We know that language is powerful, and that when we speak about important issues, the weight of words has the potential to both empower and dispossess. We also know that this is not a simple or unambiguous topic, but is one that is deeply contested, and rightly so. The terms used to describe us can become our identity, and so the words we choose is something that deserves careful consideration.
The challenge of choosing meaningful language becomes especially pronounced when engaging those who seek care for their mental health. To date, there are several terms available to describe this population with varying rationales. In the UK, phrases like ‘clients,’ ‘patients,’ ‘service users,’ ‘patients/clients,’ ‘clients/patients,’ ‘people affected by mental illness,’ and ‘user/survivor’ are popular. In the US the terms ‘customer,’ and ‘survivor’ have gained currency, and in Australia ‘consumer’ appears to have become the preferred usage.[i] In our work at the Hatching Ideas Hub, ‘person with lived experience’ has become a regularly used phrase, with both ‘content expert’ and ‘expert by experience’ recently appearing as contenders. While all of these labels refer to someone receiving support, they differ in terms of where they locate power. For instance, the terminology “person with lived experience” aims to be person-centered and strengths based, whereas the term “patient” acknowledges a power dynamic as being under the care of another.
At the Hatching Ideas Lab, our inclination is to draw on inclusive language, but we also recognize that not everyone identifies with the terminology we select. We recognize that for some individuals, these terms seem ideological because they appear to mask existing power dynamics. In research, this raises the question to what extent inclusive language can be used without obscuring existing structures of power? And more significantly, whether or not it is disingenuous to use such terminology, if the structures behind them are not nearly so accommodating?
While it can be difficult to answer the above questions, we think there are some questions that can be posed to help researchers consider the language they use when working with individuals who have historically or are presently receiving support:
· Who have I talked to from this population and what terminology do they prefer?
· What power structures are currently at work?
· In my engagement with this population, who holds the power? In what ways?
· What advocacy groups exist that I can touch base with?
As part of a series of blog posts on the topic of language use in mental health research, we will be continuing to ask these and other questions over the next few weeks. These discussions will not only address the challenge of describing service users, but also extend to our current areas of interest, and provide critiques of phrases such as “committing suicide” and “intentional self-harm.”
To open the discussion, we encourage readers to join by commenting on their preferred terminology, and explain why that term is meaningful for them.
Follow this space and our Twitter page for updates. More coming soon!
[i] Dickens, Geoff and Marco Picchioni. (2011). A Systematic Review of the Terms Used to Refer to People Who Use Mental Health Services: User Perspectives. International Journal of Social Psychiatry, 58(2), 115-122.