The Disappearing Disorder

Note: this is the second of a series expanding on FASMI’s position statements. This blog post is concerned with our position statement called Taking Mental Illness Seriously.

There’s a lot of talk about mental health these days. In fact, there are whole days and weeks set aside to discuss many aspects of mental health and its importance. And so there should be. Mental health is important.

Something that isn’t discussed so much, though, is mental illness – or its more clinical counterpart, mental disorder. You might assume psychiatric illnesses like schizophrenia, bipolar disorder or similar psychiatric conditions are included within the broader context of mental health - and there are some who believe it is. It seems like a common assumption. If you listen carefully however, you’ll often find the phrase mental illness being intentionally avoided. Instead, it’s replaced with euphemisms like “mental health issues” or “mental health concerns.” It can sometimes lead to extreme verbal gymnastics as the speaker goes to great lengths to avoid uttering the words mental illness. And when that gets too difficult it’s sometimes merely replaced with “mental health” – and thus you may hear talk about those “suffering from mental health.” How does this make any sense? How can someone suffer from health of any kind?

You may ask why this happens. Good question. We often hear it’s because there’s stigma attached to the term mental illness, so they think that by avoiding the phrase mental illness they avoid stigma. But what this does though is to push mental illness more into the shadows. It changes the conversation to the more pleasant-sounding though vaguely defined “mental health.”

In fact, you can replace the word stigma with discrimination and most of the time it’ll be more accurate. And if anyone knows about the ingrained negative attitudes, stereotypes and misconceptions about severe and persistent mental illnesses, families do. We’ve had to face all that and more from friends, neighbours, even some health care workers.

Years ago we didn’t talk about cancer, AIDS or other topics deemed indelicate – at least, not in polite company. Shunning those topics didn’t reduce the stigma/discrimination however – it allowed it to be perpetuated. It was only when advocates started talking publicly that the discrimination could be shown and ultimately reduced, if not eliminated.

But does this stigma/discrimination end when we stop uttering the words mental illness? It sure doesn’t appear so. Some reputable sources like the Mayo Clinic believe that misconceptions around mental illness cause stigma rather than the phrase itself. How can we challenge those misconceptions if we refuse to talk about it? If we avoid talking about mental illness, we allow people to avoid thinking about it. They remain caught in their false beliefs about mental illness.

In psychological terms, avoidance behaviour is “anything you do or don’t do with the main goal of avoiding or escaping an unpleasant emotion, thought or consequence.” It can also include “cognitive actions, such as trying not to think of a problem.” It seems convenient then that avoiding the phrase mental illness as a way of avoiding “stigma” actually may be a way to avoid an unpleasant “problem.”

Imagine what might happen if an organization that likes to champion mental health ran a campaign saying “let’s talk about mental illness.” Maybe if that caught on, people would open up about their own mental illness or that of family members and friends. Then our society might realize that it’s not so uncommon, and perhaps come to a better understanding of the causes, symptoms and consequences of having a mental disorder like schizophrenia, bipolar disorder or other psychiatric illness. More people might come to realize that they needn’t fear the illness – or those who have the misfortune of having one. We might all become a little more compassionate.

Our position on this has two statements: 

• The term mental illness must not be avoided by health care professionals, legislators and advocates when used to describe severe disorders such as schizophrenia, bipolar disorder and other psychotic illnesses.

• Education about severe mental illnesses needs to widespread and addressed to the public, families, and health care providers.

Instead of trying to make mental disorders disappear, we should bring them into the light so they can be discussed intelligently and better understood. And that would go a long way towards ending discrimination against those with severe mental illness.

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The opinions expressed in blog posts are those of the author and do not necessarily reflect the opinions and beliefs of FASMI. To join FASMI, visit our Sign Up page.