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Psychosis · What to say

They seem paranoid or are hearing or seeing things

The experience may feel completely real to them. You can respond to the fear without claiming that the belief or experience is true.

Stay with the feelingSpeak calmly, acknowledge that they feel frightened or unsafe, and offer one simple form of help.
Immediate danger? Call 999 or go to A&E if someone's life is at risk or you cannot keep anyone safe. For urgent mental-health help that is not an emergency, use the urgent-help page.
Sources: NHS and Rethink Mental Illness
NHS urgent-help guidance and Rethink's psychosis support guidance.

What to do in the conversation

  1. Lower the pressure. Speak slowly, avoid sudden movements and reduce noise, crowds or bright light where possible.
  2. Acknowledge the feeling. You can recognise that the person feels frightened, watched or unsafe.
  3. Keep your position honest. Do not argue about the belief and do not pretend that you see, hear or believe the same thing.
  4. Offer one practical choice. Water, a quieter place or calling someone they trust may be easier to answer than a long set of questions.
Sources: Rethink Mental Illness and Lincolnshire Partnership NHS Trust
Rethink advises calm communication, focusing on feelings and simple practical help. Lincolnshire Partnership NHS Trust advises against agreeing with or dismissing the belief.

Words you can use

Based on Rethink's guidance“That sounds really upsetting. What would help you feel safer right now?”
Based on NHS trust guidance“I do not see it the same way, but I can see that this feels real and frightening to you.”
Sources: Rethink Mental Illness and Lincolnshire Partnership NHS Trust
The example phrases are close paraphrases of public wording from Rethink and Lincolnshire Partnership NHS Trust.

What to avoid saying

  • “That is not real” or “you are imagining it.” Rethink advises acknowledging how frightening the experience feels instead of dismissing it.
  • “Yes, I can see or hear it too” when you cannot. Be honest without starting an argument.
  • “Prove it” or “that makes no sense.” Point-by-point debate can raise pressure without reducing the fear.
  • “Stop being ridiculous.” Ridicule may increase distress and make it harder to accept help.

Try: “I do not experience it that way, but I can see that you feel unsafe. What would help right now?”

Sources: Rethink Mental Illness and Lincolnshire Partnership NHS Trust
Rethink and Lincolnshire Partnership NHS Trust.

Move from conversation to help

If they already have a care coordinator or mental-health team, use that contact. If this may be a first episode, ask about the local Early Intervention in Psychosis team. Use the urgent route if the situation cannot safely wait for a routine appointment.

Find the right professional help
They do not want helpSupporting over timeSupport for you

Here for Someone is an independent information project. It is not a helpline or medical service. This page organises public guidance from the organisations linked beside the relevant information; it has not been clinically reviewed by Here for Someone.

Sources checked: 26 August 2026

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