mental health & wellness

How to Hear Sad Stories: With Mental Health First Aid

Well, I took my own blog’s advice recently and shared a sad story with someone (not with humor, alas, but perhaps with some holiness).

Gratefully, the person listened well, joining the handful of other effective listeners I’ve experienced and observed. So, now, I’m turning to the topic: How should we hear sad stories?

Mental Health First Aid training teaches 5 steps (A-L-G-E-E) for responding, in particular, to signs of mental illness. After going through A-L-G-E-E training in 2013, I’ve realized I have some favorite ways to respond to others and be responded to, described below.

  1. Assess for risk of suicide or harm. My favorite assessment response: SPECIFICITY. Like this: “Are you having suicidal thoughts?” Some people say that asking someone about suicidal thoughts might cause the person to start having suicidal thoughts. But, mental health professionals say that it’s a highly effective question. And I say it’s a highly beautiful question. It says to the hurting individual: “I so truly believe that your life is valuable that I want to make sure you believe it too.”    
  2. Listen nonjudgmentally. My favorite listening response: AWKWARDNESS. (Not in the sense of middle-school-cafeteria awkwardness but in the sense that mental illness just isn’t talked about very often, so it’s guaranteed to be a bit uncomfortable, and we have to accept that.) Ask an open-ended question like “Why are you having suicidal thoughts?” or “What are you thinking right now?” then sit back, make some eye contact, and let the silence settle in. Give the person time to identify their thoughts/feelings, ascribe words to those thoughts/feelings, and muster up the courage to share those words with you. As they share, keep up the eye contact, try not to look surprised by what they share, try not to interrupt, and occasionally re-phrase things they’re saying. Like this: “What I hear you saying is…”  
  3. Give reassurance and information. Favorite reassurance response: PRESENCE. The key is to say: I’m here, I’ll continue to be here, and you can continue to find me here. Like this: “Thank you for trusting me with this part of your life; I know that took courage. Let’s make it an ongoing conversation. You can reach me at _phone number, email address, etc._.”   
  4. Encourage appropriate professional help. Favorite helping response: SPECIFICITY again. Don’t wait for them to bring up the topic of professional help; chances are they won’t bring that up, so go ahead and say it. Like this: “Would you like a referral to a mental health professional?” See #1 for why this is great. It’s specific. It’s tangible. It’s a gift.
  5. Encourage self-help and other support strategies. Favorite strategizing response: INDIVIDUALIZATION. Generally, people really do know how to help themselves — they just might need some leading questions to realize it. Like this: “What’s helped you in the past?” or “How could your hobbies be used to help you in the future?” Individualization puts people in control of their self-care plans and increases the likelihood that they’ll follow through on implementing them.


You don’t need to be a licensed professional to listen well. You need to be a friend (or pastor or teacher or whatever you are).

As a friend, the best thing you can do is be specific, be willing to feel just a little bit awkward, and be very present.

2 thoughts on “How to Hear Sad Stories: With Mental Health First Aid”

  1. Wonderful list with concrete examples. Thanks for this. I especially appreciate the first and last items–easy to forget/avoid or think ‘unimportant.’

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