Today is the day to review mental health

Seriously and with no judgment, how are you going?

We've become much better asking those around us about their mental and emotional state and the concept of R U OK? Day has been a great help, but once someone eventually feels comfortable opening up, do we know how to support them?

Today, Thursday, September 10, is the day when we are reminded to ask people around us how they are feeling but let's discuss the next step.

Albany-based psychiatrist Noel Collins, who specialises in treating older adults, said when asking someone about their mental wellbeing, we need to be prepared for any answer and always be compassionate.

"First of all, it's good that person has expressed concern about their friend/loved one and an intention to help - that on its own can be very useful because asking someone how they're going is quite a powerful intervention on its own," Dr Collins said.

"Because you have asked that question, you might have a sense that the answer may be no, either verbally or non-verbally - sometimes men will say they're OK but their face or body might show a different story."

Dr Collins said it was important to prepare for the conversation - try to talk to the person in a private setting that will feel more comfortable for them to open up.

"Some emotion might come, there might be some tears which is fine because it's good to let feelings flow, but of course if you ask in a place like the supermarket then people might get embarrassed," he said.

Rather than providing advice on how to fix their problems, the key thing to do during the conversation is to listen to the person.

"When the conversation gets going, there is a lot of listening to give the person a chance to describe what is going on and how they're feeling," Dr Collins said.

"It might be the first time that someone has asked this person how they're feeling, so you might open the floodgates a little but that's OK.

"You don't have to jump in and ask lots of questions.

"The first part of it is usually just listening to the person, although some gentle questions about the situation might be helpful, particularly if you're not sure what the problem is.

"Follow your instinct about what's helpful in that moment - is it more listening, more questioning or a combination of both - if you're reasonably close to them you will have an inkling to know what to do."

Whether or not the person opens up about their feelings, it's important to let them know the conversation can be continued and the more you do this, the person will become more comfortable to open up with you in the future.

"Make the person aware that this is an open offer and the beginning of a conversation, not the end of it, Dr Collins said.

"Sometimes that one-off conversation might be all the person needs but they might also want to continue the conversation, so perhaps discuss where you should meet and what they'd like to do."

Perhaps the conversation might spark some concerns for the person's welfare.

"If throughout the conversation it becomes clear there are other concerns where they might need someone else's input, then suggest seeing a GP would be a good idea and GPs can refer for a mental health care plan with free counselling up to about 10-12 sessions," Dr Collins said.

"There are great counselling services in rural areas and GPs will know about them."

While it is unlikely, Dr Collins said you could be left with concerns about the person's safety because they have expressed suicidal thoughts, then it might be best for them go to a hospital emergency department.

"It's important for them to know that there is always someone available 24/7, both in person and over the phone and both friends/family and professionals," Dr Collins said.

Some of the thoughts the person reveals could sound very concerning, especially if it's the first time you have heard someone say such things about themselves.

Dr Collins advised not to appear shocked by the person's responses and not to force them into anything, but make them feel supported.

"It's important to be compassionate and not judgmental," he said.

"We need to realise that when people are in dark places their minds can also be dark, so for us as the person wanting to help, it's not about reacting or shutting down the person's thoughts but encouraging them to think about what could be useful for them.

"We want to support people to make their own decisions and they might not know their local GP can be helpful with this.

"People might feel helpless with what's going on - it might be finances, a relationship problem or a poor season, but try and maximise their autonomy and involve them in the discussion.

"You could say something like, 'you're in a really bad way, should we talk to your wife/husband or child etc and involve them in this conversation?'."

Dr Collins also highlighted that professional help was available in many forms and counselling nowadays was much more than just sitting on a couch and talking about your childhood.

"These days counselling and talking therapy can be very pragmatic and future focused - it can be problem solving; involve cognitive behaviour therapy where people look at how they're feeling and how that's linked to their thinking styles and also behaviours," he said.

"People can share what they feel comfortable sharing, they don't necessarily have to talk about the past."