12 Insights in How to Respond when it is Insisted that Mental Unwellness be kept Private.

1. Know your capabilities. Are you truly capable of giving them the very best of care? The majority of us are not, and even professionals will enlist others to give an opinion on such matters, particularly when there is a personal involvement.
2. Accept the pivotal role you have. You can be a great family member, parent, friend etc and they will need you for this.
3. Share the load. People can place incredibly difficult privacy burdens on us. For this situation I advised the family to talk about the situation with some medical professionals, just to get some advice for themselves. Mental health professionals make assessments of wellness all the time. They know what to look for. They also know what is available to help both the person involved and their family and friends. If for no other reason, involve others for your own sake, because you are worth it. You don’t need tell the person involved you are doing this because its actually about you and not them. You need the help.
4. Don’t tell the whole world. The person does need some privacy. If you are wanting to tell others, who have no real business in knowing, then check out the underlying motivations for doing so. Are you seeking sympathy,support, validation etc…
5. Get help for yourself. Their recovery is ultimately their responsibility but you will need others around you for your support. It may well be others who have been through similar situations, be might be a pastor, counselor or safe friends. Just someone who can be your confidant and cheerleader.  
6. Get on with life yourself. Don’t allow yourself to become a victim of their unwellness. This can potentially create unhealthy dependencies. They will need to see good role modelling of what life is all about. Self care is not being selfish. It will enable you to ride through many storms without drowning.
7. Tell them your Boundaries. ‘This is what I can do and this is what I can’t’. You may need to write the boundaries out for them.
8. Affirm your commitment to them and encourage Hope. Tell them that you care about them and want the very best for them and that sometimes this love and care means making tough calls nobody, especially yourself, likes to make. Tell them that there is an answer out there and together we need to go on a journey of discovery to find it.  
9. Early Warning Signs. What are the Early Warning Signs of them becoming unwell. Often there are signs that indicate that danger and further unwellness is ahead. What are they? Is it withdrawal, lack of sleep or something even more subtle that they themselves might be totally unaware of. Check out this article. I often put these on a graph asking what happens before/ after eg a lack of sleep etc. A good question to ask them is what needs to happen when these signs appear – call my nurse, Doctor?
10. Privacy limits. I always say to the person that I will keep what they say as being private unless I consider in my opinion that they are a danger to themselves (self harm etc) or  a danger to others. The weight of carrying the responsibility of someone elses unwellness is too great for anyone.
11. Create a recovery community. Recovery will involve many different people with many different roles. It may well involve the professional doctor, nurse, therapist, but in the long term it will be the friends, family, work colleagues, church members etc that will be the cheerleaders of recovery.
12. Ask them what it is that they fear if disclosure is made. They might well fear rejection from family, friends etc. Better to problem solve this and discuss who would be safe people that help can be sought from.

1. Are there other insights you have?
2. What is the danger for you and them by keeping things too private?
3. What do people fear if their mental illness is made known?

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