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Why You Should Stop Using the Phrase ‘the Mentally Ill’

February 16th, 2016


Google the phrase “mentally ill” and you’ll find the following: “Mentally Ill Man’s Shooting Fits Troubling Pattern.” “Solitary Confinement Out for Mentally Ill?” “Chicago Police to Receive New Training on How to Assist Mentally Ill.”

And so on. There’s a potentially troubling subtext to these headlines, in that it makes “the mentally ill” sound like a separate subset of the population. The fact is, however, that mental illness — which is itself a huge umbrella covering everything from depression to schizophrenia to bipolar disorder and more — affects one in five American adults (or more than 43 million people 18 and over), according to the National Alliance on Mental Illness. Now new research makes the case that simply using the phrase “the mentally ill” may be inadvertently promoting a dangerous level of intolerance.

Darcy Haag Granello and Todd A. Gibbs at the Ohio State University just released a paper in The Journal of Counseling & Development looking at this issue. They took more than 600 people — undergraduate students, adults, and counselors-in-training — and used the Community Attitudes Towards the Mentally Ill (CAMI) survey. The one twist: Half of the respondents got statements associated with “the mentally ill,” and the other half got the exact same statements with “people with mental illnesses” instead. When the phrase “the mentally ill” was used, different groups showed different levels of intolerance. College students are more likely to believe that people with mental illnesses should be controlled and isolated. Adults, on the other hand, are less empathetic or “benevolent” to those suffering from mental illness and are more likely to want to have them separated from the “normal” community.

What’s most surprising is the reaction that counselors have when the phrase “the mentally ill” is used: They’re more likely to believe that those suffering from mental illness should be controlled and isolated from the rest of the community. That’s pretty surprising, given that these counselors are perhaps the ones most likely to be aware of the special needs and varying differences in diagnoses of the group.

Counselors also showed the largest differences in how intolerant they were based on the language, which boosted the researchers’ belief that simply changing language is important in not only understanding people who suffer from mental illness but also helping them adjust and cope. “Even counselors who work every day with people who have mental illness can be affected by language,” Granello said in a press release. “They need to be aware of how language might influence their decision-making when they work with clients.”

The concept of changing the way we refer to people with mental illnesses dates back to the “person-first” (sometimes referred to as “people-first”) movement of the 1990s, when advocates argued that defining a person by their disability robbed them of their personhood and their identity. “When you say ‘people with mental illness,’ you are emphasizing that they aren’t defined solely by their disability,” Gibbs said. “But when you talk about ‘the mentally ill’ the disability is the entire definition of the person.” Despite the “person-first” movement of the 1990s, Granello and Gibbs’s study is the first one to look at how language affects how we perceive this population.

Granello is hesitant to say that a conclusion can be drawn from this, that it was too early to draw definitive conclusions about how different populations responded to the phrase “the mentally ill.” The study participants were mostly white Americans; race might have a huge factor to play. And the authors note that gender could also play a role in a person’s conception of another person with mental illness.

That said, a simple change in our language, while admittedly “cumbersome,” is something that is important to not only give people with mental illness recognition of the fact that they are more than their condition, but also a way to help them integrate into society. “The important point to take away is that no one, at least in our study, was immune,” Granello said in the news release, pointing to how counselors too showed levels of intolerance. “All showed some evidence of being affected by the language used to describe people with mental illness.”

By Tanya Basu

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