by Jenna MacKay with special thanks to Kate-Christine Miller
Crazy. Bonkers. Bananas. Disturbed. Maniac. Psycho. Psychopath. Mental. Nutter.
Throughout history, people labelled with mental health issues have been stigmatized. This continues today and is inseparable from the language we use. Take for example the shooting of men with mental health issues by the Toronto police. The actions of the police are informed by labelling certain men’s behaviour as “crazy.” This label is accompanied by assumptions such as, “that person is dangerous.” The stereotypes of people labelled with mental health issues are countless and generally remain embedded in our language without question.
Many words we use as descriptors (e.g., “She is so crazy,” “That is crazy!”) are linguistic means of maintaining the oppression of people labelled with mental health issues. Just as we have challenged other problematic words, it is important to reflect upon terms like “crazy” or “nuts,” by asking ourselves what they mean and whether we need to keep using them. Of course this is not easy, these words are so deeply ingrained that just when you think you made progress you call something “crazy.”
Lunatic/Lunacy/Loon: Lunatic and lunacy were a popular medical description used into the mid-19th century. Lunatic refers the moon (luna) and became popular for two reasons. First, Greek and Roman theories understood illness, such as melancholia (i.e., depression) to be caused by an excess of black bile in the body that was impacted by the moon. Second, the moon was thought to possess supernatural power over the mind and body (e.g., stereotype of madness and the full moon). These terms were abandoned by medicine because of their astrological connotations. (Reaume, 2002).
Idiot/Imbecile/Retarded: Idiot and Imbecile were early medical definitions for developmental disabilities that have since been replaced by retardation.
Insane: Insane was a term introduced in the late 1800s to improve public opinions of the asylum, in response to the activism of “ex-asylum inmates” (Reaume, 2002). This term fits within a binary of sane/insane, where sane is privileged and associated with health, normality and rationality. In contrast, insane connotes someone who is emotional, abnormal, unwell, irrational and “crazy.”
Mentally Ill/Mental Illness: In the 1930s this term replaced insane in Ontario, as asylums were reconceptualised as hospitals (Reaume, 2002). This shift is connected to the rise of biological theories of mental health that regard mental illness as analogous to disease in the body, focusing on organic causes (e.g., chemical imbalance). This understanding has been widely criticized and is connected to terms such as: sick, sicko, psycho, mental disorder and mental. Today many mad activists call for the end of the term mental illness (see article below).
What do we call ourselves? People who have been labelled with a mental health issue self-identify in many ways. Basically, don’t make assumptions and ask each individual what language they choose to use. Some people may identify with the term they have been labelled with, others may satirize and reclaim oppressive language, identifying as mad, crazy, psychiatrized or insane. The mad movement put forth other terms such as: consumer, survivor, service user, and psychiatric disability. Many of these terms have become normative descriptions in social services.
What is politically correct for me to say? By using language that labels mental health differences in negative terms, we devalue and exclude these people. It is important to be aware of the language you use, be open to making mistakes and continuous learning. First, remember that people are not their labels. Instead of saying, “she’s depressed” it is more inclusive to say, “she’s labelled with depression” or “she’s struggling with depression” or “she’s diagnosed with depression” (although there are critiques to be made of diagnoses). Consider not using terms like “mental illness” and think about the connotations of the medical model. Reflect upon the assumptions of “mental illness” or “mental disorders” and question whether these are ways of labelling normal difference or obscuring the full identity of the human being who is in distress and the various non-biological reasons they may be experiencing distress.
To learn more and for a list of inclusive language see David Oakly’s essay “Let’s Stop Saying ‘Mental Illness’.”
Jenna MacKay is a community worker/activist who is currently completing an MA in psychology and dreams of starting a vegetarian catering company.