Being an active mental health bystander


You might have read the title of this article with suspicion, wondering whether it would be accusing you or talking about someone else in society, some insensitive other who hasn’t quite chimed in to the mental health conversation. The truth is that the idea of a passive mental health bystander is not a label I would identify with, as I already know the key signs of mental health struggles. But then I realised I fall short. I am in fact quite awkward when talking to someone about their mental health. What would I do if a friend of a friend was having trouble? Have I even ever noticed who is in trouble?

The NHS names a lot of poor mental health symptoms on their website. Only by going through some of them have I realised that many have ended up being the butt of jokes around the student dinner table. These include: neglecting appearance or hygiene, increased alcohol consumption, loss of motivation, fatigue, prolonged low periods and fluctuations in weight.

What is the point when sighs of “ahh I’m so tired”, “I can’t be arsed with this anymore” or “one more pint won’t hurt” become more than everyday student chat and equate to mental health struggles? This generation is truly a strong force for raising awareness about mental health issues, but let’s not get complacent. We need to check ourselves and really ask if that person is coping, without dismissing these as casual comments within the homogeneity of student experience.

Mental health is undeniably personal. Speaking to students who have struggled with mental health issues, the biggest problem seems to be that we struggle to decipher symptoms and are unsure how to approach problems. Yet, there is an arsenal of strategies we can use to start an open conversation with someone who we think might be struggling: approach with caution; be non-judgemental; be patient; remember that, in most cases, you presence is more useful than your words.

Your presence is more useful than your words.

A very practical example of when these strategies can be implemented is a panic attack. Remember that mental health difficulties can affect anyone, at any time, your approach should be adaptable to both friends and strangers. Mental health advisors are very clear on the first point of action: stay calm yourself but don’t dictate this to the person suffering. A panic attack can be characterised by shortness of breath, increased heart palpitations, a sense of disorientation from reality and a feeling of complete lack of control. It is helpful to think of your words as currency: use them wisely. Avoid reflex comments such as “don’t worry, there’s no need to panic,” as this could seem unsympathetic and patronising.

If you are with a friend, use the luxury of familiarity to your advantage and lean into it. Maintain eye contact and suggest they breathe with you or breathe following your arm movements up and down. Try and get the person out of a busy area, reassure and encourage them that they are doing well and are safe. If you are trying to help a stranger, it is paramount that they feel especially safe, as the trust is not pre-existing. Holding their hand can be helpful, but this must always be consensual, or you can try refocusing their attention on a random object by asking them to describe it.

The bulwark against the escalation of mental health problems relies on professionals’ advice of patience, understanding and listening – more so than speaking. So to avoid becoming passive mental health bystanders, let us be keen observers and active listeners and helpers. If you see something, say something, or at least sit next to the person so they know they’re not alone.


Illustration by

Leave a Reply

Your email address will not be published.


This site uses Akismet to reduce spam. Learn how your comment data is processed.