One way judges can help decrease the stigma of mental health disorders
By Scott R. Mote, Esq., Executive Director of the Ohio Lawyers Assistance Program
As judges, you communicate daily—with fellow judges, attorneys, people in the courtroom, the public. When you speak, people listen. They respect your opinions and they take notice of how you communicate. Judges at times need to speak about mental health illness and substance use disorders, whether you are speaking about a person living with one of these disorders or about the topic in general. One way judges can help decrease the stigma of mental health illness and substance use disorder is to learn how to use the proper terminology for these disorders.
Using certain terms displays judgment, shame and blame
In the 1980s, HIV was initially called Gay-Related Immune Deficiency, which focused on a particular socially defined group of people (even though heterosexuals were also prone to the disease). This led people to believe that homosexuals were the cause of the disease, which led to judgment and shame.
People who suffered from Hansen’s disease (an infection caused by slow-growing bacteria that affects the nerves, skin, eyes, and lining of the nose) were called “lepers,” which actually describes a person who is to be avoided for moral or social reasons.
Other hurtful words such as cripple, retard, insane asylum, addict, junkie, crackhead, druggie display judgment, shame and blame.
When we speak of mental health/substance use (MH/SU), we are speaking about highly stigmatized conditions where people’s health and lives are at stake. One reason for the stigma is that many people still perceive MH/SU as a choice, even though they cannot control it. Some believe that people living with these disorders can just stop using or that they can just think positive or snap out of it. But the truth is, MH/SU issues are caused by chemical imbalances in a person’s brain. To help eliminate or to help decrease the effects of MH/SU, people must seek proper treatment. These are not scenarios where people can just get well through willpower or positive thinking.
Put people first
To help eliminate the stigma, learn how to use the proper terminology. Carefully choose words around the subject of MH/SU that display a non-judgmental interpretation. Substance use disorder used to be called “substance abuse.” When you think about the term “abuse,” it is usually coupled with other types of abuse, such as child abuse, domestic abuse, and physical abuse. In these types of abuse, there is a person who is causing direct harm to another person. When you say “substance abuse,” it makes one believe that the person is committing a crime. When you label addiction as substance use disorder, it conveys that this is a disorder that needs to be treated medically. When you label someone as a substance abuser it encompasses the whole person, which defines him or her by dysfunction. In contrast, the “substance use disorder” tag simply describes one problem, rather than an entire identity.
When we use certain terms related to MH/SU, they create bias, and they can make people feel ostracized. For example, you might say “Tim is schizophrenic.” When you say it this way, it equates Tim with his illness and perpetuates negative labels and stereotypes about having a mental health condition. If you say instead, “Tim has schizophrenia,” it puts the emphasis on Tim and not his illness. Tim is a person and is not defined by schizophrenia.
When you speak about MH/SU, put people first. Here are some other examples:
Don’t say: He is schizophrenic
Say this when necessary: He has schizophrenia
Don’t say: She’s anorexic
Say this when necessary: She has anorexia
Don’t say: He’s bipolar
Say this when necessary: He has bipolar disorder
Don’t say: She’s retarded
Say this when necessary: She has an intellectual or developmental disability
Don’t say: She is emotionally disturbed
Say this when necessary: She has a serious emotional condition
Don’t say: They are special education students
Say this when necessary: They are students who receive special education services
Don’t say: She’s an addict or substance abuser
Say this when necessary: She has a substance use disorder
Don’t say: He’s mentally ill
Say this when necessary: He has a mental health condition or diagnosis
Don’t say: Suffering from mental illness
Say this when necessary: Living with (or experiencing) mental illness
Some other words that we might say in our everyday language can convey stigma. For example, one might say “That’s crazy, psycho, insane.” Instead say “That’s wild, bizarre, eccentric.” Instead of saying “That drives me nuts” or “That makes me crazy,” simply say “It annoys me.” This helps remove negative words that are sometimes associated with MH/SU.
Twenty-three million people meet the criteria for substance use disorder, yet only 10% receive help. One of the reasons they do not seek proper treatment is because of the stigma that surrounds them. The legal profession is not immune to these issues. Help remove the stigma. Help others understand that substance use/mental health disorders are not a choice, but our language and terminology in how we describe them is.
If you or someone you know needs help, contact the Judicial Advisory Group, a peer-based confidential assistance group that helps judges and magistrates with personal and professional issues. For more information, go to www.ohiolap.org/judges or call (800) 348-4343.
If you find yourself stressed, anxious, or overwhelmed, seek help. The Ohio Lawyers Assistance Program helps lawyers, judges and law students manage life's stresses. OLAP has saved lives, careers, marriages and families. All inquiries are confidential. (800) 348-4343 / ohiolap.org