“The difference between the right word and the almost right word is the difference between lightning and the lightning bug.” – Mark Twain
Dear Sir
Language shapes how we see the world. The words we choose and the meanings we attach to them influence our feelings, attitudes and beliefs.
With respect to mental health, the use of language is critical to ensuring a recovery-oriented and person-centred approach. It is important that people are seen first as people and not seen as their mental health condition. People are not Schizophrenic, Bipolar, or Borderline. People are not cases or illnesses to be managed. In effect, language that emphasizes the person, not the condition or disability is a way to demonstrate respect for a person’s dignity and worth. This is sometimes called person-first language.
Many experience mental distress and while this may be a problem for them, it does not necessarily mean they are ill. We talk about the health condition only when necessary. It is important to use respectful language, which literally means putting a reference to the person first in a phrase.
For example, instead of calling someone “mentally ill,” a more respectful, people-first way of phrasing it is to say “a person living with a mental health condition.” And, the term ‘mental health problem’ should be changed to brain disorders or neuro behaviour disorder, especially since the term mental has distasteful, negative, demeaning associations.
As well:
| Don’t Say This | What To Do/Say |
| Mental health/services | Behavior health/services |
| Person is mental or a mental case (pointing to the head) | Never say this, especially since its used in a derogatory sense |
| That’s crazy, psycho, insane, nuts, | That’s wild, bizarre, odd, eccentric |
| It drives me crazy | It annoys me |
| He’s/she’s mad (maad) or is a mad (maad) person | No such thing. See below. |
| He is a paranoid schizophrenic | He has paranoid schizophrenia |
| He’s psychotic | He’s experiencing psychosis |
| She’s an anorexic | She has anorexia nervosa |
| He’s depressive | He has major depression |
| She’s OCD | She has obsessive-compulsive disorder |
| He’s bipolar | He has bipolar disorder |
| She’s mentally retarded | She has a neuro developmental disorder |
| She is emotionally disturbed | She has a serious emotional condition |
| He’s a special education student | He’s a student receiving special education services |
| She’s an addict or substance abuser | She has a substance use disorder |
| He’s mentally ill | He has a mental health/neuro behavior disorder |
| Super utilizers, high-needs adults | Individuals with complex support and service needs |
| Successful suicide, commit suicide Unsuccessful suicide |
Died by suicide, suicided Attempted suicide |
| Suffering from mental illness or mentally ill | Living with (or experiencing) a mental health or neuro behavior disorder |
| Normal behavior…how is this defined? | “Usual behavior” or “typical behavior” |
The chart provides some examples of the language that is appropriate and inappropriate. The bottom line is that in the context of mental illness, mental health, and wellbeing, negative language can be experienced as condescending, isolating, and stigmatising, whereas positive words, people-first language convey dignity, empathy, and hope.
Annan Boodram
