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During a lecture to a group of college students, I described how to show respect toward people with mental health concerns by using appropriate language. As one example, I noted that it’s better to say, “John has schizophrenia,” instead of “John is schizophrenic.”
I explained that “John has schizophrenia” puts the emphasis on the person, not his illness, while “John is schizophrenic” equates the person with their illness and perpetuates negative labels and stereotypes about having a mental health condition.
At this point, a young woman in the class raised her hand and said, "I was diagnosed with bipolar disorder about a year ago, and since then I’ve always said, ‘I’m bipolar.’ It never occurred to me to say ‘I have bipolar disorder.’ But I do see the difference. I’m a person, not a diagnosis! I may have a mental illness, but it doesn’t define me. I have goals in my life, including a career, a family, and so much more. This diagnosis won’t stop me, and I shouldn’t limit myself by implying that I’m just an illness.”
I praised her for this insightful comment, which underscores an incredibly important issue: How we talk about mental illness and people who are living with mental health conditions is often just plain wrong.
How to Talk About Mental Health
Just like that bright young woman indicated, I’m convinced that a large part of the problem is that many well-meaning people simply aren’t aware of this issue. But when you bring it to their attention and describe a more respectful way to talk about mental health, they get it. (Of course, there are still some who aren’t going to get it even if it is brought to their attention. But we can’t change the whole world overnight.)
Here’s a quick and easy lesson on how to talk about mental health issues. I’m offering a handy list of “10 commandments” suitable for copying, displaying, sharing, and teaching others. This isn’t an exhaustive list, and these aren’t just my preferences. They reflect the preferred language recommended by several leading mental health groups and the Associated Press. I’ll also include the disclaimer that today’s "politically correct" language may not be okay at some point in the future, since terminology and its usage continues to evolve.
Ten Commandments for How to Talk About Mental Health
1. When using diagnostic terms, put the person first, not the illness.
"Person-first" language is “Mary has ______” (e.g., “schizophrenia,” ”bipolar disorder”), not “Mary is _____ (e.g., “schizophrenic,” ”bipolar”).
2. Don’t say “mentally disabled,” “mentally handicapped,” or “mentally ill.”
Say, “has a mental illness.” It can also be appropriate to say “mental health condition,” since many people who deal with mental health concerns may not have a formal diagnosis or a full-fledged illness.
3. Don’t use the terms “retarded” or “mentally retarded.”
The current preferred language is to say a person “has an intellectual or developmental disability.”
4. Don’t use insensitive terms (“crazy,” “insane,” “psycho,” “nuts,” “deranged") to describe someone displaying unusual or violent behaviors, or who may have a mental illness.
5. Don’t say “addict,” “junkie,” “drunk,” or any of the other derogatory terms related to addiction or misuse of drugs and alcohol.
Say, “has a substance use disorder,” or “has an alcohol or drug problem.”
6. Don’t say “brain-damaged” or “demented.”
Say “has a brain injury” or “has dementia.”
7. Don’t say “committed suicide,” which refers to the outdated notion that suicidal acts were crimes; say “died by suicide.”
Also, don’t say that a suicide attempt was “failed” or “successful.”
8. Don’t use terms that suggest pity, like “suffering from,” “victim of,” or “afflicted with,” when referring to someone’s illness or disability.
Instead say, “has a history of,” “is being treated for,” or “lives with.”
9. Don’t use diagnostic or mental health terms to explain everyday individual idiosyncrasies or other behavior common to many people, such as, “that’s my OCD” or “I’m so ADHD.”
10. Despite these guidelines, still respect each individual’s preference for how they wish to refer to their own mental health status.
Some terms you may hear when someone refers to their personal mental health issues include “consumer,” “survivor,” “person with lived experience,” or “person in recovery,” among others. Finally, mental health providers still routinely use the terms “client” and “patient” depending on the specific treatment setting.
Let’s Make a Difference
Despite widespread distribution of these types of guidelines, you will still encounter lots of very well-informed mental health consumers and experienced, caring providers who routinely use inappropriate or insensitive language. When this happens, be polite but let people know your concerns about their choice of words. Better yet, send them a copy of this post.
One final point: Let’s turn our focus away from only referring to the “stigma” of mental illness and call it what is really is—prejudice and discrimination. By changing how we talk about mental health issues, we can begin to impact negative attitudes and behaviors which adversely affect so many people. Let’s all make a difference, starting today.
Copyright David Susman 2017
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