Communication can be a struggle for many people with a mental health disorder. Some people don't have the motivation to communicate, while others lack the confidence to say what they really want to. Some people experience hallucinations, which can affect how and when they communicate.

To help the person you care for communicate, give them enough time to make themselves heard and let them know that you accept them and their disorder. Often, people with mental health problems feel cut off from other people, including family, friends and neighbours.

It's important to listen to what they've got to say and to let them express themselves without interrupting or offering your opinion. Encourage and reassure them if they get upset or appear to be struggling with their emotions.

You may have known the person you care for before they had their mental health disorder. It's important to remember that they just happen to be going through a period of mental distress.

Diagnosis

If you care for someone who appears to have a mental health problem, they may not have sought medical advice or they may be struggling to get a specific diagnosis. Do not diagnose mental health problems yourself. A mental health diagnosis will usually be made by a psychiatrist with input from other healthcare professionals.

Getting a definite diagnosis of a mental health disorder can be difficult because there are no definitive physical tests. A diagnosis will usually be made by collecting lists of symptoms and a medical history. As a carer, you may also be asked to describe your experience of their illness.

The local doctor is an important contact for you. They can create a mental health care plan for the person and this will be a vital early step in your caring regime.

If the person you care for doesn't agree with their initial diagnosis, they can get a second opinion.

Confidentiality

People who care for someone with a mental health disorder may find that some healthcare professionals are reluctant or unwilling to share information with them. This can be very frustrating since very often the carer has the fullest picture of the person's condition. However, mental healthcare professionals are legally bound to protect the confidentiality of their patients, so they may be unable, rather than unwilling, to talk about care needs.

To avoid this problem, try to get the consent of the person you care for to discuss their care needs as early as possible after their diagnosis. This consent should be made clear on any care plans or documentation relating to their care, and any changes to this consent should be clearly noted.

Mental healthcare professionals may not be able to share certain personal details about the mental health of the person you care for, but this doesn't mean that they should not listen to your perspective.

Establishing the limits

You'll need to have a conversation with the person you care for about what you are and what you are not prepared to do. You may need to be firm with your decision. If you feel you're doing too much, see if someone else can share the caring responsibility with you.

Behaviour

If the person you care for is feeling particularly isolated or desperate, they may say that they want to kill themselves, or they may attempt to do so.

Mentioning suicide may not be the same thing as wanting to end their life. They may say that they feel overwhelmed and want it to end, or talk about feeling useless or that their life is pointless. It's important to acknowledge such statements rather than being dismissive or making light of them.

You may be worried about your safety or the safety of the person you care for or someone else. In this case, consider getting an urgent assessment for the person you care for, as well as a carer's assessment for yourself.

This may be carried out by a community mental health team already known to you, or your local hospital.

If you believe that you or anyone else is in immediate danger, call triple zero (000) and ask for an ambulance to take them to the emergency department of the nearest hospital. Police may also be involved if the person is agitated, aggressive or a risk to themselves or others.

The person you care for should be consulted at every stage of treatment and can only have treatment or tests with their consent, unless they're detained under the Mental Health Act relevant to the state or territory you live in.

Effective carer checklist

An effective carer check list may look like this:

• Ensure the condition is properly diagnosed.
• Know and establish the professional support network.
• Access the relevant information about how best to behave and what to expect.
• Look after yourself and know where to find support for your needs.
• Know the danger signals and how to respond.

Support and resources

If you're struggling to care for someone with a mental health problem, it may help to talk to other carers in a similar situation to you. Some local carers' organisations have separate meetings for carers of people with mental health problems which the local mental health team could provide contact details for.

The person you care for may become increasingly reliant on you. It's common for people with a mental health diagnosis, such as depression, to become insular and lose interest in social activities. You may be one of the few people they have contact with.

Looking after yourself

Although it's important to support the person you care for, it's essential to look after your own mental health too. It's important to maintain your own social activities. If you start to feel depressed, anxious or overwhelmed, it may be time to speak to your doctor about the impact your caring role is having on your emotional and mental health.