I wince every time I read it. So does the president-elect of the American Psychiatric Association, Dr. Paul Summergrad, he says.
I saw it most recently in The New York Times, in the headline pictured above and a recent masthead editorial: “Equal Coverage For The Mentally Ill.” It’s all over, from The Boston Globe — “New Era for the Mentally Ill“ – to The Wall Street Journal — “Crime and The Mentally Ill.” Just about any media outlet you care to name.
What’s so bad about “the mentally ill”? Isn’t it reasonable shorthand in the usual headline space crunch?
In a word, no, says Dr. Summergrad, psychiatrist-in-chief at Tufts Medical Center and chair of psychiatry at Tufts University School of Medicine. He sees two main problems with it. First, the definite article, “the.”
“Imagine if I said that about any other group. It suggests that people who suffer with these conditions are somehow other than us, and can be put in a discrete and often stigmatized category. It creates a sense of otherness that is not the reality, statistically, of these illnesses.”
Any other group? I try a thought experiment, the headline “Equal coverage for the women.” Weird. “New era for the gays.” Offensive. “Crime and the blacks.” I get the point.
The term creates ‘a notion that it’s a uni-modal type of thing. We need a more inclusive and more granular language.’
Second, Dr. Summergrad said, “there’s the denotation of what mental illness means, but there’s also the connotation. When people ask me, is it really possible that 25 percent of the population is mentally ill, what do they mean by that question?”
“That they think of it as something very extreme?’” I hazarded.
“Exactly, they mean that somebody has a form of very severe psychotic illness. But the reality is, what is a mental disorder? From a clinical standpoint, it means a disorder in various forms of mental functioning: thought, speech, emotion, behavior.”
And those disorders are myriad and mixed and often of general medical origin, with a range of “everything from Autism Spectrum Disorders to Attention Deficit Hyperactivity Disorder, through Obsessive-Compulsive Disorder, anxiety disorders, post-partum depression, recurrent depressive illness, dementing illnesses which have profound effects not only on memory but on behavior. Parkinson’s disease has high rates of very severe anxiety and depression.”
So the term “the mentally ill” creates not just a notion of separateness and otherness, Dr. Summergrad said, but also “a notion that it’s a uni-modal type of thing. And I think we need a more inclusive and more granular language.”
I’d add a third argument against “the mentally ill,” gleaned several years ago when I was writing a Boston Globe story about people who recover enough from their own mental illnesses to become “peer specialists” who help others with similar challenges. Continue reading