Times Have Changed, Terms Have Changed: Understanding Mental Health Terminology

Many things have changed in the world of mental health and mental health service delivery in the past 30 to 50 years-but nothing as much as the terms we use. "Asylums" were places where people with mental illness were "locked away." Neighborhoods used to refer to residential programs, or group homes for adults, as "half-way houses." Many times, terms used to describe mental illness were (and sadly, still can be) derisive and offensive. An individual who walks down the street talking to himself is called a "lunatic" or "psycho." Someone who is acting unusually angry is referred to as "postal." Someone who has a strong attention to detail is categorized as being "OCD."

Perhaps we have used several of these terms before. Perhaps we didn't realize that times have changed and terms have changed when it comes to mental health. Why have they changed, and what terms should you know when discussing mental illness?

Growing Understanding of Mental Illness

More and more, we understand that mental illness is something many people face during their lifetimes. According to Substance Abuse Mental Health Services Administration (SAMHA), in 2014, about 1 in 5 adults aged 18 or older (18.1%, or 43.6 million adults) had any mental illness (AMI) in the past year, and 4.1% (9.8 million adults) had serious mental illness (SMI). Additionally, in 2014, 11.4% of youths aged 12 to 17 (2.8 million adolescents) had a major depressive episode (MDE) in the past year. What used to be a secret shame is coming out into the open.

"Patients" or People?

Today, we also understand that words can hurt. It's not just the painful labels of "psycho" that are obviously hateful or offensive. We have a growing understanding that people with mental health issues are just that: people. When talking about individuals who receive services for mental illness, today many organizations encourage person-first language. This approach allows an individual to be identified as a person first and foremost. For example, terms like "patient" and "client" have been replaced with "individual." The overarching principles must always be to treat others with dignity and respect.

In conjunction with the language change for individuals receiving services, service delivery terminology and processes have changed to reflect a more individual-centered perspective. Professionals in the field currently place a greater emphasis on an individual's strengths and desired outcomes, versus his or her needs. Individual choice in the services provided and received is currently of paramount importance, and this is reflected in today's terminology.

Terms for Today's World

Here is a list of some of the more common terms and phrases along with those currently recommended:

Yesterday's Terms

Today's Preferred Terms

She is schizophrenic.

She is a person with schizophrenia.

He is mentally ill.

He was diagnosed with bipolar disorder.

Client/ consumer/ participant

Individual/ person

Assistance and supervision

Supports

Goals

Desired outcomes

Objectives (related to goals)

Support activities

Case manager/ care coordinator

Support coordinator

Guardian/ Conservator

Surrogate decision maker

Institution

Inpatient treatment

Halfway house

Group home

Defining Group Home

Another important thing to understand is that the term "group home" has multiple definitions. Wikipedia defines it as "a private residence for children or young people who cannot live with their families, people with chronic disabilities who may be adults or seniors, or people with dementia." This can also include people struggling with substance addictions. Most importantly to our mission, this also includes people with mental illnesses. The term group home is sometimes used to refer to residential treatment programs, where people receive professional services and treatment for mental illness onsite. The term "halfway house" is somewhat older and has a more negative connotation than group home.

What Sets Hopewell House Apart

Hopewell House is a private group home in the greater DC, MD, VA area for adults with mental illness. While we are not a residential treatment program or center, we offer supportive housing and care for those with mental illness who are looking for a private, therapeutic, and nurturing environment while they interact with society and their community. Our residents pursue treatment options in the larger community while we provide a supportive independent living environment. We provide all levels of care coordination from medication administration, to grocery shopping, to community activities.

At Hopewell House, our group home for adults diagnosed with mental illness are focused around people-not patients. The dignity of the individual is at the very heart of our philosophy. We believe that the right words and terms are critically important to the individuals who call Hopewell House home. Our warm, compassionate staff are highly trained in supporting adults struggling with mental illnesses, including schizophrenia and bipolar disorder. And above all, we seek to reduce the stigma associated with mental illness and to help individuals become successful in the community, while being mindful of our language and terminology in order to foster a more respectful and inclusive environment.

Despite what the old rhyme says about "sticks and stones," words and terms matter. We choose them carefully, especially when discussing mental illness and mental health. We hope we've given you a guide to help you and your loved ones get started.

Many things have changed in the world of mental health and mental health service delivery in the past 30 to 50 years-but nothing as much as the terms we use. "Asylums" were places where people with mental illness were "locked away." Neighborhoods used to refer to residential programs, or group homes for adults, as "half-way houses." Many times, terms used to describe mental illness were (and sadly, still can be) derisive and offensive. An individual who walks down the street talking to himself is called a "lunatic" or "psycho." Someone who is acting unusually angry is referred to as "postal." Someone who has a strong attention to detail is categorized as being "OCD."

Perhaps we have used several of these terms before. Perhaps we didn't realize that times have changed and terms have changed when it comes to mental health. Why have they changed, and what terms should you know when discussing mental illness?

Growing Understanding of Mental Illness

More and more, we understand that mental illness is something many people face during their lifetimes. According to Substance Abuse Mental Health Services Administration (SAMHA), in 2014, about 1 in 5 adults aged 18 or older (18.1%, or 43.6 million adults) had any mental illness (AMI) in the past year, and 4.1% (9.8 million adults) had serious mental illness (SMI). Additionally, in 2014, 11.4% of youths aged 12 to 17 (2.8 million adolescents) had a major depressive episode (MDE) in the past year. What used to be a secret shame is coming out into the open.

"Patients" or People?

Today, we also understand that words can hurt. It's not just the painful labels of "psycho" that are obviously hateful or offensive. We have a growing understanding that people with mental health issues are just that: people. When talking about individuals who receive services for mental illness, today many organizations encourage person-first language. This approach allows an individual to be identified as a person first and foremost. For example, terms like "patient" and "client" have been replaced with "individual." The overarching principles must always be to treat others with dignity and respect.

In conjunction with the language change for individuals receiving services, service delivery terminology and processes have changed to reflect a more individual-centered perspective. Professionals in the field currently place a greater emphasis on an individual's strengths and desired outcomes, versus his or her needs. Individual choice in the services provided and received is currently of paramount importance, and this is reflected in today's terminology.

Terms for Today's World

Here is a list of some of the more common terms and phrases along with those currently recommended:

Yesterday's Terms

Today's Preferred Terms

She is schizophrenic.

She is a person with schizophrenia.

He is mentally ill.

He was diagnosed with bipolar disorder.

Client/ consumer/ participant

Individual/ person

Assistance and supervision

Supports

Goals

Desired outcomes

Objectives (related to goals)

Support activities

Case manager/ care coordinator

Support coordinator

Guardian/ Conservator

Surrogate decision maker

Institution

Inpatient treatment

Halfway house

Group home

Defining Group Home

Another important thing to understand is that the term "group home" has multiple definitions. Wikipedia defines it as "a private residence for children or young people who cannot live with their families, people with chronic disabilities who may be adults or seniors, or people with dementia." This can also include people struggling with substance addictions. Most importantly to our mission, this also includes people with mental illnesses. The term group home is sometimes used to refer to residential treatment programs, where people receive professional services and treatment for mental illness onsite. The term "halfway house" is somewhat older and has a more negative connotation than group home.

What Sets Hopewell House Apart

Hopewell House is a private group home in the greater DC, MD, VA area for adults with mental illness. While we are not a residential treatment program or center, we offer supportive housing and care for those with mental illness who are looking for a private, therapeutic, and nurturing environment while they interact with society and their community. Our residents pursue treatment options in the larger community while we provide a supportive independent living environment. We provide all levels of care coordination from medication administration, to grocery shopping, to community activities.

At Hopewell House, our group home for adults diagnosed with mental illness are focused around people-not patients. The dignity of the individual is at the very heart of our philosophy. We believe that the right words and terms are critically important to the individuals who call Hopewell House home. Our warm, compassionate staff are highly trained in supporting adults struggling with mental illnesses, including schizophrenia and bipolar disorder. And above all, we seek to reduce the stigma associated with mental illness and to help individuals become successful in the community, while being mindful of our language and terminology in order to foster a more respectful and inclusive environment.

Despite what the old rhyme says about "sticks and stones," words and terms matter. We choose them carefully, especially when discussing mental illness and mental health. We hope we've given you a guide to help you and your loved ones get started.

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