New research released by Time to Change, a campaign tackling mental health issues stigma, reveals that, when asked, over three quarters (78%) of us would tell friends and family we are "fine" even if struggling with a mental health problem*.

The simple act of asking again, with interest, shows a genuine willingness to talk and listen.

When asked why we claim to be okay even if this is not true, responses suggest we doubt whether people really want to hear the honest answer. The top concerns were: 

• Just because people ask how you are, it doesn’t mean that they really want to know the honest answer (54%)
• I don’t want to burden people (52%)
• I’d only be honest if I was confident that my friend or family member really wanted to listen (39%)

The national survey of over 2,000 people highlights that asking "How are you?" just once often prompts nothing more than a meaningless exchange.

The campaign

To tackle this, Time to Change is urging people to ‘Ask Twice’ if they suspect a friend, family member, or colleague might be struggling with their mental health. The campaign says the simple act of asking again, with interest, shows a genuine willingness to talk and listen.

‘Ask Twice’ launched as part of Time to Change’s five-year In Your Corner campaign, which encourages us to be more open and supportive of the 1 in 4 people living with a mental health problem in any given year.

Whilst there has been a positive shift** in the way mental health problems are viewed in England, insight shows that, in practical terms, many people are still unsure of how to be more supportive.

Jo Loughran, Director of Time to Change, said “We all hear it dozens of times a day: ‘How are you?’ ‘Fine thanks, how are you?’. Our research shows that, as a nation, we find it hard to answer honestly. This could mean someone close to you is struggling with their mental health; they might just be waiting for your cue to talk about it. Asking twice is a simple, effective way to show our friends and family members that we are asking for real: that we are ready to listen, whether that’s now or whenever they’re ready.”

Deian, 45, from Bath, has experienced depression. He said: “I’ve pretended to be fine when I’m not countless times! I’ve had mental health problems on and off my whole life including suicidal thoughts which eventually ended my marriage. It can take a lot to open up about mental health problems. It makes a big difference knowing that people are asking because they care and want to try and support me."

“My friends do ask if I’m okay, but I’d feel more comfortable opening up if they asked me more than once. When I have been able to talk in the past, it really has been life changing. If people are unsure of how to support their friends or family, I’d say just ask how they are, twice if necessary, and find out how they are really feeling.”

Time to Change has compiled some tips on how to support a friend who does open up:
• Take it seriously, don’t judge
• Actively listen – ask open questions, summarise to show you’ve listened and reflect.
• Remember you don’t have to fix it
• A simple “that sounds difficult” can show you care

For more information, tips, and to view the campaign video, visit:



* The research was conducted by Censuswide with a nationally representative sample of 2,012 general respondents between 10.08.2018 - 13.08.2018. Census wide abide by and employ members of the Market Research Society which is based on the ESOMAR principles

** ‘Our impact’ Time to Change: