Mental Illness — Ingrown Toenail vs. Gangrene?

After the school shooting in Newtown, CT, there is much talk about mental illness. It’s an important topic, and one our nation needs to address, both through dialogue, and through regulation. I’d like to state two assumptions — then raise the issue of language.

Assumption #1) Most people do NOT have adequate access to mental health care. The whole structure of payment for mental health care is different than say, getting a well-baby check, or pap smear, or even a dental checkup. Why is that? But it is, and it keeps people from getting the care they need. Also, it is harder to find a psychiatrist who is available, competent, and within network, than it is to find other specialists.

Assumption #2) I feel frustrated when people talk about mental health INSTEAD of talking about gun regulation. It seems rather obvious that regulation of both of these areas needs improvement.

LANGUAGE! Our language about mental health is impoverished. Take the phrase “mental health” for starters. What does it mean? Does it mean everything and anything that can go wrong with someone’s psyche? Isn’t this rather a broad swath? Ringing in the ears, for instance, is covered by the same phrase as compulsive shopping?

We don’t have a parallel language problem with other aspects of health. We don’t say “foot illness” to encompass all forms of foot problems. If a person stubs their toe, even to the point of doing serious damage to a toenail, do we lump that in with gangrene? Of course not. We wouldn’t drop our voice and say, “Well, you know, George has foot illness” — leaving the hearer to guess whether we are talking about toenail problems or gangrene!

I’ve heard it said that depression is “the common cold of mental health.” Most people experience some form of depression in their lifetime. Yet that one word is also applied to people who are almost catatonic in their affect, and totally debilitated. We have to add modifiers: “major depressive disorder.” Yet, because we are rather constipated in discussing these things, we often don’t add these qualifiers, or state them in a forthright way. After all, the afflicted may suffer discrimination if their condition becomes known.

I think it’s time for America, as a nation, to grow up in the way it talks about mental health.

What language do you suggest?


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