I’ve written before about using “person-first language” when referring to people with mental illnesses. To remind you, person-first language literally puts the person first and then their condition. In other words you would say “people with mental illness” instead of “the mentally ill.”
Person-first language has been encouraged by many advocacy groups and organizations since the 1990’s. The argument goes that person-first language is more respectful and conveys more dignity to the person. Also, it puts the primary focus on the person and doesn’t equate the person with their illness.
Given my long-standing interest in this topic, I found it very interesting to read about innovative research which claims to be the first study to scientifically test the effects of using person-first versus non-person-first language.
The study was simple but ingenious. Three groups of participants were used: 1) undergraduate college students; 2) adult community residents; and 3) professional counselors and counselors in training. Each of these three groups was split in half. One half of each group completed a survey about attitudes towards “people with mental illnesses.” The other half of each group completed the same exact survey except it used the phrase “the mentally ill” instead.
The results were quite interesting. The college students and the counselors who had “the mentally ill” survey language had significantly higher ratings on a subscale of items reflecting authoritarianism. They were more likely to endorse items reflecting sentiments such as people with mental illness need more control and discipline, they need to be hospitalized or kept locked up, we need to protect the public from them and they are outcasts of society.
The college students and counselors who had “the mentally ill” language on the survey also had significantly higher ratings on a subscale of items measuring social restrictiveness. These items included things like keeping people with mental illness isolated from the community, not having them live next door, having them excluded from public office, and denying their individual rights.
The community adults showed different results if they were given “the mentally ill” version of the survey. They gave significantly lower ratings on a subscale of items reflecting benevolence. In other words, they were more likely to agree with items such as not spending more tax money on mental health services, not providing the best possible care to people with mental illness, not feeling like people with mental illness deserve sympathy, and not having a more tolerant attitude toward them.
Finally, the community adults with “the mentally ill” language also had significantly lower ratings on the subscale called community mental health ideology. Their responses were indicative of not providing neighborhood or local community services to people with mental illness, seeing people with mental illness as a risk to community residents, being fearful of them in the neighborhood, and not including them as part of the community.
These findings are quite concerning. As the authors concluded in their discussion, “no one [was] immune” from the negative effects of the non-person-first language in the survey. All three groups (students, community adults and counselors) showed less tolerance in their attitudes toward people with mental illness when the phrase “the mentally ill” was used in the survey. The authors go on to discuss how language about mental illness matters in a variety of contexts, including college textbooks, in the media, and in resources for health care professionals.
This study is quite illuminating and thought-provoking, but it would be beneficial to do further research to explore this issue in more depth. How do other terms and phrases related to people with mental illnesses impact our thoughts, attitudes, and behaviors toward them? These are important questions to answer.
Reference: The Power of Language and Labels: “The Mentally Ill” Versus “People with Mental Illnesses” – Darcy Haag Granello and Todd A. Gibbs, Journal of Counseling and Development, January 2016.
Here’s a question: What are other examples of how our language affects our attitudes related to mental health issues? Please leave a comment. Also, please subscribe to my blog and feel free to follow me on X (formerly Twitter) or Instagram, “like” my Facebook page, or connect on LinkedIn. Finally, if you enjoyed this post, please share it with a friend. Thanks!