Supporting someone who is struggling

How to start a conversation

The hardest part is often the first sentence. Many people worry about saying the wrong thing, so they say nothing at all. But silence is usually worse than an imperfect conversation.

Choose a private, calm moment. Don't force the conversation in front of others. If they don't want to talk, say: "That's okay. I'm here whenever you're ready." And mean it.

Signs to watch for

People in distress don't always say they're struggling. Often the signs are behavioural. Here's what to look for in different groups.

In young people

• Withdrawal. Pulling away from friends, family, church, school, or activities they used to enjoy.
• Anger or irritability. Sudden outbursts, fighting, or hostility — especially when it's out of character.
• Substance use. Increased use of alcohol, drugs, or inhalants.
• Declining performance. Stopping homework, quitting school, losing interest in learning.
• Giving away possessions. A serious warning sign — especially if combined with talk about being a burden.
• Talk about death or hopelessness. "There's no point", "Nobody would miss me", "I want to sleep and not wake up."

In adults

• Somatic complaints. Persistent headaches, chest pain, stomach pain, fatigue — that don't respond to medical treatment. In Swahili this is sometimes described as msongo wa mawazo ("too many thoughts").
• Isolation. Staying inside, refusing visits, dropping out of faith groups, stopping market activity.
• Sleep changes. Sleeping much more than usual or not sleeping at all.
• Neglecting children or responsibilities. Not a moral failing — it's a sign the person has exhausted their capacity.
• Hopelessness about resettlement or the future. Expressed as "Nothing will change", "We are forgotten."

Practical steps

1. 1
   If someone is in immediate danger — acting on suicidal thoughts, self-harming, or in a violent situation — go directly to Get help now. Do not leave them alone if you can safely stay.
2. 2
   Offer to accompany them. Walking with someone to JRS, the health centre, or IAFR is one of the most effective things you can do. The barrier is often not willingness but fear of going alone.
3. 3
   Help with language. If they speak Kinyarwanda, Kirundi, or Somali and the counselor speaks English or Chichewa, help them find an interpreter or a service provider who shares their language.
4. 4
   Reduce shame. Remind them that mental health is health. Most people who seek counseling look and function like everyone else. They don't need to be "crazy" to ask for help.
5. 5
   If formal counseling feels too big, start smaller. A church leader, home-based care worker, peer group, sports team, or art group can all be a first step toward connection.
6. 6
   Follow up. Don't let a single conversation be the end. Check in again in a few days. Consistency matters more than perfection.

Looking after yourself

Supporting someone in distress is emotionally demanding. If you're regularly absorbing someone else's pain — as a parent, as a teacher, as a friend — you need your own support.

• You are not their therapist. Your role is to listen, to care, and to connect them with help. You are not responsible for fixing their mental health.
• Talk to someone you trust. You can share that you're finding it hard without breaking the other person's confidence. "I've been supporting someone going through a tough time and it's weighing on me" is enough.
• Set limits. It's okay to say "I want to help, but I need to rest today. Can we continue tomorrow?"
• Use the same services. JRS, IAFR, and faith-based groups are available to supporters too. You don't have to be in crisis to access them.

Where to refer someone