The Best Ways to Offer Accountability to Your Friend with Mental Illnes

How can we help our loved ones who struggle with mental illness? How can we keep our friends and family members with mental illness accountable? How can we help them improve their lives when they are battling their mind and emotions? Learn how you can help keep your friends with mental illness accountable with these important tips.

*Disclaimer: I am in no way a medical professional and this is not medical advise. I am simply sharing what helped me when I was struggling, and the steps I'd like to use to try to help my loved-ones.

As someone who struggles with anxiety and OCD, I have experienced times in my life that were extremely difficult both emotionally and mentally. During those times, I wasn't really myself, I acted selfishly, and I forgot to truly be considerate of others. People would try to keep me accountable but I would just get angry. And although I was genuinely sick, I also needed people in my life who would challenge me and keep me accountable even when I was struggling, and even when it made me mad.

But it takes a brave and special person to try to keep someone accountable who is struggling with mental illness. I was a mild case (comparatively), but I was still extremely difficult to deal with. I knew deep down that I needed help and I needed someone to bring me back to reality and hold me accountable for my actions, but I also struggled to get out of my own head.

But now that I am much-improved and have been for several years, I see how much I needed the level-headed people in my life, and I really appreciate that they stuck by me. And I personally believe that we should do our best to stand by and help our loved ones who suffer from mental illness in the same way.

But how can we help when our help makes them angry? What is the best approach to help your friend or family member when they are spiraling into the self-consumed behavior that mental illness often brings? Keep reading to learn how you can help your loved-ones who are struggling.

Are You Close Enough to the Person?

Before you attempt to help someone be accountable, you need to be sure that you are close enough to the person to put yourself in that role. How long have you been friends? How close are you to that person? Would this friend feel that they were in a position to help you if the roles were reversed?
Trying to keep someone accountable when you really aren't very close will not end well. Be wise and recognize your limits. Wanting to help is noble, but discernment is key.

Learn to Recognize Manipulation from a Genuine Mental Struggle

When something is triggering your loved-one and causing them added turmoil, learn to recognize whether they are truly having a mental struggle, or if they are just trying to avoid accountability. There were times that I would try to play-up my struggles in order to avoid having to be held accountable for the way I was acting, but then there were other times that I was genuinely stuck in a downward spiral that kept me from being myself.

To the best of your ability, try to learn the difference between the two. Try to recognize what genuine turmoil/fear looks like in your friend, and what it looks like when your friend is trying to use pity, manipulation, or over-acting to get out of being held accountable.

This isn't easy to recognize. It will take a whole lot of paying attention to the little things. And certainly do not accuse your loved-one of faking or manipulating- that will just make things worse. But determining where their mind is will help you identify whether it is time to challenge them and keep them accountable, or if the current situation requires more empathy and compassion.

Tread very cautiously here, give grace, and even when you push and challenge your friend, do it as gently as possible.

With Kindness, Speak Truth

Don't be afraid to speak the truth to your mentally-ill loved-one. Have they been shirking their responsibilities? Have they been lying, stealing, or manipulating?  Let them know that this isn't okay and challenge them to do better. They need to know that they cannot live life like that. But when you do so, try to stay calm, and speak the truth with great kindness. It is possible to be tactful but still speak truth.

However, if being tactful or subtle doesn't work, it may be necessary to be a little more blunt. Still with love, of course, but certainly more direct. Honestly, they may still refuse to hear you. They may get mad (they probably will). But they need people to be honest with them. Most people will just cut them out of their lives and sugar-coat everything if they are forced to talk to them. But real friends speak the truth, and sometimes, the truth is hard to swallow.

Tough love doesn't mean abandoning them, nor does it mean being rude. But it does mean speaking tough truths to a friend who is both ill and doesn't want to hear it. So when you've spoken as gently and kindly as you can for as long as you can, but your loved-one still refuses to hear, then depending on the situation, it may be time to speak those truths more bluntly than you ever have before. Show your love for your friend by speaking those hard truths.

Don't Nag

Remember though, you can't "fix them". You can't always talk them into making the changes that would help them. And you can't keep someone accountable who refuses the accountability. So if you've spoken your heart, expressed your concerns, and tried hard to be the accountability that they need and it still doesn't "stick", don't keep harping. Just pray for them and love them. 

Affirm Them With Love

When all is said and done, even if you've had to use tough love, still try to verbally and actionably affirm to your loved-one that they are, in fact, loved. Communicate to them that their struggles and frustrating moments don't change your love for them. Express your desire to see them thrive, and let them know that you want what's best for them. Make it clear that they are loved by you even when they are struggling.


I hope that this is helpful to those of you who have friends or family struggling with mental illness. But I would also urge you to remember that each case is different. This is not one-size-fits-all advice, and it is not medical or professional advice.

This is also not advice for extreme cases of mental illness. If your loved-one has a more extreme case of mental illness, then this will probably not work, and may even be harmful depending on the situation. I am not giving you a formula, nor do I have any sort of psychological training. I just know what helped me, and what I needed in my life when I was at my worst. I needed people to understand me- or at least make a great effort to understand. I needed people to be full of patience and forgiveness. But I also needed people to be real with me and let me know how my actions were affecting them. And I needed people who would keep me accountable and challenge me to take steps towards getting better.