Mental Health Terminology: Words Matter
“When a stigmatized group of people such as those with mental illnesses, is struggling for increased understanding and acceptance, attention to the language used in talking and writing about them is particularly important.”[i]
The general rule is to use person-first language. The basic concept behind person-first language is that the mental health condition (or physical or other condition) is only one aspect of who the person is, not the defining characteristic.
Preferred language Instead of
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She is a person who receives help/treatment for mental health or substance use problem or a psychiatric disability
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She is a patient
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He is a person with a disability
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He is disabled/handicapped
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She is a child without disabilities
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She is normal
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He has a diagnosis of bipolar disorder
He is living with bipolar disorder
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He is (a) bipolar
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She has a mental health problem or challenge
She is a person with lived experience of a mental health condition
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She is mentally ill/emotionally disturbed/ psycho/insane/lunatic
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He has a brain injury
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He is brain damaged
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He experiences symptoms of psychosis/He hears voices
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He is psychotic
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She has an intellectual disability
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She is mentally retarded
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He has autism
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He is autistic
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Is receiving mental health services
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Mental health patient/case
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Attempted suicide
Died by suicide
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Unsuccessful suicide
Committed suicide
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A student receiving special education services
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Special education student
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Person with substance use disorder
Person experiencing alcohol/drug problem
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Addict, abuser, junkie
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Experiencing, or being treated for, or has a diagnosis of, or a history of, mental illness
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Suffering with, or a victim of, a mental illness
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Key Points about Reporting on People with Mental Illness
- Most people with mental illness are able to recover with treatment and support.
- People with mental illness are not naturally violent, unable to work, or unable to get well.
- “Mental illness” covers a broad range of conditions and symptoms. Individuals’ experiences and the effects on their lives can be very different
- Terms like “suffering from” or “afflicted with” can help to reinforce misunderstandings and fears about mental illness.
While many are opposed to any use of terms such as “crazy” or “psycho,” NAMI (National Alliance on Mental Illness) states, “We do not protest the usage of single words like “crazy,” “psycho,” or “loony” unless that refer directly to individuals struggling with mental illnesses or to the illness itself.”
Research: Labels can Alter Attitudes
Researchers found that health professionals’ attitudes were different when they were presented information on a hypothetical patient described as either a “substance abuser” or “having a substance abuse disorder.” Respondents were more likely to have a punitive attitude and to agree with statements implying the patient was more to blame if he was described as and ‘substance abuser’ rather than a person with a disorder.[ii]
Terminology Preferred by People with Mental Illness
In a 2007 study asking individual receiving services for mental illness their preferred terms describing their status:
- Client – 39%
- Patient – 22%
- Consumer – 16%
- Survivor – 11%
- Other – 11%
- Ex-patient – 1%
The study authors concluded that given the varied response and lack of consensus, that clinicians, policy-makers and others should be sensitive to individuals’ references.[iii]
Terminology in DSM-5
The term “abuse” which is used in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is expected to be removed in the forthcoming DSM-5 (e.g., Alcohol Use Disorder replacing Alcohol Abuse and Dependence and Opioid Use Disorder replacing Opioid Abuse and Dependence).
Resources
University of Kansas: Guidelines for Reporting and Writing about People with Disabilities
Disability Rights California: People First Language in Mental Health
NAMI: Resource Center to Address Discrimination and Stigma
[i] Wahl, O.F. 1998. People first language matters. The Bell (newsletter of Mental Health America, formerly the National Mental Health Association).
[iii] Covell NH, McCorkle BH, Weissman EM, et al. 2007. What’s in a name? Terms preferred by service recipients. Adm Policy Ment Health. 34(5):443-7.