Mental Health

Why we ask somebody about their mental health

There is a strong relationship between mental health and addiction, but the nature of the relationship can be complicated. From a common sense point of view, we all know that heavy drug or alcohol use can be a way of dealing with difficult circumstances or negative experiences in our lives. It can help us to escape and block out painful or distressing emotions. Using drugs or alcohol in this way, which is sometimes referred to as self-medicating, can have negative short-term and long-term effects.

Those negative short-term and long-term effects of heavy drug or alcohol use are also a risk factor for people who may not have experienced any underlying mental health difficulties. We live in a culture that is relatively tolerant when it comes to alcohol in particular so the relationship between mental health and addiction often begins with heavy (social) use which over time has seriously negative effects on our bodies and minds. Where mental health and addiction is concerned, it really can be a “chicken and egg” scenario as to which came first. When someone is experiencing a mental health problem and addiction at the same time this is known as dual diagnosis.

Short-term effects on mental health

Regardless of the motivation – whether for fun or to escape despair – alcohol and drug use can stir up a range of emotions and dampen others. Over time and with continued overuse, this may trigger mental health problems such as:

  • Anxiety – with problem drug use periods of severe anxiety or panic attacks can occur. When this is happening, a person’s heart rate increases, they can sweat, have shortness of breath, trembling and panic over losing control. Sometimes people feel their surroundings are strange or unreal. They can feel they’re losing their sense of reality and their personal identity.
  • Drug-induced psychosis – psychoactive drugs including cannabis, ecstasy, cocaine, magic mushrooms and heroin can cause delusions and hallucinations, visual and auditory.
  • Mood disorders – when someone is experiencing a mood disorder this can mean being depressed, maybe feeling sad, tired, restless and irritable. It can also mean a person may be feeling manic, being in an elevated mood or having racing thoughts, delusions and being impulsive – often swinging between high and low mood.

Long-term effects on mental health

Psychoactive drugs can cause on-going mental health problems. It’s not clear why it happens to some of us and not others. It might be that using a drug triggers an underlying condition in people with a predisposition towards mental health problems. Younger age and more regular use are thought to be associated with increased risk of longer term negative effects.

Dual diagnosis

A dual diagnosis is a term used when people have two separate conditions – a drug addiction and a mental health problem. When dealing with both a mental health problem and an addiction it’s hard to know where one ends and the other begins.

It’s often not clear which problem came first. For example people going through a tough time may use drugs to cope. This can often lead to more problems.

Using drugs (not prescribed) to deal with mental health problems can interfere with a person’s recovery. If they’re taking prescribed medication then other substances could interfere with this.

When working with someone with drug or alcohol issues it’s important to also establish any mental health diagnosis and find out about mental health service use.

Recognising and responding to a mental health problem

If you are concerned about the mental health of someone you are working with, trust your instinct and address your concerns. There is a limit to what you can do to support a Service User’s mental health but there are some practical things for you to consider if you are one-to-one with someone you believe to be in distress or at risk of self-harm.

Ask how they’re feeling

  • Use clear language. Example of what you could say: “You seem really low and I’m worried about you. Are you thinking of harming yourself?”

Many people don’t ask this for two reasons: they’re afraid of putting the idea into someone’s head, and they are afraid if the answer is yes, that they won’t know what to do.

Simply asking the question does not give someone the idea. Thoughts of suicide generally develop slowly over a long period of time and typically after a series of difficult experiences. By asking the question you’re acknowledging their distress, and giving them an opportunity to talk about something that is probably very frightening for them.

If the answer is yes, don’t panic. There is no ‘one’ right phrase that will change the way someone is thinking. The best you can do is to listen to them without judgment or blame.

Listen and understand

  • Give them some space to explain what is going on for them, and how they feel about it.
  • Avoid responses which reject how they are feeling, which minimize how they feel, or which try to change their view of their situation.

Take it seriously

Trust your instincts. If you have serious concerns about the mental health and safety of a Service User those concerns are there for a reason. This is not to say that you need to deal with a crisis situation on your own, rather, it’s more about knowing when to get additional support.

Know your limits

The limit of what you may be able to do in a given situation is to keep someone safe in the short-term and help them to get access to team-based professional support through the health services. This can involve contact with family or friends, the relevant GP or, in a crisis situation, the emergency services.

Getting help

If possible, get support from family and friends – if there is a social support network available to a Service User going through a tough time this can be the most acceptable initial source of support for the person. Of course, this will not always be available.

You can get professional help through:

A General Practitioner

Find a local family doctor (G.P.) or health centre by visiting the online service finder. If it’s late in the evening, night time or the weekend, contact a G.P. Out of Hours Service. G.P.s are also listed under ‘General Practitioners’ in the Golden Pages and on

Hospital emergency services

In a crisis, you can encourage a Service User to go to the Emergency Department of your nearest general hospital. Hospitals are listed on the online service finder. You can also contact the emergency services by calling 999 or 112 if you think there is an acute risk of harm to the person or someone else.

H.S.E. Mental health services

If the Service User has been supported by a mental health team encourage them to contact the service and ask for an appointment as soon as possible.