If you’re worried that a friend, partner or family member may be experiencing psychosis, it can be hard to know what to do. You may be unsure what you’re seeing, what to say, or whether it’s your place to step in at all.
Psychosis affects how a person experiences reality. It can involve hallucinations, delusions, and changes in thinking or behaviour, and it can be deeply distressing for the person going through it and for those around them. The good news is that psychosis is treatable, and early support makes a real difference to recovery and long‑term outcomes.
This guide brings together evidence‑based advice on how to recognise the signs of psychosis, how to start a supportive conversation, and how to help someone access the right kind of help, while also looking after yourself.
Recognising the signs of psychosis
Psychosis can look different from person to person, and symptoms may develop gradually or come on suddenly. Common signs include:
- Hallucinations — hearing voices, seeing things others don’t, or experiencing unusual sensations that feel very real.
- Delusions — strongly held beliefs that aren’t shared by others, such as feeling under threat or unusually powerful.
- Disorganised thinking or speech — thoughts may feel jumbled or racing, and speech can become hard to follow.
Some people also experience early warning signs before a full psychotic episode, such as sleep problems, withdrawal from others, increased anxiety, or suspiciousness. These changes can be subtle but noticing them early can be important.
Why acting early matters
Research consistently shows that shorter delays between the onset of psychosis and treatment are linked to better outcomes. Early support can reduce the severity of symptoms, improve recovery, and lower the risk of relapse.
If you’re unsure whether what you’re seeing is “serious enough”, it’s worth remembering that you don’t need to be certain in order to encourage someone to seek help.
If you are noticing signs that someone is unwell, just highlighting to them what you have noticed can sometimes be the trigger they need to make changes or seek help. So even if what they are experiencing isn’t psychosis but is attributed to another factor (Such as exhaustion or substance abuse for example), by broaching the subject with them in the right way you are helping.
Starting a conversation
Talking to someone about your concerns can feel daunting. You may worry about saying the wrong thing or damaging your relationship. These principles can help guide the conversation:
Choose the right moment
Pick a calm time and a private place. Avoid raising concerns in the middle of an argument or during a crisis, if possible. You also don't want them to feel 'ambushed' so if you don't feel comfortable having the conversation on your own, try to limit the number of people present to just one or two people they are likely to trust.
Remember, this is a conversation, not an intervention.
Focus on what you’ve noticed
Rather than labelling or diagnosing, talk about specific changes you’ve observed.
You might say “I’ve noticed you seem really stressed and haven’t been sleeping much lately, and I’m worried about how hard things seem for you.”
This approach reduces the chance that the person feels judged or put on the defensive. Plus remember, it’s not your job to diagnose them, just to support them.
Listen more than you speak
Let them describe their experiences in their own words. Feeling listened to and taken seriously can reduce distress and build trust.
When people feel heard, they are more likely to accept help.
Responding to distressing beliefs or experiences
If someone shares beliefs or experiences that don’t match your own reality, it’s natural to want to challenge them. However, arguing about whether something is “real” can increase fear and mistrust.
Instead:
- Acknowledge how real and frightening the experience feels to them
- Avoid confirming or denying the belief itself
- Focus on emotions and support
For example you could say “I can see how upsetting this is for you. I’m not experiencing it the same way, but I care about how frightened you feel.”
This helps the person feel understood without reinforcing the experience, or making them feel they have to defend themselves and their experience/belief to you.
Supporting them to seek professional help
Encouraging help works best when it feels collaborative, not controlling. Evidence suggests people do better when family support is calm and non‑critical.
You could:
- Offer to help book a GP appointment
- Suggest going with them for support
- In the UK, call NHS 111 together if you’re unsure where to start
If symptoms seem severe, or if there is a risk of harm, urgent support may be needed. This could involve contacting a GP, mental health services, or emergency care.
In an emergency, or if you believe there is an immediate risk of harm you should dial 999.
If the person doesn’t want help
It can be incredibly hard when someone refuses support. It could be that they don’t recognise a problem, they feel stigmatised by their symptoms, that there are other reasons their behaviour has changed that they don’t want to disclose to you. Or that they are frightened of what’s happening to them. Try to:
- Keep communication open
- Gently revisit the conversation later if symptoms persist
- Focus on your relationship and being the ‘safe person’ for them to confide in
Change often takes time, especially when someone is frightened or confused by their experiences.
Looking after yourself
Supporting someone with possible psychosis can be exhausting and emotionally draining. Feelings of fear, guilt, frustration or helplessness are common and valid. Looking after yourself isn’t selfish; it helps you stay supportive in the long term.
You might consider:
- Talking to someone you trust about how you’re coping
- Seeking peer or carer support
- Setting boundaries where needed
In the UK, organisations such as SANE and Mind offer information and support for carers and loved ones. You can find their details and more on our Get Help page.
You’re not alone
Psychosis can be isolating — for the person experiencing it and for those who care about them. But with the right support, recovery is possible.
At MQ, we fund research to better understand psychosis, improve early intervention, and develop more effective treatments. Throughout May, we’re sharing practical guidance and the latest research to help reduce stigma and improve outcomes.
Read more about MQ’s research to shape the next breakthrough for psychosis treatments and support.
