What is stigma?
Stigma is basically a word for discrimination. Slightly more technically, stigma has been described as a sign of disgrace that is perceived to set a person or group of people apart from others. It’s also a Greek letter, although everyone that uses it in that way is rubbish. Stigma can affect many groups, including people with mental health problems, the elderly, and a third less serious group that I was going to include as a joke, but didn’t because it would increase stigma too much.
The casual use of language stigmatising mental illness is exceedingly common. If you’re a bit angry you might be described as mental or psycho. If you put a book away you might be called obsessive compulsive. Media portrayals reinforce stigma by constantly associating images of violent and homicidal individuals with mental ill health. The Eurovision song contest recently got in on the stigmatising act by parading a person in a Eurovision-themed straitjacket for so called crazy fans and having one of the hosts proclaim “You know what they say – crazy is the new black.” Which is definitely saying like, “Half a cup of thunder makes the bears look at the handbag” and “You don’t have to be crazy to use stigmatising language, but it…oh…I see…I’m sorry.”
Even children’s television seems to have gotten in on the act. A study in the British Journal of Psychiatry found that during just one week’s worth of children’s television, 59 out of 128 programmes contained one or more references to mental illness. Terms like “crazy”, “mad” and “losing your mind” were commonly used to portray that a character was losing control. Six characters were identified as consistently shown to have a mental illness. These characters were almost totally devoid of positive characteristics. Luckily, children aren’t impressionable and don’t learn or pick up attitudes easily.
Does it really matter if people are offended?
In the great scheme of things, not really. Overall, it’s probably not good to upset people, although that largely depends on context. If you’re using abusive language and someone says your awful because of you’re abusive language and this upsets you, then you’re upset doesn’t matter a Katie Hopkin’s opinions worth. If someone with severe anxiety is offended because you’ve told them to “stop worrying”, then that does matter. You’re belittling a potential illness, and ignoring and heightening their distress. We’ll deal with these cases of offence on a case by case basis until we’ve Gervaised the lot of them.
However, this isn’t really about people being offended. It’s about the harm that can be caused by language and attitudes. Stigmatising attitudes towards people experiencing mental illness are responsible for substantial additional distress, as well as reduced employment and social opportunities. In addition, stigma can lead to hate crimes, a decreased ability to access appropriate healthcare and reluctance to seek appropriate help (if that help is even available). In fact, the stigma surrounding mental illness has been identified as the primary barrier to providing mental health care and the delivery of treatment. It turns out that if large portions of society hold negative beliefs about a group that aren’t necessarily true, then that group suffers.
So I’m banned from using certain words?
Not at all, but it would be nice if you thought about what you were saying and the impact it might have. Unsurprisingly in a matter involving language and society, there’s a lot of nuance involved. If I privately say “my cat is going bananas” while my cat does something adorable like climbing up the curtains or becoming non-fictional, then I’m probably not doing any harm. If I loudly proclaim to a crowd that another person who is shouting “has gone schizo” then that’s another matter. I don’t know who’s listening, who might be upset and who might avoid social situations or potentially getting help to avoid similar judgement. If you don’t believe in the potential impact of your words in this setting, perhaps you should look at the research, or at least have more confidence in yourself. You can make a difference!
Well, what other words can I use?
I’m pretty sure there are quite a few words that aren’t stigmatising towards people with mental health problems. There’s probably a word for that situation. I’ll check the dictionary. Anyway, a bit of variety in your insults will make you look more intelligent, which is always nice.
Why are people so thin skinned?
It’s not really about being offended (as discussed previously), but if we’re talking about people with certain diagnoses then there is evidence that negative terms can have greater impact than in people without those diagnoses. For example, much research has shown that people with clinical depression have what’s called a negative cognitive style. That is to say they’re much more likely to focus on or attend to the negative aspects of any personal experience and to an extent may be unable to focus on positive or neutral aspects. Conversely, other studies claim that this tendency differs across individuals with the depression with some people focusing on negative information, while others pay equal attention to negative and positive information but remember negative information more efficiently than those without depression. Either way, telling someone with this problem to just ignore the bad stuff isn’t helpful. Like telling someone with their foot caught in a bear trap to just walk it off.
I have a mental illness and it doesn’t affect me like that!
That’s good. However, there are other people who it does affect.
Isn’t this just being pedantic about language?
But you got several phrases regarding mental health wrong!
Probably, and I apologise for that. I daresay I’ll do it again, but I’ll try and do better. Which is hopefully what we’re all trying to do. Not you though. You’re perfect. You’re hair is particularly good.
In fact, a bigger problem is that throughout this post I’ve essentially referred to people with mental illness as a homogenous group. This obviously isn’t true, just as it wouldn’t be for any large group of people. It also potentially marks a large proportion of the population (1 in 4 is often bandied about, although I can’t find a good reference for that figure) as an outgroup. I certainly don’t want to do that, and a large part of reducing stigma should probably be in getting people to consider that the group they’re stigmatising contains as much variety in personality as any group they consider themselves a member of, that that group contains people just as capable of experiencing harm as they are (more so in some cases) and that their words have the power to impact real-world events. Easy done.
Are you finished yet?
Image credits: Wellcome Library, London. Wellcome Images firstname.lastname@example.org http://wellcomeimages.org A man diagnosed as suffering from melancholia with strong suicidal tendency. Lithograph, 1892, after a drawing by Alexander Johnston, 1837, for Sir Alexander Morison. 1837-1892 By: Alexander Johnstonafter: Alexander Morison and Byrom BramwellPublished: 
By Ilja.mos – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=46665757