On Terminology

March 2nd, 2016

Can we talk for a minute about the use of the term “mental health” versus “mental illness?” It is not uncommon to hear people discuss mental health – especially when it comes to things they are doing to maintain their mental health. And often people even refer to mental illness as “mental health” or “mental health issues.”

But let’s be clear – mental health and mental illness are two very different things. If you were talking to someone about the fact that they have cancer, you would say that they have an illness – you would not say that they have bad health or even health issues. In fact, most people would probably consider it in very bad taste to say something of that sort about someone suffering from a severe physical illness.

However, when it comes to mental illness, people just don’t think of it that way. There is some bizarre impression that we only need take care of our mental health to avoid mental illness. And it would not be uncommon to hear that someone with depression has bad mental health or mental health issues.

The other day I was in a training when the facilitator shared the dimensions of diversity model. She asked if there might be anything that was missing. I said, “Yes – mental health is missing.” I can’t tell you now why I chose to say mental health instead of mental illness, but it seemed appropriate at the time. She asked me whether it was an internal or external dimension. Without pausing, I said internal.

“Hmmm…” she said. “Internal? Remember, internal dimensions are those over which we have no control.”

Admittedly, inside I was less than calm when she responded in this way. However, I took a deep breath before answering. “Well, mental illness is not something over which we have control.” To be fair, I had used the term mental health instead of mental illness – perhaps she was confused about what I meant.

Yes, our behaviors can impact our mental health – much like it can impact our physical health – but all the meditation in the world, while helping to reduce stress, is not going to rid me of my depression. And no one would suggest that eating better and exercising more would help cure someone of their cancer.

I believe that this is why it’s so dangerous to use the term mental health instead of mental illness. It gives us the impression that our illness is something over which we have control, that if we just do the right combination of things, we can cure ourselves. And the flip side of this is the assumption that if we are mentally ill, we must be doing something wrong.

It’s time we started recognizing mental illness for what it is – it’s an illness. And one over which we have little control. Sure, we can medicate it, but that medication doesn’t make it go away – it only helps us to maintain it.Mental illness is a real illness, and sometimes no matter what someone does, it has control.  

It’s time we figure out how to support people with any illness instead of shaming them. Telling someone they need to “just get over” whatever mental illness they are struggling with is equivalent to telling someone with cancer to suck it up. So stop it already. Instead, try having a heart and asking how you can help them instead. It’s the only way we’re all going to live better.