Your Comments, Ideas, Personal Stories...
SAMHSA has received more than 150 emails in response to the Administrator’s call for comments. The Agency plans to keep the reader-response email box open for a while longer.
Following are selected excerpts from providers, people concerned with mental health and substance use problems, advocates, and others. They gave their reactions to the terms listed below. In particular, many people had strong reactions to the term “consumer.” Simply click on the term you wish to read about, and you’ll be taken to that section.
On Mental Health
- I like the terms “People with mental health conditions” or “People with substance misuse conditions.” Add the terms, mild, serious, chronic, severe, “that lead to psychosis,” etc., as needed to make clearer the scope of the problem.
- It’s misleading to say “mental health” and “physical health” as if they are different; the brain and central nervous system are part of the body and physical health.
- The line where “Mental Illness” is drawn seems vague and unhelpful. If you are being treated for bipolar disorder and are happy, functional, and living a full life, are you no longer “mentally ill”?
- I like the idea of the “state of mental health” and “state of mental health conditions.” We all ebb and flow from moment to moment.
- There is a huge stigma associated with the word “mental illness.” The implications are, if you have a mental illness, you are placed in a group that is not part of society; your sickness is not like other sicknesses.
- I agree that as providers we must always avoid use of stigmatizing language, but it’s all in the perception, isn't it? I was recently criticized by a well-intentioned colleague for using the phrase "a person who suffers from a mental illness" in a training presentation. The point being that "suffers from" connotes being a victim.
- Our system is a system of mental illness. It diagnoses and "treats" mental illness. We do not have any agreed-upon concept of mental health. We have not yet had the discussion of what is meant by mental health.
- We need to acknowledge mental illness, but focus on mental health.
On Behavioral Health
- I often refer to my field as “behavioral health” but can see the point that it could be conceived as just a matter of willpower. With the “whole health/whole person” focus and “parity” these days, it seems we could drop the delineation between physical, mental, and behavioral health completely and just address “individual health and wellness.”
- I prefer "behavioral health care" because it better supports the idea of resiliency and use of the expressive therapies.
- I have found the term “behavioral health” inappropriate and a bit degrading. It makes me think of a child who is deliberately misbehaving, rather than someone who has a mental illness or substance addiction.
On Substance Use
- We still use "addiction" to talk about the stage at which the body/brain cannot resist using.
- I like "substance use disorders" because it includes the heavy "recreational" user as well as someone who is addicted.
- “Substance use disorders” is a good term. However, as noted, it does not recognize that a person can be abusing long before being characterized as having a disorder.
- “Persons with the disease of addiction” is the only public consumption term with which I am comfortable.
On Recovery
- I use the term “sustained recovery” instead of “long-term recovery” because it includes the idea that recovery takes continual maintenance of our spiritual and other conditions.
- “Recovery” has become basically a “buzzword” that doesn’t have a whole lot of meaning anymore. It’s time to move on to the exciting new paradigm that eliminates traditional taboo and barriers, recognizes that folks with challenges—physical or mental—are no different than anyone else, and completely integrates them into the traditional workforce.
- “Recovery” can be self-defined, but certainly must mean at some level you have organized your issues/needs to live life in a meaningful way, even if that means medications and significant help from others.
- Some people equate “recovery” with a return to health.
General Comments
- Acronyms can be so frustrating and disempowering. I always avoid them as one way to bring people together.
- I couldn't agree more with the initial observation that just about every term we use today has problems. My personal belief is that we will accomplish great things when we start using the language of other chronic diseases.
- The point of the article is well taken: we must be mindful in our choice of words. I sometimes think, though that we spend so much time tiptoeing around connotations that we lose the point. I would instead advocate a consistent application of the simple common respect that all people deserve. Then the speaker and the listener can concentrate less on how it is said and more on what is meant.
- I believe we as a society have difficulty coming to an agreement on language because there continues to be moralistic undertones throughout our culture that cast disparagement on those afflicted with any of the “behavioral disorders.”
One term that elicited some of the most passionate responses is “consumer.” The response from readers about this word has been almost entirely negative. See below for selected comments.
- I have never really understood the origin or the meaning of “consumer” in this context. Does it mean consumer of drugs? Consumer of health care? A consumer is someone who goes shopping or eats a lot. I’m obviously missing something.
- Is a heart patient or a cancer patient called a “consumer” of health services? No.
- I have a great deal of respect for the “consumer movement” and know how hard advocates have fought to gain respect. However, it’s time for professionals and people being served to move on. The word “consumer” should be replaced by “person receiving services” or “individual.”
- I dislike the term “consumer” because many people with mental health issues do not consume mental health services at all because of social stigma. I also do not think my most important role in life is as a consumer of anything. I’d rather like to be thought of as a good son, brother, coworker, and neighbor who just happens to have schizophrenia.
- Dictionary synonyms for “consumer” are buyer, customer, purchaser, shopper, user, etc. Because “consumer” thus evokes the opposite of compassion and the need for generosity of spirit and action, it is a poorly chosen term for generating public support.
- I hate to be called a consumer. It makes me feel like I am using up all these resources and I am a waste of time.
- “Consumer” seems to brand me as a sick person whose illness is so bad that it should not be mentioned.
- Many clients don’t know that “consumer” refers to them. I think it sets up a top-down relationship between providers and clients. I also find it too business-oriented.
- To avoid using the term “consumer,” I just speak it out: “a person who happens to have a mental illness diagnosis.” It is cumbersome, but this is my preference.