How to have a conversation with someone who tells you they're not OK.

This post contains details of depression and suicide, and may be triggering for some readers.

Today, the second Thursday of September, is R U OK? day.

The campaign is a national nudge to ask our friends and family how they are - like, really are - and to encourage an ongoing conversation about mental health. 

Research tells us that one in four Australians feel lonely and have no one to speak to, according to Lifeline Australia. We also know that suicide is the number one killer of young people in Australia. 

So having these conversations are as important as they can be uncomfortable. 

Mamamia spoke with clinical psychologist Cliff Battley about how exactly to navigate these discussions.

1. Start with an empathetic statement.

Starting the conversation can often be the hardest, and Battley explains it's important to be gentle in your approach. 

Here are some conversation starters he provided: 

• "You don't seem yourself lately."

• "I noticed you seem a little more down than normal."

• "You're normally such a happy person. I just noticed that spark is not there today."

• "You're always so upbeat. I just noticed today you don't seem as good."

• "Hey, time's are tough, aren't they? I know how you feel."

The clinical psychologist, who has over 25 years experience in the field, shares: "The best thing you can always do is make some specific positive compliments first - something you genuinely love about this person - to let them know that you are here for them."

He adds that it is important to "make the discussion safe," and to "show empathy and vulnerability".

If the person admits they are struggling, and a conversation ensues, Battley suggests gateway statements that will "allow the person the freedom to open up to you". Here are some examples:

• The challenges of life can get you down. It's 100 per cent normal to feel this way."

• "It's absolutely fine to have feelings."

• "I'm your friend when you are happy, why wouldn't I be your friend when you're sad?"

• "You're my friend no matter what. I'll always be here for you."

Battley adds you can "remind them of how well they've done in a previous challenge in life," and let them know "how many people genuinely care about them in the world".

Listen to The Quicky, Mamamia's daily news podcast. Post continues below. 

2. Can I help you? 

If the person admits they are struggling, the next step is to move to ways to help them. This is a good time to bring up solutions and suggestions, Battley says.

There are easy ways to ask this, and could be as simple as:

• "Is there something I could do?"

• "Would you like me to to help you?"

• "Is there anything you have in mind?"

If the person admits they are struggling, the next step is to move to ways to help them . Image: Getty. 

3. What might that help be? 

The person may have ideas themselves for useful ways they can move forward. If not, they may tell you, "I genuinely need help, but I don't know what to do - I'm stuck and I'm lonely."

"That's your gateway to perhaps suggesting they seek help," Battley says, sharing some gentle ways to ask this:

• "Have you thought about seeing a GP that you trust?"

• "Have you thought about a counsellor or a psychologist?"

• "Have you thought about anyone else you can talk to?"

Battley emphasises that throughout the conversation, it's important to let the person know how much they matter to you and that you genuinely care about them. Here are some ways to say this:

• "You know I'm here for you when you're happy or sad."

• "You know our friendship is not dependent on moods."

What if the person initially dismisses the conversation?

The clinical psychologist says it will be common for people suffering from depression to dismiss the conversation by saying they're "fine".

"Most people who are depressed will be the first to tell you that they feel like they're a burden, and so they don't want to talk about it," he explains. 

In some cases, the person could become angry. Battley says if this happens, it's important to not take it personally, and to recognise it's a reflection of their feelings. 

"Then if you're genuinely worried, you have to contact someone - generally, a close friend or a relative is a good place to start," he continues. "But if you absolutely think this person is going to harm or hurt themselves, then you need to call an ambulance."

How to talk about suicide.

Suicide can be the hardest topic to talk to a loved one about, but it can also be a life-saving conversation. 

Battley says the key to a discussion about suicide is being vulnerable yourself. Here are some suggestions for how to begin that conversation:

• "I'm really nervous about asking this because you matter so much to me."

• "I don't want to be treading on anyone's toes."

• "I'm just going to get really vulnerable here and say, are you okay? You just don't seem yourself."

• "At the risk of me not asking this correctly, I want you to know that you matter to me. Can I just check in with you and see if you're okay?"

• "I don't know how to ask this. All I know is, I want to say, are you okay?"

Watch: Here are stories of people who have lived through suicidal thoughts and feelings. Post continues below. 

What not to say.

The clinical psychologist says it is crucial to not minimise how they feel or to judge their experiences of mental health.

"Let the person know there is no judgement here. If someone feels judged, they're going to be quiet."  

Here are some examples of phrases that are not helpful.

• "Just cheer up."

• "You'll snap out of it."

• "It's not that bad."

• "Don't worry."

Battley adds that it is important to "not go on about yourself" because this "is about you checking in with your friend."

He adds: "Do not force them to see anybody. You never want that person to think that they're not going to please you if they don't do what you want."

Ultimately, though, the worst thing you can say to someone you know is suffering, is nothing at all. 

If you think you may be experiencing depression or another mental health problem, please contact your general practitioner. If you're based in Australia, please contact Lifeline 13 11 14 for support or beyondblue 1300 22 4636.

Feature image: Getty.

Sign up for the "Mamamia Daily" newsletter. Get across the stories women are talking about today.