In a study conducted in 2022 by Mental Health America (MHA), the nation’s leading community-based nonprofit organization dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of all, researchers found that close to 50 million or 19.86% of American adults experience mental illness each year. 24.7% of adults with a mental illness report an unmet need for treatment. This number has increased each year since 2011.(1) The statistics are even more alarming for Black Americans. According to the Health and Human Services Office of Minority Health, Black American adults are 20% more likely to experience serious mental health problems, such as major depressive disorder or generalized anxiety disorder than the general population.(2) Black Americans are also more likely than white Americans to report persistent symptoms of emotional distress, but only a third receive the mental health care they need. Only 33% of Black Americans with any mental health disorder sought professional help in 2019, while 50% of white Americans did. Mental illness-related stigma, lack of trust in the healthcare system, lack of ethnic and racial diversity among providers (only 2% of psychiatrists and 4% of psychologists in the United States identify as Black), and lack of insurance are just a few factors contributing to this disparity.(3)
More than 80% of Black Americans are very concerned about the stigma associated with mental illness, which discourages them from seeking treatment.(4) Negative attitudes and beliefs towards people who live with mental health conditions are pervasive within the US and can be particularly strong within the Black community. Although beliefs and attitudes vary, research shows that many Black adults – especially older adults – view mental health conditions as a consequence of personal weakness. As a result, people may experience shame about having a mental health disorder and worry that they may be discriminated against due to their condition. If these pervasive negative beliefs exist in our communities, how can we help our brothers and sisters embrace mental health awareness more openly? Research conducted by psychiatrists and psychologists across multiple disciplines have found many factors that play a critical role in making this happen.(5) Some of these areas include: (a) family support – encouraging people with mental health disorders to get guidance from their loved ones; (b) spirituality – incorporating faith and religious values into treatment; (c) recognizing provider biases – being aware that provider biases exist and that finding the right psychiatrist and therapist is critical to successful long-term care; (d) using validation and empowerment – normalizing instead of pathologizing the feelings of stress and anxiety that Black Americans experience when confronted with mental health disorders; and (e) using healing circles – introducing healing circles have been shown to be an effective technique through which individuals with similar life experiences can discuss their problems. Although all these factors play a critical role in raising mental health awareness, our team at Bandelli & Associates has found that one of the most important skills for people with mental health disorders to learn and put into practice is Relational Intelligence.
Relational Intelligence is the ability to successfully connect with people and build strong, long-lasting relationships. (6) It is a set of skills that can help those with mental health disorders build and maintain healthy social support systems. Our research has also found that these skills are important to learn for caretakers and people supporting those with mental health disorders. Managing one’s mental health and emotional well-being is not something people should do alone. Feelings of despair and hopelessness are often amplified when individuals do not feel they have people to turn to during difficult times. An estimated 700,000 people commit suicide each year.(7) For every suicide, there are likely 20 other people making a suicide attempt or having serious thoughts of doing so. Relational Intelligence is one of the ways to combat many of the negative emotions that lead to loneliness, isolation, and suicidal thoughts. It is through the relationships we build with others that we can develop perspective, resilience, courage, and faith to lead a healthy and productive life.
The Bandelli Relational Intelligence Model™ is comprised of five essential skills that enable those with mental health disorders to build strong relationships with the people in their personal and professional lives. Establishing Rapport is the ability to use ENERGY to create a positive initial connection with others. Establishing Rapport is vital in the early stages of relationship development between people with mental health disorders and their medical providers. When done correctly, rapport building lays the foundation for creating and maintaining one’s treatment plan. When it does not take place, or a patient experiences poor bedside manner the first time they meet with a healthcare provider, it can prevent them from seeking further treatment.
Understanding Others is the ability to be INTENTIONAL about putting in the time and effort needed to get to know someone on a deep level. This skill plays an important role for people supporting those with mental health disorders. It’s about being curious and asking questions to learn about their disease and what it means for them personally. It is about active listening and taking the time to understand their worries, anxieties, or fears. It is about being empathetic and compassionate when they’re struggling with their health. Understanding what is important to someone living with a mental health disorder is critical if you are going to provide the right support when it is needed.
Embracing Individual Differences is the ability to be AUTHENTIC in acknowledging and accepting that everyone comes from different backgrounds and experiences. For people living with a mental health disorder, this is a critical skill to master. They must put in the work, often through therapy, to understand that their disease is not their identity. It is one part of their life that must be managed. Embracing one’s authenticity is about developing an awareness of the values, beliefs, personality factors, behavioral patterns, strengths, and weaknesses that make up our complete identity. When those living with a mental health disorder develop a deeper understanding of what makes them unique, it creates the condition through which they can start to build healthy habits into their lifestyles.
Developing Trust is the ability to be VULNERABLE and risk being exposed to the actions and behaviors of others. Vulnerability is a hard thing for many people to practice. This is especially the case for many Black American men, who view mental health as a taboo subject that is often avoided because of the strong stigma that exists. Issues related to culture, masculinity, and the socio-political environment keep Black men from tackling problems related to their mental health.(8) This is where people who support someone with a mental health disorder play such a crucial role. To develop and maintain trust, caretakers or loved ones must continually nurture the relationship. This means honoring commitments that have been made, especially during times when someone is struggling. It also means showing up consistently for them so they will feel comfortable coming to you for support. Lastly, it means demonstrating courage to be honest and candid when observing changes in their mood or behaviors.
Cultivating Influence, the final skill in the framework, is the ability to have a positive and meaningful IMPACT on the growth and development of others. This skill is important for those supporting someone with a mental health disorder. It’s about truly investing time to learn about their disease, helping them get the professional resources and support they need, and being proactive about putting in place strategies for how they can manage the difficult periods. This all requires honest and open communication, offering your input or advice when they ask for it, and being a source of hope and encouragement when they are having dark moments.
There are many ways the five essential skills of Relational Intelligence can be used to strengthen your social support system. This applies to people living with a mental health disorder and those that are supporting them. Here are some practical recommendations for how to use each of the skills in your life.
1. Establishing Rapport – using ENERGY to create a positive initial connection with someone.
Living with a Mental Health Disorder: Establishing rapport is critical to the success of any relationship. This is most important in the relationships you develop with your psychiatrist and therapist. Great rapport builders have empathy for people. They know how to relate to the needs of others and can see things from their perspectives. When you meet with a medical professional for the first time, watch how they treat you. Do they make a good first impression? Do they attempt to find common ground with you? Are they asking a lot of questions not just to make a diagnosis but truly understand your story? Do they listen attentively? Do you feel that they are compassionate or just treating you as another patient? You should be thinking about all these questions as you make the decision of who should be on your treatment team.
Supporting a Loved One with a Mental Health Disorder: People who are skilled at establishing rapport know how to make others feel understood. They invest time to make others feel comfortable and accepted. This should be the mindset when you’re first building a relationship with a person who has a mental health disorder. Don’t walk into your first conversation with any stereotypes, biases, or preconceived notions. Their disease is not their identity. They are a human being just like you are. They have a story that extends beyond their diagnosis. When they are disclosing personal, and sometimes difficult information, remember to maintain eye contact to show interest in what they are saying. Use nonverbal communication and body language to demonstrate empathy and compassion. The first interaction you have can lay the foundation for them to come back to you for support when they are struggling or in a crisis.
2. Understanding Others – being INTENTIONAL about getting to know someone on a deep level.
Living with a Mental Health Disorder: To build effective relationships with others you must develop strong emotional intelligence. This is the ability to understand your emotions, the emotions of others, and how to manage your emotions effectively. Your mental health disorder may change your mood if you’re feeling depressed, anxious, or manic. To effectively navigate the ups and downs of your disorder, you need to put in the work with your therapist to understand how to process negative emotions. Developing the strategies, tools, and techniques to get through difficult periods is paramount to the long-term success of your treatment program. When you’ve equipped yourself with the right gameplan, you can better leverage the people in your social support system.
Supporting a Loved One with a Mental Health Disorder: Taking time to truly understand someone with a mental health disorder takes effort, attention, and patience. You must be intentional about how you get to know them and learn about their disease. This requires strong active listening skills, which creates the psychological safety they will need to openly share their thoughts, feelings, and emotions with you. It also requires you to be curious and inquisitive. Empathetic people ask questions to get to know someone on a deep level. This extends beyond just learning about their diagnosis. Be consistent in your communications with them. The more you keep lines of communication open the more opportunities you will have to strengthen the relationship. But it is not just about the frequency of your communications, it is about “how” you are communicating with them. Are you genuinely interested in getting to know their story? Can you adjust your approach depending on their mood or how they are feeling on a particular day? Great communicators adapt to the needs of others. This is a critical skill to master if you’re going to be effective in supporting someone with a mental health disorder.
3. Embracing Individual Differences – being AUTHENTIC in acknowledging and accepting that everyone comes from different backgrounds and experiences.
Living with a Mental Health Disorder: Coming to terms with your mental health disorder takes time. People sometimes live in denial for years because they do not want to look at themselves in the mirror and accept their diagnosis. You must get comfortable in your own skin to live an authentic life. This will require you to put in the time and effort to learn about yourself and not just your mental health disorder. Journaling is a great way to do this. It enables you to track your thoughts, feelings, and emotions on a daily basis. It helps you identify triggers or other factors that can lead to a depressive, anxious, or manic episode. Working on developing strong self-awareness is key to effectively managing your disease. There will be times when you’re sad, but this does not mean you’re depressed. There will be times when you’re worried, but this does not mean you’re having an anxiety attack. There will be times when you’re excited and exhilarated about something, but this does not mean you’re being manic. When you know how you’re wired and what makes you tick it enables you to get the support you need when a crisis hits.
Supporting a Loved One with a Mental Health Disorder: Embracing individual differences is about having a favorable reception towards people who think, act, and behave differently than you do. It means understanding, acknowledging, and appreciating that the person in your life with a mental health disorder is different from you. They will have ups and downs that you may not have experienced in your own life. There will be times when they don’t ask for help when they really need it. Your primary job in supporting them is to create the conditions for psychological safety in the relationship. This means being genuine and authentic with them. Sharing the challenges or adversity that you face in your own life humanizes you and doesn’t make it a one-way relationship. People who embrace individual differences have open, candid, and transparent conversations with others. This will encourage the person you’re supporting to do the same with you. You have to model the behaviors you want them to emulate.
4. Developing Trust – willing to be VULNERABLE and risk being exposed to the actions or behaviors of another person.
Living with a Mental Health Disorder: One of the most difficult things to do when you’re living with a mental health disorder is to be vulnerable and ask for help when you need it. Women do this better than men. Research has found that women are more likely to discuss their struggles with loved ones and seek treatment when it is needed.(9) Most men are taught from an early age to never show emotions or signs of weakness. They have been conditioned to “suck it up” and just “dust the dirt off their shoulders” when dealing with whatever challenge they’re facing. This can be dangerous and deadly when you’re living with a mental health disorder. There will be times when you need help from others to effectively manage your disease. This requires humility and understanding that it is okay to not be okay. It is okay to turn to others when times are difficult. It is okay to rely on others when you’re not feeling like yourself. It is okay to get the support you need when you can’t do it all on your own.
Supporting a Loved One with a Mental Health Disorder: Developing trust is the most important thing you can do when supporting someone with a mental health disorder. To do this, you must practice the currency of trust. We call these the 5 C’s: (a) competence – can they trust that you have the knowledge, skills, and abilities to help them when they are in need? (b) commitment – can they trust that you will honor the commitments you make to them in both good and bad times? (c) consistency – can they trust that you will show up for them in the same way when they are feeling well and when they are struggling with their health? (d) character – can they trust that you have strong morals, values, and integrity to never use their diagnosis against them? and (e) courage – can they trust that you will be open and honest with them when you’re observing that their moods or behaviors have changed? Developing trust also requires that you live with a deposit mentality. You must continually make investments in the relationship to show them that you care. We call this intentional generosity, which involves making sacrifices for the person in your life that has a mental health disorder without the expectation that you need to get something in return.
5. Cultivating Influence – having a positive and meaningful IMPACT on someone’s life.
Living with a Mental Health Disorder: To live a healthy and productive lifestyle you must ask for feedback and input from your support system. Your system should be made up of both professional and personal support. Getting the right healthcare providers, which must include a psychiatrist and therapist, is critical if you want to effectively manage your disease. A great psychiatrist will work with you to prescribe the proper medications you will need to take on a regular basis. It is important to stick to your medication regimen. Many people stop taking their meds for a variety of different reasons and this can lead to more challenges with their mental health. If you had cancer, you would stick to your treatment plan. If you had diabetes, you would stick to your medications. The same must apply to the medications you take for your mental health. A great therapist will work with you to navigate the day-to-day ups and downs of your disorder. Find a therapist that will give you guidance and counsel, not just one that will listen to you without providing consistent feedback. When it comes to family, close friends, and loved ones in your support system, be proactive about discussing your mental health with them. They may not know what to ask you. They may not fully understand what you’re going through at a particular time. Don’t be afraid to reach out and ask for their thoughts and perspectives.
Supporting a Loved One with a Mental Health Disorder: Cultivating influence is one of the most powerful ways to build a great relationship with a person you care about with a mental health disorder. This relational intelligence skill is about putting their needs before your own. It’s about being selfless, especially in the moments when they are struggling with their health. What this looks like behaviorally will be different depending on the situation. There will be times when they come to you for help. Be there to listen, empathize with their experience, and offer advice if it is requested. There may also be times when you observe certain behaviors and need to give them feedback. They may not ask for it, or think that they don’t need it, but it is your responsibility to provide it to them. The “how” you provide feedback is much more important than “what” you are trying to communicate. For example, if someone is manic, they probably aren’t going to want to listen to you. It takes patience to work through these types of situations.
Relational Intelligence is the playbook you need to effectively manage a mental health disorder. The five essential skills can be learned by both those living with a mental illness and the people that support them. This takes diligence on everyone’s part to understand what the skills mean for you and how to develop them over time. For example, how one person develops trust will be different from someone else. Factors like our personality, belief systems, and values often dictate how we interact with others, but the skills are universal (e.g., developing trust is important for everyone if they want to build a successful long-term relationship). Take time to learn and understand these skills. Start putting them into practice in all your relationships. You’ll begin to see the impact they have on transforming the quality of your life.
Adam C. Bandelli, Ph.D., is the Visionary Founder & Managing Director of Bandelli & Associates, a boutique consulting firm focusing on leadership advisory services and organizational development. He is the author of the book Relational Intelligence: The Five Essential Skills You Need to Build Life-Changing Relationships. It is available on Amazon, Barnes & Noble, Apple Books, and everywhere books are sold. Follow Dr. Bandelli on Instagram at @adambandelli to learn more. You can also visit the firm’s website at www.bandelliandassociates.com for information on other leadership topics and to learn about their consulting services.
References
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2. American Psychiatric Association. (2017). Mental Health Facts for African Americans. psychiatry.org.
3. American Psychiatric Association. (2019). “Treating African Americans.” Stress & Trauma Toolkit for Treating Historically Marginalized Populations in a Changing Political and Social Environment. psychiatry.org.
4. Columbia University Department of Psychiatry. (2019). Columbia University Department of Psychiatry.
5. Centers for Disease Control and Prevention (CDC). (2018). CDC’s National Health Interview Survey.
6. Bandelli, A.C. (2022). Relational Intelligence: The Five Essential Skills You Need to Build Life-Changing Relationships. New York: Covenant Books.
7. Garnett, M.F., Curtin, S.C., & Stone, D.M. (2022). Suicide Mortality in the United States (2000-2020). NCHS Data Brief, 433, 1-7.
8. Black Mental Health Alliance for Education and Consultation, Inc. (2016). Souls of Black Men: African American Men Discuss Mental Health.
9. Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women’s attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing research. Retrieved February 4, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279858/.
