Caregiver Strategies

There is rarely a perfect response to mental illness in a young adult. Caregivers navigate uncertainty with limited influence and information. The goal is to be someone that the young adult can count on, a consistent, validating person with reasonable boundaries, rather than to fix, manage, or control. The relationship itself may be an important source of support.

Communication Strategies for Common Situations

Situation	What TO Do	What NOT TO Do
They share distress	Validate emotions	Problem solve immediately or minimize their emotions
They go silent	Send a warm, non-demandning text	Flood them with calls/texts
They are in crisis and you are concerned about suicide	Ask directly, “Are you thinking about suicide?”	Avoid asking because you are afraid of the answer
They tell you something you believe is untrue	Validate their emotions (without agreeing or disagreeing with their belief)	Debate the facts or try to prove them wrong
You’re terrified	Use your own support system to stay as grounded as possible	Call your adult child while dysregulated
They push you away	Stay present, low pressure	Withdraw or retaliate

Expectations

Careful, thoughtful decisions do not guarantee positive outcomes with mental illness (this is true for many physical illnesses as well). Caregivers play an important role, but they cannot control the course of an illness or guarantee that treatment will work.

Balancing Options

Caregivers continue to balance the risk of harming the relationship with the young adult with the desire to report safety concerns during a crisis. Review here.

When thinking about possible responses to situations, caregivers often have to choose between imperfect options. Some actions reduce immediate risk but may affect long-term trust. Some boundaries support more independence over time but increase short-term instability. Acknowledging these tradeoffs is a good start.

Caregivers may feel pulled toward rescuing the young adult to prevent failure or harm. Watching natural consequences happen is emotionally difficult. The goal is not to withhold needed support, but to provide an appropriate level of support. This is sometimes called scaffolding: providing support for parts of a task while encouraging the young adult to take responsibility for other parts, then gradually reducing support as stability and skills increase. For example, if a young adult spends all of their grocery money early, rescuing might mean immediately sending more money. Scaffolding might mean helping them make a plan for the remaining days, ensuring basic needs are met while allowing them to experience some consequences of running short and take responsibility for managing their budget. The appropriate level of support will depend on the young adult's current abilities, circumstances, and safety.

Regulating Your Own Emotions During a Crisis

When a young adult is in crisis, caregivers may be afraid and confused. Staying emotionally grounded during a crisis does not come naturally but it may improve with practice and time. Staying grounded doesn't mean a caregiver is not worried. Despite being worried, they can be a calm and stable presence, which may lead to better communication.

When a person is dysregulated, conversations may escalate into arguments. The skill STOP may help us think before we respond: Stop, Take a step back, Observe what is happening (including your own emotional state), and Proceed mindfully rather than reactively. This may slow things down, so the response can be intentional instead of reactive.

Connection Challenges

Families or caregivers may be dealing with ongoing disagreements with the young adult unrelated to the crisis itself. While those issues are still important, it may be helpful to focus on safety and preserving the relationship, and return to other issues after the crisis has stabilized.

Sometimes a young adult will prefer communicating with one caregiver over another. Respecting that preference may help preserve connection. When the young adult communicates with both caregivers, that connection is valuable, even when the caregivers don't agree on every message or decision. Caregivers who coordinate with each other may be able to reduce conflict.

In reality, ◐ Limited Engagement situations are common. Engagement may also fluctuate over time, so maintaining even a partial connection may be an important short-term goal. An infrequent or limited connection to one person can help keep the door open to greater engagement later.

Building Caregiver Capacity

It's common for caregivers to be unfamiliar with the world of mental health when an adult child has an acute crisis. Caregivers may start to educate themselves about mental health conditions, treatment options, crisis systems, and communication strategies. This guide is a good starting point.