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Talking to Mental Health Patients/Clients

The extent to which mental health patients/clients are willing to discuss traumatic events can vary, as well their emotional responses.  Feelings of fear, grief, anger, anxiety, worry, avoidance and guilt are all common. It’s important to remember to remain neutral and avoid expressing your own views or opinions with patients. If the subject of tragic or violent events arises during patient care, please refer to the tips below to help navigate those conversations: 

Actively listen by validating how patients/clients feel:

  • Redirect the conversation from discussion of events to talking about feelings and emotions.
  • Example: “It sounds like you have a lot of feelings about this. That makes sense to me.” 

Ask if events have triggered memories of other situations or events:

  • Memories may provoke painful emotions and negative behaviors (withdrawal, avoidance, hyper-vigilance)  as ways to cope with these events
  • Examples: “Have you found yourself thinking about things from the past?” or “Have you been in similar situations before?” 

Avoid clinical, diagnostic and pathological language:

  • You may see symptoms of clinical issues such as anxiety, depression, and PTSD, but steer away from language that connects to diagnosis
  • Example:  Instead of saying “That’s your depression talking,” say “Those kinds of feelings are normal.”

Communicate person to person rather than “expert” to “victim:”

  • Use straightforward terms
  • Foster rapport and trust by expressing genuine concern rather than the expert position of treating them as a victim of an event
  • Example: This is a really difficult time.  I’ve been wondering how this has affected you” or “How have you been coping with all of this?” 

Foster resilience in mental health patients/clients:

  • A strengths-based approach can promote long-term recovery by helping patients/clients adapt to traumatic events
  • The path to resilience varies from person to person
  • Example: “I’ve seen you get through a lot of hard times -- we can figure out this one too.”

Encourage patients/clients to minimize their exposure to media coverage:

  • Extensive media coverage can exacerbate negative emotions and serve as constant reminders of what happened
  • Place media coverage into context and remind patients/clients that there are also positive things occurring in the world
  • Example:  “I wonder if you and the kids could use a break from all the TV news.  How about turning off the TV and doing some activities with them tonight?”

Understand your comfort level with dealing with violent traumatic events:

  • Our own emotions can be triggered by our work.  Get help from co-workers or other practitioners to talk through your responses
  • Avoid discussing the situation, staff opinions or interpretation of the events in the presence of patients. This can inflame and evoke conflict.
  • Find a trusted co-worker to share your feelings with -- away from patient areas.

Listen carefully to how patients are responding:

  • Look for risky behavior, serious symptoms and signs of significant difficulty.  Encourage patients to seek help after being discharged.
  • For patients in crisis, share contact information for:

 

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