, try to engage them in collective brainstorming about a range of possible solutions. Remember there are numerous resources at ASU to assist students with challenges or stressors they are facing. If you are not sure what is available, ask a faculty or staff member. If you think your friend may benefit from speaking with a counselor, you can accompany your friend to any ASU Counseling Services location between 8a.m.-5p.m. M-F and ask to speak with a counselor. No appointment is necessary. Sometimes accompanying someone can be the additional support they need to seek professional help.
- Reconnect and follow up. Your friend may need time to digest and process your concerns-it can be a lot to take in all at once. After a few days, reconnect and check-in to see how they are doing. Express your genuine concern and offer further support or assistance.
Consult
Helping someone in distress can be overwhelming and stressful. Know that you are not alone and that there are numerous resources at ASU available to support you and to help make sure your friend gets help. For example, counselors are available 24/7 to discuss your concerns and to help you determine what path is best given your friend’s circumstances. Counselors can also inform you of other resources available to address challenges your friend may be experiencing. So take advantage of the support available to you and your friend through difficult times.

IN CASE OF AN EMERGENCY
If your friend appears to be in extreme distress and/or has made any statements suggesting their safety or the safety of others may be at risk, you need to consult immediately. During business hours, call ASU Counseling Services at 480-965-6146. After business hours and on weekends, call EMPACT’s 24-hour ASU-dedicated Crisis Line: 480-921-1006. If someone is in immediate danger, call 911.