Behavioral Health Versus Mental Health

I'm reminded of a time growing up when my mom would tell us to behave and I found myself wondering how I could possibly know when I was "being have."

Joking aside, there is something you mentioned that I find might solve your dilema about what to call mental/behavioral health. The fact that external factors sometimes affect this health, or that underlying, changeable or unchangeable factors certainly contribute, but, all things considered, the question essentially has more to do with simply giving people guidance and assistance not with how to be mentally healthy or even with how to behave but with how to be, or simply being. We're not given a user's manual with our existence; if we're lucky, which few are, we'll figure out how to be without causing too much damage in the process, however, for most of us, we never quite figure out how to be and life ends up being a series of trials and errors often with harmful repercussions. Behavioral health conjures images of dog training or potty training, a rather pavlovian approach to this confounding notion of how we are to exist.

Really, behavioral health simply describes acting out one's existence in a manner consistent with the expectations of society, it means conforming, it means following the rules whether they are apt or irrelevant, appropriate or dangerous, correct or ill-advised and honestly, conformity can have negative repercussions on one's mental health (especially considering that homosexuality is considered bad behavior by a large portion of the population, yet feels the true course for some). And indeed, mental health is not fitting for habits or addictions that are detrimental to one's health. Really, I think what you seek is a term that might describe the guidance, knowledge, practices, and tools required for one to derive the greatest benefits from life while minimizing the harm and dangers (to self and others) that might result from living recklessly, carelessly or unhealthily. Perhaps Mortal Health or Life Health...yeah, I understand your connundrum in naming this notion, because really, you seek to place human existence into a nice neat little package that will apply to each and every; however not all creatures that claim human sentience can fit into one particular category, what is defined as "broken" for some is quite normal and beneficial to others (I refer here to my own often pessimistic outlooks, my tumultuous childhood, my borderline insanity and breakdowns and the poetic and artistic insights that suicidal thoughts have given me and have given artists throughout history.) Also, some measure of abnormality is required in order for us to come to a decision on what defines normality, therefore, if psychologists were to succeed in curing every ailing mind or behavior, they would effectively recalibrate our notion of normalcy, because without the broken, you cannot know what is whole.

If a guy walked into an ER, bleeding profusely from a bullet wound in his leg, we would not diagnose him as having a "bleeding disorder."

The behaviors associated with mental illness are symptoms of something else. Nowhere in medicinal vernacular should we advocate naming an illness for its symptoms rather than for the origin of the illness.

Not only that, "behavioral health" carries with it the weight of a whole bunch of issues regarding conformity, and with that it conjures up the culture's general distrust of psychology. Think "One Flew Over the Cuckoo's Nest" or Tom Cruise berating postpartum depression and the pharm industry.

From my personal experience, my behavioral symptoms have not been typical. Yet, despite looking "normal," I have suffered considerably from a sick mind.

Behavioral health sounds like crazy people running amok because they don't know how to behave. Stick them in a straight jacket or dope them up so that they do not behave badly then they would stop being behaviorally ill, yet would remain mentally ill.

Stick with mental health and encourage the public to see the brain as they do their hearts or pancreas: as something that can occasionally not work optimally and as an organ that requires good care. http://bipolarproject.wordpress.com

I think someone, caring like yourself, gets to say whatever you want.

Sincerely,David

I agree with your comment about the term most likely being coined by a health insurance company. I personally find the term quite limiting and misleading. As professional therapists, our work is never limited to the "behaviors" of our clients. Although the work we do will likely positively impact our client's forth-coming behaviors, it is NOT the sole focus of our work. This term is a convenient way to separate what we do from "medical" practitioners who address the physical body. However, in reality this separation between body and mind is artificial and stifling.

Perhaps the term "Counselor" is most descriptive of licensed MFT's, MSW's, and Psychologists. I personally prefer to use this term over all others because it described exactly how we heal, and it leaves the door open for many more possibilities.

Thank you for starting this conversation.

I decided to identify myself as the author of the above entry entitled: "We do so much more then change people's behaviors" dated June 26th, 2012.

I have been in the field of mental health for 24 years, the field of spiritual health for 17 years and the field of therapeutic bodywork for 13 years. Health care is really about the WHOLE PERSON. The hats we wear are just that "hats." Even if we only practice a very focused role in healthcare, we are impacting the whole person, and a growing number of us are starting to "wake up" to this fact.

I have been tagged by the pros with all sorts of labels to describe what ails me. After a while the labels become meaningless as a means of coping with their negative connotations and limited capacity to encompass the whole picture.

Wholistic Health says it for me. Terms like Mental Health or Behavioural Health miss the mark as accurate descriptors.

According to the teachings of the native american medicine wheel, wellness -- balance and harmony are achieved as we attend equally to our physical, emotion, mental and spiritual needs. It teaches us to respect the self as a whole beings.

Feelings, thoughts, beliefs and actions are influenced by each other. Isolating one from another with incomplete, stigmatized and blaming game labels is problematic.

I am an alcoholic. Such an ugly word which conjures up images of a horrible human being, a waste of life. I am also a wife, mother, a military spouse of 25 years, daughter, sister and friend. I prefer the term behavioral disorder because it gives me back the control, I can control my behavior, I can change it!Calling it a mental disorder makes me feel that recovery is out of my control. I am sober now almost 10 months, I have used many behavioral modification techniques for my behavioral disorder :)

Too many parents do not know how to spot the difference between a behavior problem and a mental health problem. I recently had a young man removed from my home by the police and taken to the hospital because it was obvious to me that he had a severe mental health problem that wasn't being addressed. He showed up at my home uninvited. When asked why he was here he said my daughter summoned him telepathically. The rest of the conversation left me with no choice as to what needed to be done and I did it. After the ambulance left with him in it I called his mother who launched into a tirade about her child's bad behavior at which point I asked to speak with the father. I said to him you need to understand your son has no control over what he is doing he has a mental health problem not a behavior problem. He said "What's the difference?". The difference is simple. A child with a behavior problem learns to correct their behavior when disciplined in a loving manner. They change their behavior. They have CONTROL! A child with a mental heath issue doesn't change their behavior because the are not in control of what they are doing and not capable of changing! This young man was hearing many voices, some of which he recognized and some unknown. He has been hearing voices for years. This young man also behaves in a reckless manner and nothing his parents do change his behavior. And this young man also speaks with his parents in a brazen manner about subjects that no teen would be caught dead talking to their parents about on a voluntary basis!
In summary it's a behavior problem if discipline corrects the problem. It may be a mental health issue if discipline isn't correcting the problems. It is a mental health issue if your child is having hallucinations, hearing voices, being totally belligerent speaking about sex, drugs and other topics teens are usually a bit shy talking about! And on the opposite end of the spectrum if you child is not communicating at all and being secretive you as a parent need to get to the bottom of what is going on.

'Behavioral health'/'behavioral disorder' is a pejorative term that sounds like scolding a child for misbehaving. ("Little Johnny has a behavior problem; we can't get him to play nice with the other kids.") Very condescending, dehumanizing, and unhelpful. Whoever uses such a disrespectful term for a fellow human being ought to be ashamed of herself.

The term behavioral health seems to have been hijacked by 'popular' avoidance of the term mental health until it is no longer meaningful. Behavioral health refers to all behaviors that impact health. Mental health and substance use disorders are a very small, but attention getting subset of behavioral health, which includes behaviors related to obesity, diabetes, heart disease, HIV, even ebola, malaria, tuberculosis, and other diseases. It is amazing how many people don't even pay attention to the two words, which speak only of behavior and health, not mental health or mental illness.

I find the term behavioral health offensive and it diminishes the person who is suffering. Having had depression all my adult life, I can tell you without equivocation that any behaviors associated with my illness were NOT the problem. The problem was the black, black hopelessness I would feel. The problem was that these spells of hopelessness would come on without warning and would keep me in their grip for several days. And even after they passed, I knew they would come again. To define this as a 'behavior problem' is to completely discount the very real suffering. I was finally correctly diagnosed and medicated in my late 30s and for the first time in my life I felt normal. I also realized that my illness was not my fault. It wasn't my choice and I didn't have it because I was a weak or flawed person. I know now that it was caused by bad brain chemistry because it is managed by meds that correct that chemistry. 'Behavior' implies conscious choice. Feeling hopeless was not a choice. And even though most mental illnesses are manifested in behaviors, the behaviors do not define the illness. When I finally was diagnosed the doctor didn't ask me, "So how have you been behaving lately?" Given that my issue is chemical, I'd prefer to call it a neurological illness. I also think that is a more accurate term.

The issue with behavioural health is problematic because, if we refer a client to mental health services because we are concerned about their mental health, an all too common response is that it is not a mental health issue but a behavioural one. Therefore the client is not seen by mental health services and then fall through the gap.

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What about brain health?

In the movie "Full Metal Jacket", it a recruit's behavior did not suit the drill sergeant he would yell at him, "Soldier, what seems to be your MAJOR MALFUNCTION?" In the service, if a trainee could change his behavior and shape up, then he had a behavioral disorder. If he did not "shape up", then he would be kicked out of the service for a "mental disorder".

Behavior, as something observable and measurable, seems the more inclusive term. I think the author's objections to the use of the term "behavioral" are weak.

1. Behavior is caused by both genetics, which is currently unalterable, at least for most people, and experience, which is only sometimes a matter of choice. So, to assume that the term "behavior" implies that an individual has choice about his/her disease is somewhat shortsighted.

2. Focusing on behavior does not exclude consideration of cause. In fact, without considering cause, you cannot have a proper study of behavior.

3. As to the term "behavioral health" seeming like a term created by someone at an insurance company, I completely disagree, and, even if this were true, since when should we ever make decisions about terminology based on who uses the term first? If it is a good term, use it!

I have heard or read no arguments that support using any other term than "behavioral health".

I have been to hospitals where they watch your behavior and if you are 'good' they will give you privileges and let you out.

I think it is more appropriate to let someone out of a hospital when they are well.

Supposedly being manic is being ill, not being badly behaved. Even if when manic a person may behave strangely.

Sometimes the psychosis occurs inside the person's head and there is no bad behavior to correct. I have had experiences of being in a waking nightmare, and medicine helps me get back to a normal state. It seems more like an illness than a behavioral problem to me.

However 'nice it seems to euphemistically use the term 'behavioral health', It doesn't describe what dealing with mental illness actually entails. Though I guess, if you create structure in your life and go to the health club every day and watch your diet, you might get better... no, wait, as far as I know it's still the medications that make someone better.

And being well behaved, being 'good' and taking your medications as prescribed, is key. So yeah, the words can be used in sentences, but it's still not right to call the whole field Behavioral. Just be good and compliant you won't be sick. No, actually, most of the medications cause such awful side effects you end up feeling sicker for taking them, and gain lots of weight no matter what you do.

So much of depression and mania are internal, and not manifested in the behavior, that this label makes little sense. Neither depression, mania, or anxiety are controlled by changing behavior. Even if changing your life, and adjusting your activities to curb stresses, can help somewhat, these illnesses are illnesses, and medication is what helps.

I don't like the name 'mental illness' either, especially since it's said to be a lifelong condition, with no possibility of cure. I now have a dr who contacts me right away and will catch it early if I start to go off, and add medication temporarily. That is 'medication managment' , and again, it's not handled as a 'behavior problem.

yeah, 'behavioral health' is softer but still offensive.

Here is the truth from someone who has to use that term on her medical documents. I am not a fan of the term Mental Health. Behavioral Health may not be the right description, but it is softer.

In reality, can we make the stigma go away? I personally don't believe so, because the word "mental" has a negativity attached to it. It has many slang meanings, most being critical and negative.

I have a health condition, (notice I excluded the world mental): it is anxiety. And, guess what, the term Mental Health makes me anxious! i cringe when I read the questions: "Do you have a mental health disorder? List your mental illness below."

Do I want to admit to something that makes me feel so uncomfortable? Sometimes, I honestly don't want to. I don't want to be judged or feel like the person on the other side of the table is looking at me differently.

What's most important is these are conditions we want people to talk about. To enable them to live better lives - and not hide behind the shame of a word.

I say bye-bye to that term. Let's turn it into something better.

I have been told it can be considered both. My internist and my psychiatrist both.

when I had panic attacks my internist said it was musculature and a massuse helped me.

Usually I've been given lorazapine for anxiety which I think it a crock. But maybe you have a different experience with it.

nobody likes the term 'mental illness'. I agree there.

Behavioral health = Newspeak

The term "behavioral health" is offensive when substituted for the term "mental illness." It trivializes schizophrenia, bipolar disorder, borderline personality disorder, depression, and other brain-based illnesses that are not caused by a person consciously misbehaving, but instead by a chemical imbalance in the brain that can often be made better by correcting the imbalance with proper medication.

To label a mental illness a behavioral disorder suggests that mental illnesses are not true illnesses, but instead are just unwise choices and bad behaviors by people who consciously chose their actions.

Mental health advocates have spent decades trying to educate people that mental illnesses have physical causes (imbalances in brain chemistry). Switching from "mental illness" to "behavioral disorder" will undo all the progress that's been made.

While mental illness does exist, there is a tendency to classify every bad behavior as a "disorder," a "syndrome," or an "illness." And even for people who have some real mental illness, are we to assume they can never misbehave? If mentally healthy people can sometimes misbehave, are we to assume that mentally ill people are incapable of ever misbehaving? People who are always going off on people, seem to be able to behave when they are talking to their bosses or to policemen, but not to family or (soon to be ex-)friends. They can be nice to a person they are attracted to romantically, at least for a while, but can be jerks to the rest of the world.

At presence behavioral health, they have emotions anonymous meetings where they say we have some control and some must be left up to fate or God. I prefer that to saying 'i have a mental illness and i am not in control of anything', a very irresponsible stance. i also like that they include those with drug and alcohol problems. A person can improve their character. At other centers for mentally ill, the alcoholics were in charge. I'd rather be peers than have them be my keepers. behavioral health is not just a synonym for mental health. it means something different. and maybe better.

I ended up here from the Substance Abuse and Mental Health Services Administration page because they were emphasizing, "Behavioral Health" and I wanted to know what it meant.

What it means is, “we’re all junkies now”. I'm appalled at the entire SAMHSA page, its viewpoints, its twisted logical fallacies, and its pro pain anti opioid policies. Those medically unethical policies are currently denying me; at age 73 proper pain medication for my crushed spine unless I suck DEA approved Pain Doctor Dick f (If you'll excuse the necessary metaphor).

I must wait for weeks to see these superior beings with no pain relief and then wait longer while they run lucrative tests and probe my inner being with an MMPI to see if I am psychologically qualified to not suffer scream inducing pain while they make up their compassion free and ethically unencumbered minds.

Jesus what an Ill medical system. All talk and no compassion. And a big sales pitch for the latest whiz bang slave maintenance drug.

Having experienced 'Nam and read Alfred W. McCoy's 1972 book, "The Politics of Heroin in South East Asia" Recently updated and re-released as "The Politics of Heroin" - CIA Complicity in the Global Drug Trade" and knowing we just re-upped in Afghanistan, I know where to go to find decent pain relief. That of course would be the return end of the logistics chain for the 100,000 mercenaries and 20,000 troops in The Stan.

Heroin will be cheap and pure that close to the source. So why sell your soul to sociopathic pain Doctor for some schedule two crap when you can have the real thing and a few hundred bucks will get you a year’s supply if you only use it for pain like I would. Fuck the cowardly Doctors. Schedule one and some Colorado pot is the way to go and you don’t have to piss in a cup on command like a common prisoner. Such a deal.

Diagnosis is an attempt to discern the underlying cause of symptoms by gathering data. Behaviour is a symptom. To diagnose a condition as a symptom is not a useful way to discern the underlying cause. Diagnosing someone as suffering from "dizziness disorder" would not be helpful with someone presenting with chronic dizziness. A clinician would need to discern the underlying cause of the dizziness (e.g., iron deficiency, medication, low blood pressure etc.) by looking at various data (self-report of symptoms, blood pressure reading, behavioural markers like balance etc.)

It seems to me that the "behavioural health" phenomena is an extension of a tendency to fixate on behaviour in the psychological sciences. Maybe this is because it is the most salient data available regarding what is occurring on a mental level, but it is still data, and should not be privileged more than other types of data, such as brain imaging, responses to questionnaires, and measurement of various bio-markers (e.g., heart rate variability).

I find "behavioral health" an extremely offensive term. My behavior is just fine; I'm a practicing attorney, a good and involved parent, and pretty functional in life. However, I have severe anxiety and panic attacks (treated with medication), and PTSD, and these disorders stem from the behaviors that others directed at me when I was a child.

I'm really tired of the lies and gaslighting and distortions of the APA. For example, the APA has eliminated (in the new DSM) the diagnosis of "narcissistic personality disorder." Years ago, the APA eliminated the diagnosis of "psychopath" and watered it down by replacing it with "antisocial personality disorder." The APA also eliminated any mention of the concept of "sadistic personality disorder."

Sadists exist. Narcissists exist. Psychopaths exist. And yet, the APA pretends that they don't, which invalidates the experiences of those of us who have been victimized by these predators.

For members of the APA to then victimize those of us with PTSD and so forth by saying we have a "behavioral health" problem is downright emotionally abusive. My behavior is just fine, thanks.

When I first heard the term Behavioral Health a few years ago, I remember asking myself what was driving that change? A couple of years back I came to a conclusion which seems to be similar to a lot of you:

The field has been focused more and more on brief interventions usually directed at symptomology and symptom management. Mostly by the payers and Managed Care. I'm reminded of the Helen Keller story when her teacher was being excused because she'd gotten her to bathe and family was happy. They hadn't yet tapped into the beauty of person because of the focus on making her look "good enough".

I tend to think this is a move by managed care to control and time limit services. So you focus on a symptom, apply bandage, next patient. A therapist then struggles with the pressure of doing what they're told and doing what's right. But eventually it will seep into University settings and clinical training and we won't really see what we're missing anymore.

Don't get me wrong, there is a place for both. Helping someone manage difficult behavior can be an important element to healing. But the underlying condition also needs to be acknowledged and given the proper and caring treatment it deserves.

Behavioral health includes 12 step programs coda and ea. And it includes God. Also the mentally ill are less isolated in programs that include both psych patients and addicts

Mental illness is not a behavioral issue, but behavior is a symptom of mental illness. My stepson has severe mental illness. He is paranoid schizophrenic and bipolar, with low IQ (70). He also is OCD, explosive rage, narcissistic, antisocial, etc. What is behavioral and what is mental illness? I believe that his personality disorders cause stress which in turn causes decompensation that often results in hospitalizations. Many of his behaviors were learned and are magnified due to his severe mental illness. It is impossible to medicate these behaviors away. Lets call mental illness what it is, we do not need another words for it. Mental illness doesn't go away with talk therapy or behavior modification attempts. However, with proper therapy for behavior problems perhaps psychotic episodes and subsequent hospitalization can be reduced.

I looked up the definition of "Behavioral Health" and saw this article. I received a questionnaire in the mail from my insurance about my experiences with my behavioral health provider. I worked in a substance abuse clinic for years and never knew that the term "Behavioral Health" was an umbrella over the term "Mental Health", I thought it was the other way around. I do not consider my depression behavioral health. I do not gain anything from this "behavior", and I don't consider it anything I have control over. Usually if it is a behavior that keep repeating and you have control over it there is some gain. In my experience working at the substance abuse clinic, most have underlying mental health issues which they are trying to self-medicate. Mental Health is more appropriate than behavioral health. Behavioral health seems dismissive of the fact that there is something wrong with me, instead it sounds like I am the problem. If we don't call it what it is "Mental Health" then mental health issues will always be something to be ashamed of and something we don't want to talk about.

After suffering with Depression and other mental health issues, I have more compassion for the "addicts" (sorry no better word). I understand the need to do something that will help, or at least try. Mental health should not be a stigma, for the patient or for others. People with substance abuse issues also should not be looked upon as having a behavioral issue, but a medical issue.

Back to my questionnaire, which asked about the services I received in the past year. I was asked if my provider talked with me about why you might not want to take your medication. No my doctor just put me on anti-depressants because I was depressed, why would he want to take me off of them. My only thought was that they were talking about Opiates. I am on opiates because I have fibromyalgia, degenerative scoliosis, and foot problems. I am also allergic to anti-inflammatories. My husband is on opiates because he has Cancer. I received this questionnaire in the mail, just after we tried to fill a prescription for my husband. The pharmacy told us that the insurance will no longer be able to fill prescriptions for opiates for longer than 7 days. We saw his oncologist this morning and he couldn't believe it and he was very upset. He said all his patients are on opiates.

We need to do something about health care in this country. Our health care is compromised because of our preconceived notions, that mental health issues can be helped with behavior modification and that everyone who uses pain medication is seeking to get high. No wonder there are so many prejudices around mental health.

I literally despise this label. The only way I'd be cool with it is if we were to start calling oncology the "bald head ward". Is there a problem with the word "psychiatry"? People can't jive with proper labels for my disorder? I'll show 'em some "behavior".