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Hugh Laurie’s Richard Roper in the BBC series, the Night Manager,
Hugh Laurie’s Richard Roper in the BBC series, the Night Manager, may have been a criminal mastermind but psychosis is something else entirely. Photograph: Des Willie/BBC/The Ink Factory
Hugh Laurie’s Richard Roper in the BBC series, the Night Manager, may have been a criminal mastermind but psychosis is something else entirely. Photograph: Des Willie/BBC/The Ink Factory

Why words matter when it comes to mental health

This article is more than 7 years old
Clare Allan

I choose to speak out when I hear people misusing epithets such as psycho and nutter. This doesn’t make me a po-faced party pooper – language shapes attitudes

It happens all the time. If not every day then at the very least several times a week. Someone describes someone else as a “nutter” or a situation as “mental”, and, listening, I am faced with a choice: to speak or not to speak.

It happens in the media too. And not just in tabloid headlines about “schizos”, “psychos” and so forth. In arts discussions on BBC Radio 4, I regularly hear the word “psychotic” used as a shorthand for lacking in conscience, or “schizophrenic”, when what is meant is in two minds.

Even the Guardian described Richard Roper, the arms dealer at the centre of the BBC’s recent drama The Night Manager as a “psychotic criminal mastermind” in a recent review. And this despite the Guardian style guide clearly stating that “terms such a psychotic should be used only in a medical context”, suggesting that even when a media organisation recognises that there is an issue and has a code to address it, it’s not easy to enforce.

What’s needed are not just guidelines but an awareness on the part of journalists of the reasons for, and importance of, such guidelines. Training delivered by people who have experienced psychosis might be an effective way of raising such awareness.

I can picture eyes rolling at the suggestion. Nobody wants to be thought of as a draconian PC killjoy. But the problem I can’t shrug off is that I really do think this matters. I think it matters a great deal. This misuse of language shapes attitudes, and whether the epithet is “psychotic” or “mental” or “schizo” or “borderline” (a new, but increasingly common addition to the derogatory lexicon), the impact is every bit as damaging as slurs attached to race or gender, sexuality or religion.

And perhaps even more so, because, as a group, people with mental health problems are, to a large extent, invisible. We hear very little from people who have experienced psychosis, for example. It may be that your colleague has, or your boss, or that woman you see at the gym; they’re unlikely to tell you, and who can blame them, given the common preconceptions. But this invisibility means that there is little to redress the balance. Psychos are “other”, be they “bunny boilers” or “criminal masterminds”. They’re not ordinary people like you and me (OK, perhaps not me).

Which brings us back to the problem of what to do. To wince in silence, or speak up and risk being considered self-righteous, PC, or a po-faced party pooper.

Almost always, it is simply a case of a thoughtless use of language. No harm is intended and for me to speak up risks causing embarrassment, awkwardness or even offence. “But you know I didn’t mean it like that!” someone once responded when I questioned her description of a mutual acquaintance as “a fucking psycho nutter”. “You know I don’t think like that,” she said, and she seemed so appalled that I felt terrible for raising the issue at all.

Speaking up creates a division. Or, perhaps more accurately, exposes a division that is already there. I don’t want people to feel awkward. I don’t want them to feel that they have to watch their language when I am around. I don’t want to be different, and that’s kind of the point. But not speaking up feels like a betrayal, a betrayal of myself and of thousands of others and of things that I think are important. To speak or not to speak. I hate it. I hate it when I speak up and I hate it when I don’t. Either way I end up feeling bad. And it’s perhaps being placed in this position, a position where I am forced to choose, that I hate most of all.

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