Using the right language around mental health and wellbeing
Mental health
Mental health is perhaps the most flexible and broad term used and is, to some extent, all encompassing when it comes to both mental health conditions and wellbeing, both of which we attempt to define below.
Some people we spoke to distinguished between ‘mental health’ and ‘mental illness’, seeing the former as applicable to a range of issues including depression and anxiety, and the latter as about having severe and enduring mental health conditions.
Mental health conditions
Mental health conditions are typically diagnosed by a medical professional and include a diverse range of conditions, from learning disabilities to bipolar disorder. Although less commonly used these days, ‘mental illness’ is also applied when it comes to diagnosed mental health conditions.
Some of the reasons why CHEX member organisations prefer to use or avoid terms like mental illness are discussed below.
Mental wellbeing
In community-led health, we tend to focus more, although not exclusively, on wellbeing when it comes to mental health. Whether we have good or poor mental wellbeing will depend on a range of factors, including our material and social conditions. For instance, if we are struggling financially or live in poor quality housing this will create anxiety and stress, negatively affecting our mental wellbeing.
Similarly, social factors such as our level of social connectedness will have a direct impact on our wellbeing, with social isolation leading to loneliness for instance. These links are well understood and underpin the ‘social determinants of health’ as set out by the World Health Organisation.
Using the right language
Getting the language right is important for two main reasons. Firstly, using the wrong language increases stigma, something most of the people we spoke to had concerns about, and a key focus of the Scottish Government’s Mental Health and Wellbeing Strategy. For instance, they tended to prefer terms like ‘members’ or ‘participants’ over ‘patients’ and ‘clients’.
“I mean we call people that come to _________ members, not patients or clients. People always want to kind of ‘other'’ folk a wee bit or ‘medicalise’ them. I think in the past they've been medicalised all the time. So we thought that ‘members’ was just… you’re members of a group, so that implies belonging right from the start, that you're part of something, not a patient.” (Manager of community-led mental health project)
Similarly, the term ‘wellbeing’ was preferred in many instances to that of ‘mental illness’.
“So we're quite careful around about the language that we're using in promoting positive well-being or positive mental health so that people don't feel stigmatised or don't feel like that's a service that they can't access for whatever reason.” (Worker for family support charity)
Two people we spoke to said the term ‘wellbeing’ was a way of reducing barriers when working with people from communities where mental illness was culturally taboo.
“One of the challenges that was presented to us is that that some cultures really won't engage with the idea of mental illness. And so a lot of the times organisations that are working with different ethnic communities might tend to use wellbeing as a way to enable people to take part and enable people to have conversions in a way that using the terminology ‘mental illness’ would actually create a barrier, and I guess that's just another example in terms of how one thing doesn't work for everybody.” (Manager of national mental health charity)
The key area where getting the language right matters is related to the nature of services, or support, being provided. The manager of a community-led health organisation in CHEX’s network we spoke to was keen to point out that they weren’t a mental health service, stating “Our activities are aimed at supporting people's mental well-being.”
In contrast, the manager of a community-led mental health project, also in our network, said they tended to use the terms ‘mental illness’ or ‘mental ill-health' as this worked better for their members. In their case, the language of wellbeing “doesn't reflect the raw reality of the experiences that people with severe mental-illness have had.”
