“Madness”, “lunacy” and “insanity” were accepted medical usage into the early 1900s. Those words are still associated with people with mental illness. Over time and with more medical research, we have discarded “mongoloid”, “retard”, “moron”, “crippled” as demeaning, disrespectful, disparaging and dehumanizing. The time has come to discard “mental” as well.
The word “mental” carries fearful images; a man decapitating a passenger on a bus; a young man seemingly dressed as a super hero shooting randomly in a movie theatre; mothers, fathers and nannies killing children and pleading insanity. These are our referents when we think of mental illness. How else to explain the treatment of Ashley Smith? The videos of her inhumane treatment are right out of a B-rated horror/science fiction movie. She was tied down, shackled like an alien waiting to be dissected by others clothed in protective coverings as if they feared contamination. She was injected, involuntarily, with anti-psychotic drugs. She was shipped all over the country, trussed up like Hannibal Lecter, without a thought about her needs or fears. After all, she was just “mental.”
If she had come into the system with a diagnosis of diabetes and had become comatose while in detention, she would have been taken to a hospital. Why was she not taken to a proper psychiatric facility when she exhibited all the signs of a breakdown that was just as dangerous to her life as a diabetic coma. She was abused by the people who were responsible for her well-being.
It is the stigma, the shame and prejudice attached to the phrase “mental illness” that keeps people from accessing care. They fear the diagnosis; they fear the response of others to them. They fear being considered morally weak, flawed in character. They fear it is a death sentence. These fears keep too many from seeking help.
Mental illness afflicts more than 20% of our population; seven million Canadians from all walks of life. About 3,600 people commit suicide in Canada each year. That’s about 10 suicides per day. For every suicide death, there are an estimated 20 to 25 attempts. Suicide is the second leading cause of death for Canadians between the ages of 10 and 24.There’s no excuse, today, for death from mental illness because the prognosis for mental illness is as good as if not better than those diagnosed with chronic physical diseases.
Dr. David Koczerginski, Chief of Psychiatry: Medical Director, Mental Health and Addictions; William Osler Health Centre in Ontario, says that words and labels matter. “Psychiatric Illness and Mental Illness has a pejorative meaning for many, reflective of a lack of understanding of such illnesses and continued societal stigma… Psychiatric illness also has similar biological/neurochemical underpinnings and similar predisposing risk factors as one finds in other areas of medicine, however they are less easily understood and this has sadly contributed to diminished empathy and ultimately diminished investment of health care resources.”
Dr. Eric Kandel, the Nobel-Prize-winning neurologist and professor of brain science at Columbia University contends that the term “mental” illness can distort public understanding of the nature of these disorders. “All mental processes are brain processes, and therefore all disorders of mental functioning are biological diseases,” he says. “The brain is the organ of the mind. Where else could [mental illness] be if not in the brain?” Social and environmental factors, “do not act in a vacuum…They act in the brain.”Describing mental illnesses as brain malfunctions helps minimize the shame often associated with them. “Schizophrenia is a disease like pneumonia. Seeing it as a brain disorder destigmatizes it immediately.”
Mental illness is not in the mind; it is in the brain. This is a relatively new understanding. Depression, bipolar disorder, schizophrenia, OCD, have biological and environmental pre-disposing risk factors. Why should these illnesses still carry the stigma-it’s all in your head, pull up your bootstraps, it’s your fault, just get over it? Changing the name from “mental” to brain illness, can be the beginning of a change in attitude towards those of us with these illnesses. A change in perspective can lead to better understanding and acceptance. It will at the very least begin to reduce the stigma the term has carried from centuries of misconceptions and fear. .
