What to say when you want to ask ‘R U OK?’

Neelima Choahan

12/09/2018 3:37:54 PM

R U OK? Day is about starting a conversation and being a good listener. newsGP spoke with Dr Jenny Presser about the best way to ask the question, and what to do with the answer.

R U OK? Day aims to encourage family, friends and colleagues to start a conversation about mental wellbeing.
R U OK? Day aims to encourage family, friends and colleagues to start a conversation about mental wellbeing.

How do you ask someone if they are okay? And what do you do if they say they are not?
These are some of the questions that RACGP Tasmania Chair Dr Jenny Presser says make people reluctant to ask their family, friends and colleagues, ‘R U OK?’.
‘The purpose of the day was to encourage people to have the confidence to approach family or friends or work colleagues who seem to be struggling a bit with their mental health. To give people that confidence to make an approach and ask them about it,’ Dr Presser told newsGP.
‘[But] people are worried to ask because they don’t know what to do with the answer: “What if the person said they were really in trouble and I don’t know what to do?” So they were reluctant to ask the question.’
R U OK? Day is on 13 September this year. It started in 2009 to honour Barry Larkin, who died by suicide, and aims to connect and protect people from suicide.
According to a survey conducted by the charity, more than half of Australians, wanted someone to ask them if they were okay in the last 12 months, while 52% thought about asking someone if they were okay at least once, but didn’t.
Campaign Director Katherine Newton said every day should be R U OK? Day.
‘With around eight people taking their lives in Australia each day, and many more attempting, there’s still so much work to do,’ she said. ‘Each of us can be there for someone struggling with life by following R U OK?’s four steps and pointing people to available help.
‘Going forward, we want our statistics to reflect that the majority of Aussies are asking the question anytime they spot the signs that someone they care about is behaving out of the norm.’
R U OK?’s four steps:

  • Ask
  • Listen
  • Encourage action
  • Check in
So what is the best way to ask the question?
Dr Presser said there is no one-size-fits-all approach and the question depends on the circumstances.
‘You have got to do it in a way that feels comfortable for you,’ she said.
‘Often, a good way to ask is to base it on your concern. So to say, “I have been a bit worried about you”, and mention something that you have noticed, “I have noticed you haven’t been your usual sunny self”.
‘So you are not putting people in a defensive position.’
Dr Presser said asking people a direct question may also elicit an automatic response.
‘If you ask people how they are doing, you might get, “Yeah, I am okay”,’ she said.
‘Sometime people feel like it’s their fault if they are not doing okay – “I am not looking after myself, I am not resilient enough” – so turning it around and saying it’s about your concern … it’s not about them … can be a way where people can open up and talk about things.’
Dr Presser has found making a comment with which people can agree can also be a good option.
‘[You can say], “Jeez, things have been crazy around here, haven’t they?”,’ she said. ‘Or, “All this new work that the department has asked us to do, it’s nuts, isn’t it?”
‘And then they can agree, “Yeah, it’s nuts. I hate it”.’

Presser-photo-Article.jpgDr Jenny Presser says the way people ask ‘R U OK?’ depends on the situation, and it is important for people to ask in a way in which they are comfortable.
Dr Presser said however a person approaches the question, it is best to ask it in a secluded spot rather than “in the middle of the tearoom”. And if a person speaks up about their troubles, the best thing to do is to validate them, rather than trying to provide and immediate solution.
‘What you can do with the answer is to realise that you don’t have to deal with the answer,’ Dr Presser said.
‘All you have to do is say, “I am here to help, and you are not alone and I can connect you with people who are able to support you”.’
Dr Presser said, in some circumstances, it might be good to ask if the person wants to call their family or even a medical practitioner, including a GP.  She said people can also gather information from websites like beyondblue or Lifeline to handout.
But it is better to try again another day rather than push someone who doesn’t admit to anything being wrong.
‘So if you have asked the question and they have said no, it’s not necessarily worth making a big fuss at that time and making them feel defensive and upset,’ Dr Presser said.
‘Come back the next day and say, “I noticed you were late this morning. I am still worried about you. Are you sure there is nothing I can help with?”
‘It’s more common for [people] not to say something the first time, but if you continue to let them know that you are worried about them, that you are happy to help them, then you might be able to talk about it the second time or the third time.’
Dr Presser believes a common misconception is that talking about suicide will negatively affect the medical health of the distressed person.
‘People definitely shouldn’t be too scared to ask if they are really worried about someone if they are thinking of suicide,’ she said.
‘It doesn’t make people feel more suicidal when you ask them.
‘As a friend or a colleague you might just say, “Have you been thinking about suicide?” Obviously, it is not the first question you ask.’
If the person answers in the affirmative, Dr Presser said people can offer to help them connect with support, as well as encourage them to talk to their family.
‘If their family is aware of how they are feeling, that makes them so much safer as well,’ she explained.
GPs can take the same approach to their patients and probe deeper for any underlying issues.
‘I am sure all GPs know [that] quite often you will get a presentation with something else and underlying is the distress that’s been going on,’ Dr Presser said.
‘They have come in for their cervical screening test or they have come in with a cold, and if you ask, “Have you been feeling a bit rundown recently?” you will get the whole story about all the terrible things that have been going on.’
Dr Presser believes everyone should ask that kind of ‘check-in question’, whether they are a patient, family or friend.
‘Someone might say, “I am just tired. Thank you for asking”, but they won’t be upset [that you have asked],’ Dr Presser said.
‘R U OK? Day is about that cultural change for all of us … to … [bring mental health issues] into the open, into the workplaces and the sports club.’

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