Words Matter

Words Matter

How to combat stigma associated with mental illness

Chris Pfitzer

Division of Mental Health, Developmental Disabilities and Substance Abuse Services

Traditionally, there has been a great deal of misunderstanding, fear, and stigma associated with mental illness.  Stigma toward people with a mental illness has a detrimental effect on their choice to seek treatment, their ability to obtain services, the type of treatment and support they receive, their success at recovery and regaining a meaningful life, along with their acceptance in the community.

These stigmas can be reinforced or reduced by media coverage, popular culture and the way we talk about mental illness.

On March 7, 2013, the Associated Press added an entry on mental illness to its influential AP Stylebook.

According to Kathleen Carroll, AP senior vice president and executive editor, “It is the right time to address how journalists handle questions of mental illness in coverage.  This isn’t only a question of which words one uses to describe a person’s illness.  There are important journalistic questions, too.”

“When is such information relevant to a story?  Who is an authoritative source for a person’s illness, diagnosis and treatment?  These are very delicate issues and this Stylebook entry is intended to help journalists work through them thoughtfully, accurately and fairly,” said Carroll.

Recent national and local news coverage involving people with mental illness has been varied and often relied on stereotypes, negative portrayals and reinforced stigmas associated with mental disease.

“It is important to remember that a person living with schizophrenia is a person first and that a child or youth who lives with mental health challenges is a child first,” said Susan Robinson, mental health program manager with the N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS).  “Using language that acknowledges the individual or person is very important and can help reduce the stigmas around mental health issues.  Mental illness is just an illness affecting the body.  In these cases, that body part is the mind.”

According to the AP Stylebook:

Do not describe an individual as mentally ill unless it is clearly pertinent to a story and the diagnosis is properly sourced.

Mental illness is a general condition. Specific disorders are types of mental illness and should be used whenever possible: He was diagnosed with schizophrenia, according to court documents. She was diagnosed with anorexia, according to her parents. He was treated for depression.

Do not use derogatory terms, such as insane, crazy/crazed, nuts or deranged, unless they are part of a quotation that is essential to the story.

Avoid descriptions that connote pity, such as afflicted with, suffers from or victim of. Rather, he has obsessive-compulsive disorder.

Double-check specific symptoms and diagnoses. Avoid interpreting behavior common to many people as symptoms of mental illness. Sadness, anger, exuberance and the occasional desire to be alone are normal emotions experienced by people who have mental illness as well as those who don’t.

Wherever possible, rely on people with mental illness to talk about their own diagnoses.

While not specifically mentioned, the AP has adopted a person first language philosophy regarding mental illness, as recommended by many advocacy groups.  This philosophy, way of speaking, and writing, places the person first and their illness or disability second.  Person first language is designed to avoid perceived or subconscious dehumanization when discussing illnesses or people with disabilities.

For example, instead of saying, “He is a crazy person,” say “He is being treated for bipolar disorder.”

Mental health advocates have also long called for an end to the correlation between violence and mental illness.  The Associated Press supports this position.

From the AP Stylebook:

Do not assume that mental illness is a factor in a violent crime, and verify statements to that effect. A past history of mental illness is not necessarily a reliable indicator. Studies have shown that the vast majority of people with mental illness are not violent, and experts say most people who are violent do not suffer from mental illness.

The Associated Press (AP) was founded in 1846 and today delivers unbiased, independent news content around the world.  The AP Stylebook was initially published in 1953 and is the most used writing guide for journalists, writers and professionals.


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