Health Matters: Recognizing Mental Health Concerns and How to Help


By Deborah Millar, RN

Chances are you or someone you know has experienced a mental health issue.

In fact, according to the National Institute of Mental Health, one out of every five adults will experience a diagnosable mental illness in any given year. In children and teens ages 6 to 17, the rate is one in six.

Being able to recognize a mental health issue and knowing how to address it are invaluable skills. Penn Medicine Princeton Health has partnered with the Mental Health First Aid program from the National Council for Mental Wellness to offer training sessions to help you identify and understand signs and symptoms of individuals who may be dealing with a mental health challenge and to learn how to respond.

No Single Cause

A mental health problem is a serious condition that can affect how a person thinks, feels or behaves. Mental health issues may persist over time or can occur on occasion.  Examples of mental health issues include depression, anxiety, substance use, eating disorders, trauma, psychosis and deliberate self-injury.

While there is no single cause of a mental health condition, the National Institutes of Health outlines several risk factors, including:

  • Family history of mental health challenges.
  • Biological factors, such as genetics or brain chemistry.
  • Current or past trauma or abuse.
  • Lifestyle habits including diet, physical activity and substance use.
  • Life experiences, such as stressful situations like financial problems, a loved one’s death or divorce.
  • Having a serious medical condition, like cancer.
  • Having few friends and feeling lonely or isolated.
  • A previous mental illness.

What to Watch For

Every person who suffers with a mental health condition experiences their own unique symptoms that can sometimes overlap. However, there are common signs to watch for if you think an adult or teen in your life may be experiencing mental illness. These include:

• Excessive anxiety, worry or fear.

• Extreme mood changes, including periods of euphoria.

• Prolonged anger or extreme irritability.

• Changes in sleeping habits, exhaustion and low energy.

• Increased hunger or lack of appetite.

• Reliance on or overuse of alcohol or drugs.

• Thoughts of committing suicide or self-harm.

• Confusion, difficulty concentrating, struggling to carry out daily activities.

• Intense concerns about weight gain or unhealthy concern with physical appearance.

When mental health issues develop in young children who aren’t equipped to identify or describe their feelings, symptoms may present as behavioral issues and can include:

• Frequent and prolonged temper tantrums.

• Hyperactivity.

• Regular nightmares.

• Refusal to behave, acting aggressively.

• Excessive worry or anxiety.

• Changes in school performance.

How You Can Help

If a friend or family member exhibits any of the above symptoms, it is important to learn more about what they are experiencing and whether it is affecting their daily life.

Mental Health First Aid is a public education program that teaches people how to identify, understand and respond to signs of mental illness and substance abuse. The purpose of the program is to give people the tools they need to talk about mental health and substance use with someone they care about.

The program lays out a Mental Health First Aid Action Plan that follows five key steps:

• Assess for risk of suicide or harm. When helping someone through a mental health crisis, first look for signs of suicidal thoughts and behaviors or other self-harm.

• Listen non-judgmentally. Being a skilled and patient listener is critical to helping the person feel accepted and understood.

• Give reassurance and information. Provide emotional support and practical help without placing blame.

• Encourage appropriate professional help. There are many professionals who can help someone who is experiencing a mental health issue.

• Encourage self-help and other support strategies. Offer tips that can contribute to a person’s recovery including exercise, socialization, meditation, support groups, and more.

In addition, the program offers tips on how to communicate effectively and be a good listener, including:

• Ask questions that show you genuinely care and seek clarification about what you are hearing.

• Check your understanding by restating what your friend or family member has said and summarizing facts and feelings.

• Listen to what the person says, as well as how it is said. Tone of voice and nonverbal cues will give extra clues about feelings.

• Be patient, even when the person may not be communicating well or is speaking less clearly than usual.

• Be careful to not be critical or express frustration with the person.

• Avoid giving unhelpful advice such as “pull yourself together” or “cheer up.”

• Do not interrupt the person, especially to share your opinions or experiences.

• Avoid confrontation unless necessary to prevent harmful or dangerous acts.

• Maintain comfortable eye contact and an open body position. Don’t cross your arms over your body, as this may appear defensive.

• Reassure the person that, with time and help, they will feel better.

Connect to Care

There are a variety of health professionals who can provide help to someone experiencing a mental health issue. They are:

• Primary care physicians.
• Mental health professionals.
• Certified peer specialists.
• Psychiatrists.

If a person is uncertain about what to do, encourage them to contact their primary care physician, who can check for an underlying physical health cause or refer the person to a mental health professional.

If you have reason to believe someone is suicidal, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

The Mental Health First Aid training program offered through Princeton Health is designed to help people identify and understand signs and symptoms of a mental health condition. Participants also learn how to respond in a mental health crisis, offer support to someone who appears to be in emotional distress, and if, if necessary, guide the person to appropriate services. Training sessions are offered in-person as well as virtually. Advanced registration is required.

To learn more or to register, visit

To find a physician affiliated with Princeton Health, call 888-742-7496 or visit

Deborah Millar, RN, is director of Community Wellness and Engagement for Penn Medicine Princeton Health.