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'Crazy Talk': How We Characterize Mental Illness


May 8 2013
Our careless language reinforces stigma.

As a writer, an editor, and an advocate for people affected by mental illness, I was deeply encouraged to learn of a new entry in the Associated Press Stylebook, offering guidelines on how to describe and characterize mental illness. As the definitive guide to using language in American journalism, the AP Stylebook guides most professional news media and others to at least to some degree. It's significant to see the stylebook offer guidance on how (and when) to address mental illness.

The entry calls for journalists to "avoid unsubstantiated statements by witnesses or first responders attributing violence to mental illness. A first responder often is quoted as saying, without direct knowledge, that a crime was committed by a person with a 'history of mental illness.' Such comments should always be attributed to someone who has knowledge of the person's history and can authoritatively speak to its relevance to the incident."

It's about time.

This is a hugely valuable step toward a national conversation that treats people affected by mental illness with dignity and respect—and accuracy. Irresponsible journalism is culpable for perpetuating myths and misconceptions about mental illness, particularly the widely held, erroneous belief that most people with mental illness are more violent and dangerous than the general population.

Studies consistently show this is not true. As with the general population, substance abuse does increase tendencies toward violence, but mental illness itself does not make people significantly more prone to violence than others. In fact, according to the U.S. Surgeon General's office, "There is very little risk of violence or harm to a stranger from casual contact with an individual who has a mental disorder…the overall contribution of mental disorders to the total level of violence in society is exceptionally small."

The guidelines also say, "Do not use derogatory terms, such as insane, crazy/crazed, nuts or deranged, unless they are part of a quotation that is essential to the story."

Journalists sometimes do use common derogatory terms that perpetuate the stigma attached to mental illness. But to be fair, when they do so, they're simply reflecting the speech most of us use without thinking. While journalists' voices may be amplified, their words are no more important than anyone else's. And the rest of us reinforce stigma with our own language, too.

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