Having schizophrenia is not being ‘schizophrenic’: Your words matter

To the Editor

The 2019 Royal Commission into Victoria’s Mental Health has stigma as a key focus. Stigma, both public and personal, is an extremely damaging aspect of having a mental illness. Public stigma describes the pre-conceived notions (i.e. stereotypes, prejudice and discrimination [Rüsch et al., 2005]) held by individuals not personally affected by mental illness, while personal stigma can be further classified into anticipated/perceived, experienced and self-stigma (Gerlinger et al., 2013). These can be described as the expectation of stigma by stigmatised individuals, the stigma actually experienced in daily life and the stigma they place on themselves.

Growing recognition of stigma impact has led to efforts to decrease levels of mental illness stigma in broader society such as through educational campaigns. Recent evidence suggests that the language surrounding mental illnesses, particularly adjectives such as ‘schizophrenic’ or ‘delusional’, have been linked to increased negative and stigmatising attitudes (Cuttler and Ryckman, 2019). These terms are highly detrimental as they reduce understanding and characterisation of the individual to just their illness in the social lexicon. This has severe consequences for these individuals in broader society leading to negative questions about their capabilities and experiences and affecting both public and personal perceptions.

While societal attitude changes towards people with mental illnesses will undoubtedly take time, there are simple steps that can be adopted immediately in relation to changing the language we use in these scenarios. This follows strongly from evidence that, for example, anticipated stigma (Gerlinger et al., 2013) can be targeted by changing noun language. A move away from debasing terminology in discussing mental illnesses will help to re-centre the discussion on the person who has these experiences, and contribute to a kinder context for them. Changing terminology could help ameliorate levels of public prejudice and discrimination, which will positively impact on the components of personal stigma as well as reducing levels of distress and improving support structures around managing a mental illness diagnosis.

The Royal Commission heard about the important role of the media in addressing stigmatising attitudes. The media provide the perfect vehicle for broad promotion of positive language use, and reducing the impact and spread of stigma. Change in language used to discuss mental illnesses such as schizophrenia can happen both at the institutional and interpersonal levels. It is contingent on society to engage in practices to ensure that individuals are not defined and limited by their mental challenges.