A poor choice of words

A couple of months ago, I noted an initiative by a group to banish the term “mentally ill” from our lexicon. At the time I read it, I suppose that I thought of it as just one more decent, but farfetched idea.

But recent experience has sharpened my perspective, convincing me that something ought to be done. My concern isn’t that the term is overly descriptive, offensive, or even demeaning – in a professional sense, anyway. Instead, my concern is that the term means almost anything, and therefore, almost nothing at all.  

The realization first hit me as I edited our cover story, “Untreated mental disorders, unchecked guns,” which explores the controversial connection between “the mentally ill” and gun-related violence. One thing really jumped out at me:  What needs to be done about the latter, if anything, has a lot to do with what one assumes about the former.

Only a day later, the futility of this term hit me again as I responded to a reader’s note asking why I thought it was OK for the magazine to run a story in which a county’s mental health and criminal justice systems were presented as “partners.”  

“Thanks for continuing the stigma,” wrote the reader. “For some of us, these are not partners.”

When I wrote back, asking her to explain, she replied, “Nowhere in the article is there any reference to the fact that the vast majority of people who seek and benefit from professional assistance have nothing to do with the criminal justice system. It is the conceit of this article that anyone who seeks professional help has the potential to become a criminal or to be perceived as one. Thus,” she concluded, “the continued stigmatization of seeking and receiving help.”

Well stated, I thought. Then, I replied:

“When it comes to publicly-funded county systems of care, the justice system is, sadly, a primary funnel for the most seriously mentally ill individuals, people whose degree of illness renders them unable to work (therefore poor and often homeless), likely to be self-medicating with alcohol or street drugs in the absence of proper care, most likely to drop into emergency rooms for psychiatric or physical care, and most likely to be picked up in an encounter with police.  

“These characteristics certainly don’t cover ‘most’ mentally ill, including the many who work... but those individuals aren’t the focus of the article,” I continued, ultimately concluding with the sad compression of logic that humanity has known for centuries: “The mentally ill aren’t criminals, but the poorest and sickest of them often get treated that way.”  If only the article had said that, she replied.

So my point – “mentally ill.” A term that means anything or nothing, yet certainly something very different when spoken by Rosalynn Carter versus Wayne LaPierre, for example.  A term that conjures a million images – of a teenager with ADHD and depression, a veteran with PTSD, a mom who drinks, a panhandler who knows he is Jesus Christ, a young man who shoots teachers and schoolkids, or millions of brave souls who get up, eat breakfast and ride the bus to work every day, with friends and colleagues none the wiser.

I’ve used the term “mentally ill” to describe all sorts of people like these for a long time now. But today, I’ve just realized how little these words say about the real people we are talking about.