Friday, January 03, 2014

The "Mentally Ill" Bucket

Dinah wants me to post more, so she asked me to put up my comment to her post on Results of the Survey on Who are the Mentally Ill. (If you didn't see the original survey, it is here.)

So, here's my comment. But I'll begin with the limerick...
There once was a man from Nantucket
With a thought that was quite a nugget.
   "The world is round," he exclaimed;
   Which confirmed he's insane.
So they placed him in "the mentally ill" bucket.

When I first saw this survey, I told Dinah it was a terrible survey and that she should take it down, because by even asking people 'who are "the mentally ill" ', it lends credence to the concept that one can put everyone with a mental illness -- or even more simply, a "mental health problem" -- into the same bucket.

This phrase -- "the mentally ill" -- promotes the stigma, stereotypes, and myths, that many people have about mental health problems of any sort. It also is a phrase that dehumanizes people by labeling them by their disease. "People first" language is preferred. "The person with schizophrenia", not "the schizophrenic."

Labeling people as their disease (or illness or symptom) dehumanizes people. They are no longer a person, but a disease. "Diabetics" don't seem to be bothered by this so much, but in psychiatry our patients continue to face discrimination, stigma, misunderstanding. By using these terms -- as many politicians and journalists still do -- it uses language to convey that it is okay to define people as their disease, that this is the most important thing to know about them. By breaking them down into people with, it is harder to say things that apply to all of them.

"The mentally ill are violent."
"People with mental illnesses are violent."
It is much easier to counter the last one (how can this apply to every person with a mental illness?), but the first is more fear-mongering, and stops you from thinking critically. Even so, these myths continue. (Only 5% of violent attacks are caused by people with a mental illness.)

Are there surveys about Who are the Physically Ill? Or, Who are the Cancerous? Or the Blacks? The Jews? The Gays?  You get my point.  Unfortunately, the survey did not have responses that said, "None of the above, because people are not defined by their illness and to say otherwise would be stigmatizing."

So, now that I have declared my bias against this term and this survey, I will share my thoughts on the results, anyway. The answers suggest that people are all over the place about what characteristics they deem necessary to put others into "the mentally ill" bucket. The most consistent themes seem to be those of persistence and severity. The longer that one has a condition, and the more severely it affects one's life and relationships, the more likely one is placed in the bucket.

I was also surprised to see bipolar disorder scoring almost as highly as schizophrenia; same with mood stabilizers like lithium scoring right up there with antipsychotics.

  * * *

Since there were already some comments to my comment, I'll address some here.
Liz used to feel hopeless and hate herself when accepting the "borderline" label. She has since changed her perspective and feels better. Good for you.

Three people (Not me and two Anonymi) thought the survey responses didn't fit their answers; "pretty impossible to answer because so many of the questions required more information." While I agree, I have come to see that this forces people to address their assumptions. This is good for the stigma discussion.

Dr Reidbord was quicker to get this than I was, finding the results revealing that this term is used in a variable and nonspecific way, often used "when the speaker can't express himself, for either linguistic or political reasons, more precisely."

I thought the wisest quote was from Borderline, who said:
"It's easy to pigeon hole and hard not to sometimes." 
  * * *

I googled "mentally ill bucket" and found only ten links. The best is "There are no excuses" from K. Wolf-Madison, who wrote more eloquently along the same line as I do above. "The marginalizing of the mentally ill with those words continues to damage us all."