The Importance of Language to Promoting Community Integration of Individuals with Psychiatric Disabilities

By Harold A. Maio, Consulting Editor, Psychiatric Rehabilitation Journal


What is people first language?

'People first' acknowledges, before any other reference, the personhood of an individual. Beyond any label that one can attach to a person, and beyond any reason someone has for attaching that label, selfish or unselfish, prejudiced or unprejudiced, is the person. It is to that person we must learn to relate, not to any imposed label. In the field of disability, and even more specifically, in the field of mental disabilities, common grammars tend to insist that people are their disability.

Why is language important in Community Integration?

* Language reflects beliefs. In general language reflects the beliefs of the society in which a person resides.


* Persons who control language, consciously or unconsciously, hold power over people deprived of language, language of process, political process.


* Embedded within language are the rudiments of discrimination.


* Language maintains negatives beliefs and serves to isolate people with differences.


* Language undermines community integration outcomes (i.e. - employment, housing, education, etc.).


* Language undermines self-determination, which is the integration of people in decision-making capacity at the specific level of their ability.


How language change occurs

At times language change does arise, contesting commonly held beliefs. This language may or may not successfully challenge those beliefs, but often provides the impetus to change.

Currently language in mental health is in flux. There are several specific reasons for this:

1. People in the mental health professions are reacting to past prejudices: Language change can come from within a profession.


2. People who have experienced the historical language of mental health are publicly self-identifying, and responding to the effects the language of the mental health system has had on them.


3. A partnership is developing between people in mental health professions and people who have directly experienced mental health services. Integration on this level leads to discussions of self-determination, and of setting mutual goals of how to accomplish language change, self-determination as a team.


4. Mental health systems are themselves in flux, moving from immense, institution-sized facilities to small, community based programs, which may or may not be facility based.


Language addressing negative beliefs

1. Isolation breeds fear: A group without the ability to self-define is left to the prejudicial definition of a society. About that which we do not know we often develop negative stereotypes. America's policy of segregating people with mental disorders in large, isolated mental institutions has lead to a folk culture of what it is like to live with a mental disorder. Folk beliefs have basis in reality, but are often exaggerated beyond specific context.


2. Like all illnesses, mental illnesses exist in vastly varying degree, but as presented in folk culture one encounters only an extreme. Stereotypes are expressed on a daily basis in the media, in the form of drama, in novels, poetry, as well as in professional literature, for folk culture affects all.


3. The reality, the infinite variety and degree of mental disorders, is only recently coming into public view, as new generations are presenting mental illnesses in the same manner as physical illnesses, addressing all the inherent variety.


4. Pharmaceutical companies, marketing directly to the consumers of their products, are educating the public. Advocacies representing single-named illnesses, for example bi-polar disorder, are acquainting the public with the specific needs of a specific disorder, and through the power of naming are encouraging acceptance.


5. A new generation of people entering the mental health field is bringing new life into the profession. All the signs are propitious for positive change.


Best Practices

* Name the individual illness, rather than labeling the person (i.e. a person diagnosed with paranoid schizophrenia rather than a diagnosed paranoid schizophrenic).


* Avoid generic stereotypes (i.e. "the" mentally ill is a generic stereotype, there are many mental illnesses)


* Recognize that people with disabilities have many differences. What they most often have in common is the prejudice and discrimination they face, particularly when described by the media.


* Modeling a behavior (i.e. using people first language, integrating process) is a powerful tool.


* Proactive involvement of people in the profession - involving persons with a psychiatric disability to use their voice in the writing of grants, editing of articles, participation in advisory board panels, etc.


Language Links

http://www.marthachurchill.com/ddBPGconsumer.htm
http://www.stigmaresearch.org/publications/bulletin/
http://www.disabilityisnatural.com/peoplefirstlanguage.htm
http://www.bu.edu/prj/winter2001/personfirst.html
http://www.bu.edu/prj/spring2002/maio.html