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Reframing language in mental health

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), mental illness is nothing to be ashamed of.

It is a medical problem, just like heart disease or diabetes. Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities, and they are often accompanied by substance use. It’s critical that we talk about these challenges and that we do so in the right way.

Why changing our thinking, our actions, and our language matters

The terms we use to describe mental illness matter. We have all heard derogatory terms used to describe someone who has a mental illness. Here are a few to jog your memory: Cuckoo, mad as a hatter, screwy, having a screw loose, bananas, loopy, crackers, wacko (whacko), loony, nuts, freak, crazy, weirdo. Can you imagine mocking someone with an illness such as cancer or heart disease? Here’s how we can do better.

Updated language and why it matters:

Prejudice and discrimination: Prejudice refers to thinking, discrimination refers to action - both can be changed. Outdated: “stigma.”

Acceptance: Being aware doesn’t call for action, change in behavior or thinking. Outdated: “awareness.”

Experiencing or living with a mental illness: People who experience mental health conditions can and do live healthy, fulfilling lives. Suffering implies one is unwell, unhappy or can’t recover. Outdated: “suffering from a mental illness.”

Experiences/has been treated for emotional, mental and/or behavioral health challenges: Being diagnosed, experiencing symptoms of or having been treated for a mental illness is a common part of the human experience. The term disturbed perpetuates prejudice and creates a barrier to treatment. Outdated: “emotionally disturbed.”

Person experiencing /living with or diagnosed with a mental illness: Certain language exaggerates mental illness and reinforces prejudice. Always use person-first language. Outdated: Mentally ill person; referring to someone with a diagnosis as schizophrenic, autistic, bipolar, OCD, etc.

Person who experiences substance use challenges: Avoid words that suggest a lack of quality of life for people with substance use concerns. Terms like addict reduce a person’s identity, deny dignity/humanity and imply powerlessness or the inability to recover. Outdated: Drug abuser; alcoholic; addict; substance abuse.

The importance of using person-first language when talking about mental illness and substance use cannot be overstated. This is true for members of the media, support and treatment professionals, family members, friends and the community at large. Person-first language separates the individual from the symptoms they experience - maintaining their identity as people with strengths who have the power to recover. Here are a few examples.

Person-first phrases that promote recovery:

• A person living with a mental health condition vs.

• A person with substance use challenges

• My son was diagnosed with bipolar disorder

• My daughter with schizophrenia

• My neighbor who has autism

• The client I’m treating for depression

• My father who has alcoholism

If you or a loved one is facing mental health struggles, emotional distress, alcohol or drug use concerns, or just need someone to talk to, call, text or chat 988.

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