Stigmas in Mental Health Care

Breaking Stigmas in Mental Health Treatment: Say What You Mean

In terms of breaking stigmas in mental health care and how we think about mental health, does what we say matter? Do we actually perpetuate stigmas by participating in conversations where the misinformed or stigmatized language is used?

Imagine Joe, who has privately managed bipolar disorder for the past 12 years, having a conversation with a coworker. The coworker mentions a mutual acquaintance. This acquaintance just returned from a stay at a residential mental health treatment center.

Joe’s coworker says, “I had no idea she was crazy, did you?”

Joe’s insides do a few somersaults. Joe currently receives mental health treatment. Despite years of education, support, mental health treatment and self-awareness around his bipolar diagnosis, Joe still has a thought flash through his head, “Does this mean I’m crazy?”

During his time at the company, Joe had taken sick leave when his medication needed adjusting. He even took vacation time when his depression became severe and interfered with his ability to work.

Recently, he considered sharing his diagnosis with human resources to create some accommodations, which could profoundly lighten Joe’s burden around work and mental health management. After the conversation with this coworker, however, Joe shuts down any thought of sharing his diagnosis.

While privacy laws prevent human resources from sharing personal details, Joe’s coworker brought back a harsh reality for many managing a mental health disorder. 

There are still stigmas around mental health care. The language we use on the subject is a powerful gauge and reflection on our collective bias.

Joe isn’t crazy, and neither is his friend who exhibited the courage to reach out for help. Sadly, despite some staggering statistics around the prevalence of mental health disorders, misinformation and stigmas still prevail. According to the National Institute of Mental Health, one in five Americans is diagnosed with a mental health disorder annually as of 2019.

Is this something we can change? 

Yes. We can change stigmas, but this means watching our words carefully. The Ranch Pennsylvania offers insight into this complicated topic.

How does language impact what we think? 

Linguists research the relationship between language, thought and perception. These discoveries are helpful in terms of mental health care stigmas and mental health treatment.

For example, if you know about cognitive therapy, then the idea that language impacts our thoughts and feelings isn’t new. Cognitive therapy is centered on an awareness of our automatic negative thinking and how these thoughts contribute to our mental health.

Is the same true, however, for casual conversation? For instance, in Joe’s case, does his co-worker’s poor use of language impact him? Does this language contribute to Joe’s own bias with mental illness?

How we learn a language is a vital part of our development when it comes to biases.

According to the Linguistic Society of America’s article, “Does the language I speak influence the way I think?” people tend to group words and thoughts into categories when learning a language. A toddler may see a cow and comment “dog.” When learning English, according to linguists, the child may first group all similar-looking creatures under the category of one word, like “dog.” Eventually, your brain sorts it out and refines it. 

In New Guinea, the Dani people only have two words (or two categories) for color. In the Dani language, color is either light or dark. also covers language development in the 2017 article, “How the Language We Speak Affects the Way We Think,” published online.

So, what does this have to do with Joe’s conversation and use of the word “crazy” for someone with a mental health disorder?

Think about Joe as a child. He likely heard many conversations and references on TV about people who were “crazy.” In American society, there’s a tendency to see mental health much like the Dani and their perception of color—either healthy or unhealthy. You are, according to this imprecise idea, either crazy or sane.

In truth, there are many shades of colors and many nuances of mental health disorders. However, Joe may still use his original frame of reference despite many hours of education, therapy, other treatment and support. 

He may have a deep-seated belief because of the language he heard while developing language and, then, throughout his life, supporting the idea that mentally ill people were “crazy.” In this case, “crazy” is negative and bad.

In the end, society did a number on Joe and his coworker. The consequences are felt today. As someone with a serious, lifelong mental health disorder requiring vigilance and good management, he still must deal with his own and other wrong perceptions around mental health. Sadly, these perceptions still impact his work situation, friendships, recovery and sense of his own worth.

Remove mental health stigmas by talking mindfully

We’ve established that the language we use impacts our thinking and can strengthen mental health stigmas. If we want to weaken these mental health care stigmas and, hopefully, eliminate them for future generations, everyone needs to watch what the current generation says. Can we make mental health treatment as acceptable as the treatment we receive for physical ailments and wellness checks?

For a sobering look at how mental health is stigmatized via the English language, read the journal abstract, “250 labels used to stigmatise people with mental illness,” published by BMC Health Services Research. Put the list on your fridge and work to avoid using this language.

Some words to use mindfully:

  • Don’t use words like “crazy” or “disturbed” when referencing someone’s behavior or personality. It’s one thing to remark, “The weather last week was crazy” vs. “She was crazy jealous.”
  • Avoid saying “unhinged” and “psychotic” to describe anyone, even in a joking manner. It makes the misuse of these words acceptable. Psychosis isn’t acceptable as a means of describing anything except actual psychosis. A person who experiences psychosis isn’t a “psychotic” any more than you’d label someone with an allergy as an “allergic.”
  • “Suffering from mental illness” contributes to the misnomer that anyone managing a mental illness is miserable and suffering. The term “suffering” is obviously negative. People living with a mental illness can live fulfilling, happy lives. Managing a mental illness doesn’t mean a person is suffering. Instead, use “living with a mental illness.” Mental health disorders are highly treatable, and the majority of those treated live improved full lives.
  • Don’t overgeneralize with the label “mental illness.” Mental illness covers a lot of mental health ground. The phrase can be misleading and vague. Instead, say, “a person has a mental illness,” which supports the reality there are many, many nuances when discussing mental illnesses.
  • Avoid using the word “victim” when describing someone’s experience with a mental illness. Someone managing a mental illness is anything but a victim. Living with a mental illness requires courage, action and self-awareness. Victimhood is not a healthy category to place anyone.
  • Phrases and words like “Not right in the head,” “retarded,” or “simple-minded” are often used as derogatory descriptions for someone with a developmental disorder, a mental illness, an unconventional way of living and more. The bottom line is simple. Don’t use phrases or terms meant to insult someone or someone’s choices. Be mindful and specific.
  • Try to look beyond the simplistic categories of “normal” and “abnormal.” Normal doesn’t really exist, does it? What’s normal to one person could be considered abnormal to another. Broaden your understanding of all the complexities which make up one human being. Each of us is normal and abnormal in our own unique way.

Read more about specific words to avoid in the article, “Language and stigma,”

published on the website.

What if you mess up?

How can you always say the right thing? Well, truthfully, you can’t. Chances are, at some point, you or someone else will cross the line. We all need to be kind to one another, even ourselves when we mess up. 

Let’s go back to Joe. He’s still feeling uncomfortable after his coworker called a mutual acquaintance “crazy” in casual conversation after the acquaintance sought help for a mental health crisis. Joe, with this own history of bipolar disorder, is upset and angry about the conversation. The brief remarks left Joe feeling triggered. On some level, he’s also angry with himself for keeping quiet. 

Stigmas prevail when we are complicit in conversations where the inappropriate language is used.

How can Joe confront his coworker without coming off badly? In a work situation, no less? 

Is it possible for Joe to confront the “crazy” language used without pulverizing his misinformed co-worker and causing a scene? And, jeopardizing his job in the process?

How to handle this conversation is a decision only Joe can make. He needs to make sure he doesn’t put himself in harm’s way, and he’s able to speak his truth about being further offended. 

Speaking up

Scenario One: Joe is diplomatically honest.

Joe doesn’t laugh when his coworker makes inappropriate and offensive remarks about the mutual acquaintance. Instead, he says, “I know you don’t mean anything by it, but I can’t laugh about this situation. This is a mutual friend, and I know she’s facing some challenges right now. I prefer to avoid using language like “crazy.” I also don’t particularly appreciate laughing when someone is in pain.” 

Scenario Two: Joe ignores the language but makes his feelings known.

Joe takes a breath and says, “It must have taken such courage for her to seek help for a mental illness. I admire such bravery. Instead of using the word “crazy,” I think “brave” is a better description. Too many people still misunderstand mental illness. Hopefully, we will learn something from brave people like our friend. I need to get back to work.” 

Scenario Three: Joe circles back to the conversation after seeking his own support.

Joe went home and slept on the situation. He also talked to a few of the people in his mental health support group. The next day, he catches his coworker in the parking lot after work. “Yesterday, I felt uncomfortable when we talked about our mutual friend and the word “crazy” was used. I have some experience dealing with a mental illness in my own family. I’m sure you didn’t mean to say anything offensive, but I felt I needed to speak up. If you have any questions about mental health disorders, I’d be happy to discuss.”

In this last example, Joe doesn’t reveal his own diagnosis, but he does share his expertise on the subject. He also turns the situation into an opportunity for discussion. In this way, Joe may be able to dispel some misinformation. This scenario, of course, is assuming Joe’s coworker has the maturity to handle such a conversation.

Joe isn’t responsible for setting someone else on the right path. He’s only responsible for being true to himself. If at any time, he felt threatened by this coworker, then all bets are off. Joe cannot put himself in harm’s way.

Sadly, some people are comfortable with old stigmas and beliefs. In this case, Joe doesn’t need to put himself in the path of more offensive language.  

Instead, Joe, and all of us, can lead by example. Watch what you say. Language has consequences. When we stray off the path, apologize, if necessary, and get back on the horse.

Mindfully, we can push mental health stigmas back under the rock from where they came.

Whether you are looking to help fight stigmas in mental health treatment or you need mental health care, The Ranch Pennsylvania is here to help. 

If you or your loved one is in need, we are ready to help you better understand yourself outside of your mental health condition. Call us today at 717.969.9126 to speak with our recovery specialists and find out more about our mental health disorder treatment options.

By Heather Berry

Contributing Writer with Promises Behavioral Health 

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