Wanting to help someone can have powerful, positive consequences. Reaching out to a friend, family member or colleague at work can let that person know they have a support network. It can act as a timely reminder they are not alone, especially during moments of high stress or a mental health crisis.
However, not all attempts to help someone go to plan. There may be barriers to an effective conversation like poor timing or even help refusal. Readiness to participate in a mental health conversation, or even the ability to divulge what may be troubling them, can also influence the outcome of an approach and offer to help. It may be that the vulnerability required to share personal experiences, thoughts, and feelings is simply too much for someone to consider at a particular point in time.
Yet, declining help isn’t always the end of the conversation – in fact it can be an opportunity to rethink the approach or consider other ways to reach a person.
Learn the art of reframing a mental health conversation that hasn’t gone to plan as a step toward a positive change in the future.
Why would someone refuse help?
Even with the most compassionate, well-timed approach, a person might not accept help when offered. The reasons are often a mix of situations, beliefs, experiences, and upbringing.
Understanding why someone may not want help can be of use in deciding the next steps.
The decision to decline help may be influenced by:
- Stigmatising beliefs, the difficulty of communicating needs, or a preference for self-reliance
- Their previous experiences. For example, someone may hesitate to open up if they have previously been excluded or discriminated against because of their sexuality, race, belief, disability, age or gender
- There may be a lack of culturally sensitive, tailored supports available
- Experiences of asking for help that have not gone to plan or have reaffirmed doubts about seeking help. For example, someone may be reluctant to seek help if a previous attempt has not been effective or has provided a negative experience, if they have encountered an unavailability of treatment or resources, or if they found minimal relief from the options explored
- A lack of insight about how professional help may be beneficial. This may be present in a person with disordered thinking or a mental health condition, or if they are experiencing psychosis
- The influence of drugs or alcohol on their thinking and mood. This includes casual usage, the effects of a hangover, dependence and other substance use problems, or the cognitive impact of prolonged substance use
- Deeply ingrained belief systems conflicting with mental health messaging. It may be difficult to reach someone in need of help if their belief system views mental health symptoms as a religious sign or observance, or if it actively shuns seeking mental health support services
- A lack of understanding of what mental health support or treatment involves. This can include assumptions about cost, the delivery methods, the commitment on the help seeker’s part, or what’s involved in receiving support
- A history of trauma and issues with self-esteem or self-worth. Someone who has felt excluded, devalued or rejected at crucial stages of psychological development, or as a regular feature of their life via exclusion or abuse, may feel undeserving of help.
People can decline help for a single reason or a combination of factors. That’s why investigating the situation and keeping an objective, person-centred approach is paramount.
What to do if someone refuses help
In any situation where the offer of help has been refused, it’s important not to take any rebuff personally, and to remain objective and focused on the person.
Consider the following steps:
Identify why the help was declined
No one knows exactly what is going on in another person’s life or mind, or what pressures and problems they may be facing. Sometimes, the best course of action is to try to identify the reasons that someone might have rejected an offer of help. Often these are not immediately visible.
This may include:
- Asking questions to understand a person’s reasons for refusing help
- Challenging preconceptions and assumptions in a supportive, thoughtful and non-judgemental way
- Providing information about specific barriers to seeking help, such as cost, accessibility, privacy or cultural appropriateness.
This should always be done with respect and a positive regard for the person you are trying to support. This includes using non-judgemental language and ensuring the person’s safety is at the centre of the exploration at all times.
Keep the door open
Any approach to initiate a mental health conversation is not time wasted – even if the offer is initially rebuffed. Sometimes, a person may need time to reflect on the offer of help and come back to the idea of support on their own terms. Opening the door and ensuring that door stays open is a big part of making that happen.
Letting someone know that they can revisit a mental health conversation may include:
- Checking in with how they felt after the previous approach
- Apologising if your own reflection on the conversation identified barriers like poor timing, too much pressure to talk or not listening as well as you could have
- Reaffirming that the door is open if they want to revisit the conversation in the future. This is especially helpful if they approach you to apologise for their rebuff
- Ensuring rejection doesn’t get the better of your mood or behaviour. Aim to be consistent in how you treat the person before, during, and after any mental health conversation.
Consider making another approach
Before you re-approach someone who has previously refused help, check in with the following questions:
- Am I the correct person for re-approaching this person?
- Is this person ready to talk or do they need more time?
- Are they capable of holding a meaningful conversation right now?
- Am I respecting their boundaries?
- Is the environment I am creating for disclosure welcoming, open and pressure-free?
- Should I encourage this person to call a support service or investigate another option instead?
If you feel a person would benefit from another attempt to engage in a mental health first aid conversation, have your ALGEE Action Plan on hand as a reference and guide:
Embody genuine care for their welfare
Genuine care for another person’s welfare is not about ensuring they follow a roadmap or a complete mental health conversation. Sometimes, it’s about making difficult choices.
Genuine care may involve:
- Respecting a person’s choices about where, when and why they seek help
- Intervening if their behaviour puts them at risk of accident, injury, self-harm or suicide
- Seeking guidance or assistance if their behaviour potentially puts others at risk of abuse, violence or safety issues such as intoxication in the workplace or in relation to children in their care.
Offer other options for support
Sometimes, it’s helpful to focus on promoting services that offer privacy and the flexibility for the individual to engage when they feel the time is right. These telehealth services are provided free of charge and have a database of resources available that that they can utilise to provide additional support after the phone call has ended.
