Language matters. Always. But perhaps nowhere more importantly than in our discussions of suicide and mental illness where, for decades, the language used was dismissive and stigmatizing.
Sadly, despite gains in public discourse surrounding mental health, the language used remains dismissive. And, often, it remains stigmatizing.
Mental Health v Mental Illness
Notice my subtle shift from introducing the issue of mental illness to a discussion of mental health. That’s part of the problem, the conflating of the terms, the popular interchangeable use of them. But I used each term deliberately. Because language matters, I’m precise in my use of each term.
I believe that the cavalier use of the term mental health to mean all things mental obscures discussions of mental illness. It causes issues in interpretation and sews confusion in meaning because mental health and mental illness aren’t the same things.
I often see, in an effort to widen the audience for a book, the same sense of conflation. Yes, we might all experience anxiety or sadness, but we don’t all live with Generalized Anxiety Disorder or Major Depressive Disorder. We all have mental health, sometimes good, sometimes bad. But we don’t all live with a mental illness. Conflating normal moments of anxiety or sadness with these illnesses, diminishes the illnesses, minimizes the suffering they cause.
To my mind, interchanging these terms, which clearly mean different things, is lazy. By diminishing the mental illness, by minimizing the suffering of those living with mental illness, it’s as if that suffering, that individual, doesn’t matter. It confirms that mental illness is still taboo.
Mental Illness or Mental Disease?
But is mental illness the correct term, the best term?
It’s the term that I use, however, I was recently introduced to the terms mental disease and mental health disease. I heard them during a Tedx talk and saw them used by that speaker, DR. Ashley (@BecauseIMatter), on Twitter. I reached out to Dr. Ashley by DM to ask why she used those terms and not mental illness. She graciously answered me and gave her reasoning.
Dr. Ashley explained that her language flows out of her career as a medical provider. She said that we treat diseases, heart disease, diabetes, liver disease, etcetera. When our brain isn’t working correctly, we treat that organ just as we treat other, diseased, organs.
She distinguished disease from illness. Illness, she said, is commonly perceived as something you can catch or pass on, like a cold or the flu or measles. Moreover, stigma tells us that people fear “catching” a mental illness, something that is patently impossible. Because of the stigmatizing connotations of the word illness, and because of her medical background, Dr. Ashley prefers to use the word disease.
While Dr. Ashley’s reasoning is persuasive, for now, I’ll stick with mental illness. I concede that stigma is attached to it, but illness is the word people commonly use, the word they’re familiar with. People speak of being ill, not of being diseased.
If we want to normalize the conversation, we can’t always change the language we use. Sometimes we must use common terms and use the language people are familiar with.
We can still take action against stigma. We can instill in the common language the meaning we intend. Language matters.
But we need to do this while preserving the dichotomy between mental illness and mental health. Those of us with mental illness deserve to be heard. We deserve to be counted. We matter and we ought not to be dismissed.
Language and Suicide
Consider this. During an online conference hosted by a mental health charity, one of the speakers repeatedly referred to completed suicide. He was referring to the deaths of colleagues, and the horrific statistics surrounding suicide and bipolar disorder, and used this phrase multiple times.
Another speaker at this conference used the phrase committed suicide.
I was shocked.
To me, the phrase completed suicide raised troubling thoughts. It created the impression that the suicides in question were successes, jobs well done. It also created the impression that attempts were incomplete suicides and, as such, failures. This reminded me of another mental health charity on a mental health awareness day tweeting about failed suicide.
The term committed suicide takes us back to another age when suicide was a crime that one commits. I saw this term used as recently as this past Wednesday on Twitter by a respected mental health advocate. In the comments, I saw at least one person speak of successful suicide. Really?
Such horribly stigmatizing language.
We’re talking about tragedies here, tragedies that can often be remedied by medication and/or talk therapies. A life lost to suicide isn’t a success, it isn’t a task completed. Surviving an attempt isn’t a failure. These events are signs of someone unnecessarily lost, of someone in peril. They deserve better than language like this. The language we use matters.
I ask you, is this really the messaging we should hear from mental health charities? If they use such stigmatizing language, how can we expect to rid society of the taboo and stigma surrounding suicide? I expect mental health charities to do better.
For me, hearing these phrases during the conference was off-putting. I found myself tuning out the speaker and leaving the conference early. I wonder, in passing, if others reacted in the same way. Or maybe it was just me.
Let me be clear. Suicide is an important and complex public health issue that touches on many elements of a person’s life. Only one of them is mental illness. This complexity necessitates approaching it with clarity of thought and language.
The site, bloggingonsuicide.org, addresses the sensitivity and complexity inherent in discussing suicide by giving guidance on terms to use. Death by suicide is the term they recommend, and it’s the one I prefer myself. I know from personal experience that those running that site are responsive to the community and have given careful thought to the language they propose.
Language matters. It certainly matters when we talk of mental illness and suicide. While both are elements of the larger discussion around mental health, they are fully deserving of their own dialogue. If we don’t remember this, discussing mental illness or suicide will become taboo once again.
I urge you, be careful and precise in your use of language when discussing mental health, mental illness and suicide.
If you believe that you’re in need of help regarding your mental health, or if you’re experiencing thoughts of suicide, I urge you to speak to your family doctor immediately or call your local Canadian Mental Health Association branch. They can direct you to resources in your community. Crisis Services Canada can be reached by calling 1-833-456-4566 or by texting 45645. You can also get immediate help by dialing 911 or visiting your local emergency room.
Image by Daniel Reche from Pixabay