Discrimination is only one part of stigma. Stigma can be seen as an overarching term that contains three elements. First is ignorance or the lack of knowledge or misconceptions about mental illness. Second is prejudice or having strong and often negative attitudes and feelings towards people with mental illness, such as anxiety, anger, resentment, hostility or disgust. Third is discrimination or behaviorally depriving the rights of, rejecting, or excluding people with mental illness. (Thornicroft et al., 2007) .

In other words, discrimination, such as rejecting a job application, refusing to rent an apartment, is only one of the crucial elements of stigma, which often is a result of other components of stigma – ignorance and prejudice. 

There is no absolute rule on what we can or cannot say. You may ask yourself, in what context do you say this, and what’s your attitude and intended meaning behind using this phrase.

Before saying “have you gone nuts”, try to take a moment to think about your intention behind using this phrase, and how others would react upon hearing it. Are we assuming that people with mental illness behave differently than others, or are we simply expressing our shaken emotion, or other emotions?  For example, when your friend tells you, s/he is going to quit her/his job  and go travel around the world. You may respond with, “have you gone nuts (Cantonese: Chi sin)?”. It’s worth contemplating whether you have any assumption towards people with mental illness that they behave or think outrageously, which is the reason why you used “goen nuts” to describe your friend? We have to bear in mind our implicit bias in our language is perpetuating mental illness stigma.

We may change our attitudes and beliefs or take further action in leveling the difference in social status of disadvantaged groups.

We can start by understanding more about mental illness. Our lack of knowledge and misunderstanding about mental illness may form negative stereotypes (e.g., people with mental illness lack the ability to think clearly, cannot recover etc.) In reality, these are not facts. To reduce stigma, apart from educating ourselves, interacting and getting to know someone with mental illness is useful, too. By educating ourselves and contacting people with lived experience, we have a chance to review whether our assumptions are true, thereby reducing stigma.

Next, we could work on the language used in our daily life. This is an important component in reducing stigma and breaking down negative stereotypes associated with mental illness. By using recovery-oriented language, we can break down the barriers that people in recovery might experience in the society.

Here are some suggestions of recovery-based language in mental health:

People with mental illness VS the mentally ill

Mental illness is not the entirety of a person. Just like some people might have nasal allergy, while some people might have asthma; some people are introverted, while some people are extroverted. Experience of mental illness is only part of the person’s life. This does not define the essence of a person.

Normal VS abnormal/ Us VS them

The world is composed of different types of people. If all of us define the meaning of normality and abnormality using our own narrow frame of reference, the worlde we could see will be very limited. All of us have our unique lifestyle and ways of thinking; we don’t need to classify people into in-group and out-group to widen our divide.

Of course, as mentioned on this website, if all of us step up to advocate for people in recovery, such as voicing out for people being discriminated against, sharing accurate information about mental illness, we can make a strong impact in changing the social climate.

(Source: StoryTaler Facebook page)

You can find many dos and don’ts on the Internet, listing out what you should say and what you shouldn’t say in a conversation to someone with mental illness. These prescriptions make it seem like  we could not say anything openly and freely, in fear of saying something wrong or offensive. In fact, such hesitation might further distance us. There is no gold standard  in social interactions. When we are taking reference from some suggested wording or language, we need to understand the values, intentions, and attitudes behind what we are saying, instead of simply verbalizing from memory.

Communication is not formulaic and can’t be simply classified into “good” or “bad”. To understand more, the following three albums from StoryTaler may be helpful to you.

1)  Active listening
2) Acknowledging our emotions
3) Active listening (Advanced)

Reference
Thornicroft, G., Rose, D., Kassam, A. & Sartorius, N. (2007). Stigma: ignorance, prejudice, or discrimination? British Journal of Psychiatry, 190 (3), 192 – 193.