Helpful things to do when someone who has a mental illness is experiencing hallucinations, delusions or paranoia.
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Delusions & hallucinations
How a person might act:
Talking to voices that are not there
Talking about a strongly held false belief (delusion)
Talking about something they hear, see or feel that is not there (hallucination).
Behaving oddly because they have a false belief, or because they are hearing, seeing or feeling something that is not there.
Being distracted and unable to concentrate.
Helpful things to do:
Avoid arguing with the person about their delusions. Delusions are extremely fixed and difficult to change.
Connect with the emotion of the delusion or hallucination e.g. It must be frightening to believe that all your water is poisoned.
Calm things down—reduce noise and have fewer people around the person.
Show compassion for the how the person feels about their false belief. If possible do what you can to help when the person is acutely unwell. e.g.: turn off the TV if they think it is talking to them.
Note: Unusual beliefs and behaviour may be part of a person’s normal belief system or culture. If they are, they may have nothing to do with mental illness.
Paranoia
How the person might act:
Behaving as though they are being followed, tricked or spied on
Being overly sensitive and suspicious
Being irritable
Being aggressive. The person could be afraid because of the delusion and may act out of fear.
Helpful things to do:
Avoid arguing with the person about what they are being paranoid about.
Let them know you can understand why they would feel afraid, given the things they are thinking.
Show them with your body language that you are on the same side. E.g.: Sit beside rather than in front of them. Stay calm. Consider your own safety as well as theirs.
Disordered thinking
How the person might act:
Talking in a way that does not make sense.
Not seeming to cooperate or seeming ‘spacey’ and ‘not there’.
Having a hard time doing regular things like as making meals and keeping themselves clean.
Dressing inappropriately or strangely e.g. lots of clothes on a hot day.
Helpful things to do:
Speak to the person clearly and simply.
If necessary, repeat things talking slowly and allowing plenty of time for the person to answer.
Give step-by-step instructions.
Not showing a wide range of feelings (affective flattening)
How the person might act:
The person’s face may seem not to move or respond, or have no expression.
The person may not meet your eye or looks away.
The person may not express much using their body.
Helpful things to do:
Be aware that this may be a symptom of the illness. Don’t take it personally.
Try not to get frustrated or hurt that the person isn’t showing their feelings much.
Be aware that just because the person is not showing their feelings very much, does not mean that they are not feeling anything.
Being silent or not talking much
What the person might do:
Having trouble starting and keeping going with activities or getting things done.
Sitting for a long time doing nothing.
Not showing much interest in participating in any sort of activity.
Helpful things to do:
Understand and acknowledge that these are likely part of the illness. The person is not behaving this way on purpose.
Try not to become frustrated with how they are acting.
Encourage them gently to participate in activities.
This information is adapted and reprinted with the permission of the Mental Illness Fellowship of Victoria (Australia).
About the author
The BC Schizophrenia Society helps individuals and families find their way in the mental health system. They also provide regional programs and services to help people with serious mental illnesses and their families. For more, visit www.bcss.org or call 1-888-888-0029.
