Aims: To explore insights between friendship and mental health through a critical narrative inquiry. To conceptualise friendship and inform public health approaches to loneliness and mental health. Method: Seventeen interviews were conducted with middle-age people who had experienced mental health difficulties. Stories were subjected to a narrative analysis and interrogated further using critical theory. Results: Compassion in friendship reduces alterity and loneliness, and results in mutual discovery of dignity in relation to distress and stage of life. This is not achievable in all friendship. Conclusion: The temporary encounter of friendship can provide new bases for authentically relating. Through dignity and authenticity, friendship can contribute to mental health and reduce loneliness. Suggestions are made to inform public health approaches to friendship.