Derogatory language referring to mental illness and intellectual disabilities abounds. It hurts mental health patients. Let’s stop such usage.
By Chong Siow Ann, Published The Straits Times, 22 Mar 2014
RECENTLY I came across a radio documentary called The Rhetoric Of Cancer which was broadcast on the BBC World Service. The presenter, Andrew Graystone, was a cancer survivor. He observed that the “language of warfare has dominated cancer discourse” and that “today it’s commonplace to speak about battling cancer, fighting cancer, even kicking cancer”.
Such language is disconcerting to Mr Graystone – partly because, as he ruefully commented, he is “not really the fighting kind” and partly because there wasn’t much that he could do to fight his cancer. “Like most cancers, mine was out of reach. I couldn’t see it or touch it. I couldn’t operate on myself or prescribe medication. My chief aim was to live well with cancer, and then hopefully to live well without it.”
The language of disability
I’M NOT sure if any of my patients feel the same way about their mental illness. But I now suspect that some do, and are too polite to point out the unhelpfulness of my occasional pep talks, laced as they often are, with battlefield metaphors.
The use of such militant language, while common in medical fields like cancer and infectious diseases, is actually rather uncommon when people talk about mental illness and intellectual disabilities. Here, the language is usually much more negative and disparaging.
Derogatory language referring to mental illness and intellectual disabilities abound in everyday conversation, print, broadcast, social media, movies and other popular entertainment.
Take for example what researchers in Britain found when they asked a large sample of 14-year-old school students for words or terms that they would use to describe someone with mental health problems or illness. Of the 44 words that were most frequently occurring, three quarters were strongly negative – words like psycho, spastic, crazy, mental, weird, loony, and mad.
They are even used by people who ought to know better. Some time last year, French politician Pierre Lellouche described the British Prime Minister’s plans for the European Union as “autistic”; while an article in an august British broadsheet described Britain’s attitude to politicians’ wives as “schizophrenic”.
Following the last of the US presidential debates in 2012, a political commentator referred to President Barack Obama as a “retard” in her tweet.
The careless and cavalier use of psychiatric nomenclature is not just inaccurate. It obfuscates the understanding of mental illness.
Slurs also both offend and reduce people with mental and intellectual disabilities to stereotypes, and into objects of ridicule and derision.
Most people who use such language might protest that it is merely a means of referring to behaviour that is bizarre or out of character. There is no intention, they may argue, to refer specifically to those with mental illness or intellectual disabilities. They might even throw their hands up and moan about the excesses of political correctness.
Such terms, however, are profoundly hurtful to people who have to live with these problems.
Given the pervasiveness of mental illnesses – an estimated one in four in the general population has some sort of mental illness – it is also likely that those who misuse psychiatric nomenclature are offending people that they know.
Loneliness and exclusion
LURKING behind such language is a certain attitude, prejudice or ignorance. Its use stigmatises people with mental and intellectual disabilities.
And there is a more serious consequence. It excludes people with disabilities from the opportunities and activities that most other people take for granted. These include studies, employment, career advancement, friendships, romantic relationships, and even medical and psychiatric treatment.
A nationwide survey called Mind Matters was launched last month to gauge people’s beliefs and attitudes that will aid recognition, management and prevention of mental illness in Singapore.
“The hardest thing about having an intellectual disability is the loneliness,” writes John Franklin Stephens, a Special Olympics athlete with Down’s syndrome in the Denver Post. “I can only tell you what it means to me and people like me when we hear it (he was referring to the word “retard”). It means that the rest of you are excluding us from your group. We are something that is not like you and something that none of you would ever want to be. We are something outside the ‘in’ group. We are someone that is not your kind.”
This exclusion can start early in life. A survey of 546 teaching staff in Britain found that 88 per cent of teachers and 96 per cent of teaching assistants had heard students using phrases which stigmatise people’s mental health problem. Research shows that 20 per cent of children have a mental health problem in any given year. The common use of these negative terms, which may also be accompanied by explicitly expressed negative emotions and behaviour, is hardly going to leave a mentally unwell young person unscathed.
Children with autism as well as those with attention deficit hyperactivity disorder (ADHD) are far more likely to be bullied (subject to teasing, name-calling and even assault) in school. It is, therefore, not surprising that young people are far more unwilling to seek help when mentally unwell so as not to draw more attention to themselves.
Many would rather try to cope on their own, sometimes with dire and tragic consequences.
There are a number of sources from which children pick up such language. One unlikely source is the seemingly innocuous children’s television shows. One British study found that out of a sample of a week’s children’s television, 59 out of 128 programmes contained one or more references to mental illness.
Children’s programmes in the United States and New Zealand also reportedly include a high rate of negative references to mental illness. “If thought corrupts language, language can also corrupt thought,” wrote George Orwell. “A bad usage can spread by tradition and imitation, even among people who should and do know better.”
As mature adults and parents, we ought to know better and do better. We ought not to tolerate the use of such language in the same way as we do not put up with any language that is offensive to another’s race, religion, gender or age.
It is all part of that difficult enterprise of raising children. Among the things to be nurtured in them are the things enumerated by the 19th century American novelist Henry James: “Three things in human life are important. The first is to be kind. The second is to be kind. The third is to be kind.”
The writer is the vice-chairman, Medical Board (Research), of the Institute of Mental Health.