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Language We Should and Shouldn't Use When Talking About Mental Health

This article contains references to suicide.

As humans, language is our foremost method of communication. It is how we connect, share our thoughts, emotions, and our experiences. Both verbally and in written form. And this gives language power.

The words we use are impactful. They can be liberating, uplifting, and inspiring. But equally, they can be harmful.

It is for this reason that we need to be aware of the language that we should and shouldn’t use. Sometimes, it has a larger effect than we may initially comprehend.

No matter how aware you are, and how sensitive you are to the feelings of others, the reality is that we don’t always use the correct language when we talk about sensitive topics. When it comes to mental health, several words and phrases have become ingrained into our daily vocabulary based on dated misconceptions of mental health. While society has come a long way from these damaging views of mental health, and we now often don’t mean any ill-intent by these language choices, the use of this vocabulary can still be problematic.

The words and terms I refer to contribute, even subtly, to keep negative misconceptions about mental health problems rife. These negative misconceptions become stigmas and fuel negative behaviours, which become discrimination. Something we so badly need to move away from. The Mental Health Foundation report that nearly 9 out of 10 people with mental health problems report that stigma and discrimination have an impact on their lives, oftentimes worsening the problems they are experiencing, and potentially becoming internalised and becoming barriers to seeking help, among many other ramifications.

Through working in mental health research and on Inspire the Mind, I have become increasingly aware of these language choices and the inadvertent effect that can be had. Despite striving to be inclusive and sensitive, I too am guilty of some of these and by writing this article I do not want to portray myself as always saying the right thing. What I think is the most important thing is that we become mindful of our language choices and try to communicate in ways that are as inclusive as possible.

It is for this reason that I have compiled a list of the language we should and shouldn’t use when talking about all things mental health. By no means an extensive or complete list, I hope that being aware of these language choices and the reasons behind them can help us all be as respectful as we can and help to break down the stigma that still clings to mental health.

So, let’s get into it.

1. Put the person first

In our everyday language, some diagnoses are used as a label. Describing someone as an "addict" or an "alcoholic" isn’t something uncommon, as just two examples. Labels as such tend to define the person by their experiences. By using person-first language we can avoid reducing them to a diagnosis but also validate their experiences. Essentially putting the person before the diagnosis.

Instead of calling someone mentally ill, try replacing it with "person with a mental illness", or "person living with a mental health issue". This small change shift in our words makes a big change in the narrative, from the person being a problem (an elucidating blame), to the person having a problem. This is particularly relevant for examples such as people with substance use disorders where there is a clear need for a better understanding that there are factors outside of our control that might increase our chances of struggling with addiction, such as our genetics or environment, because there is so much preconception of blame.

Person-first language is also not exclusive to mental health either and, in fact, is a very big topic of discussion across different areas of health care. In some communities, person-first language has been rejected for various reasons including the autism community who have shared that autism is a key part of their identity and something they take pride in and therefore are more driven towards "identity-first" language.

2. Suicide isn’t something you 'commit'.

What might be surprising to some, is that it used to be a crime to die by suicide in England and Wales. Until the Suicide Act of 1961, it was a criminal offence to survive a suicide attempt, and even to die by suicide, a crime that could get you imprisoned. While it is now only illegal to assist or encourage a person to end their life by suicide, the criminalised language from way back then has become ingrained in our language, with many people still using the term "committed suicide".

Unfortunately, the continued use of this term still tinges this as a crime and once again fuels the stigma associated. As a stark comparison, we wouldn’t say someone "committed cancer", but rather they "died from cancer". In the same way, we should instead change our language to "died by suicide".

In the same realm as labels that place blame, "committed" suggests the same. Removing this blame removes the culpability.

3. Avoid using labels in a non-clinical sense

There are small moments or occurrences in the day that might ellicit responses such as "you’re so OCD" (referring to obsessive-compulsive disorder) when you show a tendency to like something clean or organised. Another common one is "he’s so bipolar" (referring to bipolar disorder) describing someone who appears to change their mood.

What these have in common is that the diagnoses for real mental health experiences are being thrown around in the non-clinical sense.

Often based on surface-level attributes of the diagnoses — for example, the common misconception that OCD is just an obsession with things being clean, or that bipolar is just unpredictable changes in mood — throwing around such terms diminishes the reality and severity of such diagnoses. While not intended, the more non-clinical use of this language to describe small moments, the more damage it has.

Beyond diluting the experience of someone who is actually experiencing OCD or bipolar disorder, for example, these throw-away comments are unhelpful for stigma as we limit the understanding we have of these conditions. In the case of OCD, this continues the assumption that the disorder is just liking things neat and tidy and doesn’t reflect the intrusive and distressing thoughts that a person with OCD may experience, the intense anxiety it causes, or the many different ways in which the obsessions and compulsions can manifest.

4. Change your choice of descriptive words

"Psycho", "mad", "crazy", and "mental" are frequently used words to describe things in daily life. But, these are prime examples of how the past misconceptions of mental health have remained part of our language today. These terms are incredibly derogatory and offensive and should never be used. Some of these date back as early as the 13th Century and of course are no longer medical terms but were used widely in a medical context historically.

Perhaps aside from "psycho", I find that often these words are not used to necessarily describe mental health nowadays, but rather to describe something that we don’t necessarily understand. "This happened, it was crazy!" While this isn’t intended to cause harm, like many of the examples here, it doesn’t serve to reduce stigma and still draws on stereotypes that we want to avoid. Whether it seems connected or not, the connotation remains and so it may be more appropriate to aim for descriptors for more specific attributes that you are trying to portray, such as "unpredictable", as just one example.

What I don’t want from this article is to induce fear. It is not the intention to make anyone shy away from talking about mental health. Doing so would still only serve to perpetuate stigma. The more we talk about mental health, the more we can educate one another, understand one another, and most importantly, support one another.

We won’t all get it right all of the time, and that’s ok. So long as we are educating ourselves and increasing our awareness, we are taking a step in the right direction.

Let us know in the comments down below if you can think of any others!

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