When someone you love has a mental illness, it's not always easy to know what to say or how to help. Sarah Hamid-Balma, director of public education and communications at the Canadian Mental Health Association's B.C. division, says that one-third of the calls the organization receives through its provincewide information line come from family members or friends who want to show their support but don't know how. Here are a few things that will help you convey that you care.

RECOGNIZE SYMPTOMS

The early warning signs of mental illness include weight gain or loss, changes in eating or sleeping patterns, nervousness or irritability, social withdrawal, apathy, and substance use or abuse, according to the Here to Help Web site (www.heretohelp.bc.ca), a project of the B.C. Partners for Mental Health and Addictions Information.

RULE OUT PHYSICAL CAUSES

Hamid-Balma notes some medical conditions can affect emotional or mental states. Encourage the person to see a doctor and offer to go along.

TALK

"If you care about someone, sit down and say, 'How are things going? I'm noticing you're not acting like yourself. Do you want to talk?'" says Hamid-Balma. "They may not come forward at that moment, but at least they know they have a safe harbour. It's all about compassion, not about judgment or trying to diagnose."

OFFER PRACTICAL SUGGESTIONS

A person with a mental disorder might acknowledge that something is wrong but might not know where to go for help. Hamid-Balma has numerous suggestions. The Crisis Intervention and Suicide Prevention Centre of British Columbia has a free, 24-hour, confidential distress line at 604-872-3311. Family doctors can refer patients to a psychiatrist, a psychologist, or a counsellor. And there's the B.C. Ministry of Health's free, 24-hour Mental Health Information Line at 604-669-7600.

ACCEPT THAT RELAPSES HAPPEN

Family members might be so focused on recovery that they fail to acknowledge that progress can come to a halt. "Good communication skills are vital, especially in relationships with added stress," Hamid-Balma says. "Express concern, but don't blame or shame them in any way. Recognize that mental illnesses are cyclical. When people are well, it's a good time to talk about prevention, side effects from medication, self-care, what they find helpful, and a crisis plan. It's very hard to do that when someone is really sick."