MH1 Promote effective communication and relationships with people who are troubled or distressed


This standard covers promoting communication and relationships with individuals whose communication and relationships are affected, directly or indirectly, by mental health problems. The distress or impairment may be a transient, fluctuating or permanent feature of the individual’s social functioning.

This standard applies to mental health practitioners who work with people who are troubled or distressed. The distress may be directly associated with mental illness or caused by other factors, such as physical illness or bereavement, which may create mental health problems.

Users of this standard will need to ensure that practice reflects up to date information and policies.

Version No 1

Knowledge and Understanding

You will need to know and understand:

  1. Country, UK, EU legislation, statutory codes, standards, frameworks and guidance relevant to mental health practice and related fields, including multi disciplinary and multi organisational practice on accountability and continuing professional development, data protection and confidentiality of information
  2. The rules and ethics of professional practice and codes of conduct and how to interpret and apply these to relationships with service users, especially those who are troubled or distressed
  3. The relationship between physical, social, psychological and emotional development and behaviour and associated patterns
  4. The effect of mental illness in relation to individuals’ ability to form relationships with others
  5. Signs and symptoms of mental health needs which can affect communication and an individual’s capacity for relationship formation and maintenance, and the language used to describe those signs and symptoms to other agencies
  6. Why individuals should be encouraged to be as self-managing and independent as possible
  7. The issues that affect individuals with mental health needs in society, how they can manage these and the sort of assistance they need
  8. The impact of the broader social environment on individuals with mental health needs (e.g. area of material deprivation, poor housing, poverty, separation from family and friends)
  9. The different forms and range of effective communication (e.g. total communication)
  10. The effect of culture on communication (e.g. the use of sensory contact - touch, presence, contact, distance between individuals when communicating, the terms of respect and address used etc); when physical contact is appropriate and when it is not (e.g. when it is a way of dealing with your distress rather than the individual's); issues arising from the gender of the practitioner
  11. Where and how support for communication can be obtained (such as interpreters and translators, carers, advocates, equipment and facilities)
  12. How culture, gender and beliefs can affect attitudes and behaviour and how it may be perceived by others, including those considered maladaptive, (e.g. it may be seen to be more acceptable for men to be assertive than women), why it is important to recognise and challenge this in oneself
  13. The ways in which individuals will seek to communicate with others
  14. The role which communication plays in maintaining an individual's identity
  15. The role of communication in establishing and maintaining relationships
  16. Behaviours which demonstrate value for others and those which do not
  17. Why the ability to listen effectively is important
  18. How to establish an atmosphere of trust and mutual respect how to demonstrate respect for, and the promotion of:
    1. each person as an individual
    2. independence and quality of life
    3. dignity and privacy of individuals and their family and friends
  19. How to recognise what people are trying to convey by their behaviour
  20. How facial expression may affect tone of voice used and may reveal personal attitudes or emotions
  21. How to challenge sensitively behaviour which adversely affects others
  22. How to make the interaction supportive of the individual concerned
  23. How to deal with confrontation in a supportive and positive manner
  24. Working methods and styles which may be used in developing, sustaining and enabling individuals to move on from relationships; how to empower individuals to develop effective relationships in the future
  25. The agency’s policy and procedures regarding confidentiality of information and the disclosure of information to third parties, and the specific circumstances under which disclosure may be made
  26. Your own role and responsibilities and from whom assistance and advice should be sought if you are unsure
  27. How to apply the principles of equality, diversity and anti-discriminatory practice to your work
  28. The options you have in relating to individuals who are troubled or distressed, including any statutory powers, and the factors you should take into account when selecting the approach to take
  29. Understanding the effects on practitioners of working with distress and professional ways of addressing these
  30. The importance of agreed consistency within staff teams in working with individuals, especially those with behavioural issues

Performance Criteria

You must be able to do the following:

  1. identify the factors that may affect the development of the relationship and take the appropriate actions to establish and maintain a therapeutic relationship
  2. create and seize appropriate opportunities for positive interactions with individuals in a range of contexts
  3. act in ways that promote anti-discriminatory practice and respond appropriately to discriminatory behaviours and attitudes
  4. engage constructively with individuals modelling appropriate behaviour whilst recognising the differences in power between yourself and the individuals
  5. behave in ways that promote the value of individuals as people in their own right and that encourage meaningful interactions with them
  6. spend sufficient time with individuals to explore, understand and support their interests, needs and concerns.
  7. communicate with individuals in a manner, and at a level and pace that gives consideration to their:
    1. abilities
    2. preferred form of communication
    3. manner of expression
    4. personal beliefs and preferences (and is consistent with anti-discriminatory practice)
  8. use body language, position, tone of voice and active listening to encourage individuals to communicate
  9. minimise obstacles to effective communication as far as possible given the constraints of the situation
  10. respond to individual’s expression of feelings and needs in a manner which supports the right to such expression
  11. observe individual’s behaviour and use this to develop an understanding of them as people in their own right
  12. communicate with individuals as people in their own right with their own needs and wishes
  13. set and agree boundaries with individuals in relation to their behaviour towards yourself and others when you are with them
  14. encourage movement away from inappropriate forms of expression to more appropriate ways of communicating needs or feelings
  15. act as a role model to individuals in the way that you behave towards the individual and to others
  16. balance the need for individuals to be self-managing and independent with their need for control and boundary setting, challenging them when they prejudice the rights of others
  17. take opportunities to reflect on your own behaviour with, and reactions to, different individuals and use this to evaluate your own practice

Additional Information

This National Occupational Standard was developed by Skills for Health.

This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):

Dimension: Core 1 Communication
MH1 Promote effective communication and relationships with people who are troubled or distressed
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk