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Warning Signs

How do you know when someone you care about is struggling with a behavioral or mental health issue? The signs are not always obvious, or easy to talk about.

Regional Primary Care Network, in partnership with the United Health Foundation, has developed the #SpeakTheUnspeakable Campaign to assist in identifying some potential warning signs. Below are some symptoms, ways to approach a conversation with someone you’re concerned about, and next steps in connecting them with assistance. A good first step can be their primary care provider, as many primary care practices now have resources available to treat behavioral and mental health concerns right in the office.


If you notice something is out of place with a friend or loved one, don’t let it go unspoken. Symptoms and warning signs of a behavioral or mental health struggle can show up in different ways for different people. Here are some potential signs:

Social withdrawal from friends and loved ones

Changes in showering, sleeping, or eating patterns

Sudden changes in mood or behavior; or you get the feeling you’re walking on eggshells around them

Falling behind on responsibilities like paying bills, home upkeep or taking care of family members

Increased substance use or other risky behaviors

Excessive engagement in addictive behaviors such as video games, gambling or shopping


Behavioral or mental health issues can affect anyone. Too often we avoid conversations about these topics because they are uncomfortable or we don't know how to talk about them. However, talking with a friend or loved one when we're concerned about them can be a good first step in getting them the support they need. Here are some tips for having a productive conversation with a friend or loved one you're concerned about:

Express concern. Tell them specifically what you have observed. “I’ve noticed your mail has been piling up.” “I’ve noticed you’re drinking more than before.”  “I’m worried about you.”

Ask what they are experiencing. “Are you OK?”

Ask again. “Are you really OK?” Ask again if necessary. “Are you sure?”

Listen. If they begin opening up about what they are experiencing, listen. Do not interrupt, do not make the situation about you, do not judge. “Do you want to tell me more about that?”

Validate. Acknowledge what they are experiencing sounds difficult and you hear what they are struggling with. “It sounds like it’s been a really tough few weeks.”

Offer support. Offer to be there for them to the extent you are able. “I’m glad you told me." "I am here for you." "How can I help?”

Direct them to a professional. Suggest they speak to their primary care provider. “Have you thought about talking to someone about this? I’ve heard your primary care provider can be a good first step in finding the help you need.”

If this is an emergency, or you are need of immediate assistance, call 911 or go to your nearest emergency room.

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