Words can actually cause harm 

You’ve heard it before. Many, many times. You may have said it yourself. “She’s just crazy.” Or “I’m being insane right now.” Think of all the words we use in our everyday language that also mock or cut down someone with a mental illness—or a problem with substance use. You hear this kind of language in the media. On social media. In conversation. You even hear it in the House of Commons.  

When we insult someone (including ourselves) using words that put down or ridicule people with a mental illness or a substance use disorder, is it simply slang, and nothing more? Actually, we may be doing real harm. Even if we don’t mean to.  

Here’s how. 

Using unkind language can: 

1. make someone with a mental illness or substance use disorder feel they are damaged or defective.
2. humiliate them.
3. lead to self-hatred.
4. make them feel they don’t deserve mental health care.
5. make them want to hide their experiences out of fear of discrimination.
6. encourage discrimination against people with mental illnesses.
7. make people feel isolated.
8. prevent them from seeking help.

All of this is part of something called “stigma.” In this case, stigma means having negative ideas and judgments about a person with a mental illness or substance use disorder. Someone can also “internalize” stigma, taking in the negative judgments about themselves. Stigma is particularly serious because it can lead to discrimination. People have trouble getting housing and a job and, very often, simply having a mental illness can interfere with family and romantic relationships and with the quality of health care they receive. All because of prejudices people carry about mental illnesses or substance use disorders.

This is a call to reflect on the words we use, and to choose language that doesn’t reinforce discrimination nor cause people to feel judged or—much worse—feel less than human.

Of course, you might not mean to cause offense

Language is ever-changing and words sometimes fall out of fashion or become loaded with new meaning. As a result, we may use a word not realizing it could offend or demean someone. It might seem like a small thing but it’s worth thinking about how the words we use can be harmful. The words we’re talking about here, though, have been circulating in our everyday language for ages. 

One in every five people has a mental illness in any given year. In fact, did you know that by the age of 40, half of us will have had a mental illness? Each of us has a state of mental health that can fluctuate. Our society has come a long way in understanding that. Still, there are remnants of our language that trail behind, and using demeaning words can reinforce old beliefs about mental illnesses.  

It’s particularly important for those in positions of authority—for instance, politicians, journalists, and judges—to pay close attention to how they use language about mental illnesses and substance use disorders. Their words carry additional weight. When they don’t pay attention, they send a strong message that it’s okay to use words that cause harm, and that it’s okay to demean people.  

When we use sensitive and accurate language, we recognize that people with mental illnesses have varied and individual qualities, that “they” are actually you and me and our loved ones.

They are also our friends and colleagues. If we can help it, and we can, why would we diminish and stereotype them? 

So, check in with yourself: does the word you’re using dehumanize someone? Does it reduce someone to a condition, or refer to them in a cruel or belittling way? In the interest of avoiding harm, maybe choose a different word. 

We created an easy-to-use guide to talking about mental illnesses and substance use in a sensitive way. Please note that we use examples of stigmatizing language in this guide and are offering alternative language that is both more compassionate and more accurate. 

A note about “crazy”

The word “crazy” is used a lot in our culture. Listen for it: we hear it—and we use it—all the time. It has different meanings and is used in different contexts, but it all boils down to one thing: that having a mental illness is “not normal.”

Sometimes “crazy” is used to describe and demean people who have a mental illness, as in, “That person has bipolar disorder. They’re crazy.” This goes beyond insulting—it’s just plain cruel.

Crazy is also a kind of catch-all word used to discredit someone whose behaviour we disapprove of. As in, “That person is acting strangely. They’re crazy.” This can cause humiliation for someone with a mental illness, as well as for the person being judged or insulted.

We also use the word “crazy” in everyday language to mean something that is strange or that breaks with what is considered “normal,” as in “I had a crazy weekend.” We could easily substitute other words, like hectic, but we often just default to “crazy.” It might seem harmless to use the word crazy this way but even using it like this can reinforce stigma faced by people with mental illnesses.

Our suggestion? Pay attention to the word “crazy.” You might be surprised how often you hear it. And how often you use it. When you catch yourself, choose another way to express yourself to avoid causing others harm. Together we can help eliminate stigmatizing language and create more belonging and connection.

Sources

Choosing appropriate language to reduce the stigma around mental illness and substance use disorders (nature.com)
Language Matters (mentalhealthcommission.ca)
Public Health Language Guide (bccdc.ca) PDF
What Does “Crazy” Really Mean? (psychologytoday.com)
No, you shouldn’t call someone ‘crazy.’ But do we have to ban the word entirely? (self.com)
Harmful words about mental illness and violence (cmha.ca)
Reporting on mental health (mindset.ca)
Stigma: Why words matter (canada.ca)  
Barriers to accessibility for persons with disabilities aged 15 years and over, by disability type, age group and gender (statcan.gc.ca)