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Stigma and mental health

The power of language

Language can empower people, promote hope, and encourage people to change and move forward. The words we choose to use can support or get in the way of working and connecting with families. For example, when we think of and refer to someone as ‘mentally ill’, we focus on the illness rather than the person. Focusing on a person’s illness can lead to them feeling stigmatised, labelled or hopeless.

Practice prompt

How do you talk about mental health and mental illness with families and within your team? What words and turns-of-phrase are used when writing case notes? What are your experiences and thoughts about mental health and illness? How do these influence your practice? What are the biases or assumptions you bring to your practice?

Words and phrases to avoid

Why?

Use words that help to convey acceptance, hope and respect

Jan is mentally ill. These words focus on the illness, not the person.

Jan is a person experiencing mental health difficulties.

Jan has been diagnosed with a mental illness.

Matthew is schizophrenic.

Amanda is depressed.
People are more than their label or diagnosis.

Matthew has a diagnosis of schizophrenia.

Amanda has been diagnosed with depression.

Alicia is non-compliant/resistant/refuses support. These words convey judgement and are non-descriptive. They do not support practitioners to remain curious about why Alicia might be reluctant. The words imply she will not participate in any treatment, when she may have different ideas about what will work for her.

Alicia would prefer not to attend a mental health assessment because she is worried the doctor will not listen to her.  When she attended a service in the past, she found them to be dismissive of her concerns.

Alicia has decided not to take the medication that was prescribed to her for depression.  She finds it does not help her, and makes her feel sick. She would rather consider other options to address her depression.

John is suffering from bipolar.

Living with mental illness is not always experienced as suffering. The use of ‘suffering’ may lessen hope and optimism.

Everyone has the chance of leading a complete and satisfying life while living with mental health difficulties.
John has been diagnosed with bipolar disorder.
Taylah is emotional. Everyone experiences emotions. The term conveys judgement, rather helping to understand the context or what might be going on for Taylah.

Talk or write about the emotion the person says they are feeling, or record the behaviours observed. For example:

Taylah became short of breath, was talking fast and loudly, and was crying. This lasted about 10 minutes. She later told me she had a panic attack.

Amanda has a chronic mental illness.

These may create a sense of hopelessness. They could make recovery seem impossible. Paul has lived with mental health issues for 20 years. He has periods of feeling well, sometimes for up to 10 months, and periods of feeling unwell, sometimes for periods of up to 6 months. When Paul is unwell, he finds it hard to…
Words like ‘mad’, ‘insane’, ‘loony’, ‘nut-job’ and ‘crazy’. These terms are disrespectful and get in the way of our curiosity about what might be happening for a person.

'Ian’s behaviour is difficult for me to understand'. 

'I wonder what might be happening for him'.

Source: Adapted from the Recovery Oriented Language Guide (2nd Ed) (Mental Health Coordinating Council, 2018).

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