Navigating the language of mental health

There is undoubtedly greater recognition of mental health in society and in workplaces now more than ever.

But the use of language to describe aspects of mental health has not necessarily kept pace.

The term ‘mental health’ itself has negative connotations, since language can “unconsciously trigger our brains to think in a certain way and add to the stigma that surrounds mental health”, according to Everymind at Work.

During its interactive webinar sessions, the organisation says its attendees associate words such as ‘mad’, ‘crazy’ and ‘nuts’ with the word ‘mental’.

It adds that recent research by McKinsey & Company found that 65% of people with a mental illness perceive stigma in the workplace, and less than one in ten employees describe their workplace as free of stigma surrounding mental illness.

According to a 2022 study, 80% of employees have struggled with their mental health (as documented in Everymind’s latest report,  Workplace Mental Health Stigma: The Elephant In The Room).

A vulnerable profession

Legal professionals are among those most vulnerable to mental ill health. In a 2021 survey conducted by mental health charity Lawcare, 69% of respondents said they had experienced poor mental health over the past year.

Respondents to Life in the Law reported high levels of bullying, harassment or discrimination in the workplace. Just over one in five participants displayed higher burnout levels, lower autonomy and psychological safety at work, and reported higher levels of work intensity.

A recurring theme was also the desire to be ‘heard’ and listened to, and the most valued form of mental health support in the workplace was regular catch-ups or appraisals.

This, according to Lawcare CEO Elizabeth Rimmer, aligns with the need to build relationships and trust with people in the workplace.

“When you have a regular catch-up with someone, that’s providing an opportunity to not only talk about work, but to talk about something else that might be going on,” she says.

The power of language

Talking constructively, though, involves using the right language.

“Language is so important because it can perpetuate prejudice and discrimination if we [use inappropriate] terms,” Rimmer highlights.

Instead, using more inclusive language reduces the stigma that surrounds mental health, and promotes acceptance and empathy towards people, she adds.

“Words really matter because when we speak about things in an open and empathetic way, that helps to empower or enable people who are struggling, and they are then more likely to seek the help they’re looking for.”

Problematic words

When asked to cite examples of inappropriate words, Penelope Aspinall, mental health consultant and chair of the advisory board at charity Jonathan’s Voice, notes that there are “so many problematic words that have become part of our common parlance, it’s hard to know where to even begin.”

Particularly common, she notes, is saying something like ‘it was really crazy’ to describe a situation that was a bit disorganised, “without actually pausing to think, is that okay?”.

But when those words and phrases are used to describe a person, it’s a different story.

“It’s not appropriate to label it as banter and it’s not a veil that people should be hiding behind anymore.”
— Elissa Thursfield,
Everymind at Work

Elissa Thursfield—legal consultant at Everymind at Work and director at consultancy EMT Legal—works with businesses, either managing or training staff, or dealing with investigations.

“You still hear people say [phrases like] ‘oh ignore them, they’re a bit of a nutter’,” she says.

“Or when they hear that somebody perhaps has been off—with depression, anxiety, stress, for example—they might say ‘I wish they would pull themselves together’.”

Other phrases she has heard recently are: “it’s very bipolar” or, “they’re being very OCD” or saying someone’s “a bit mental” or a “head case”.

“Those sorts of things are very damaging and they absolutely lack empathy,” states Thursfield. “We shouldn’t be hearing things like that in the workplace or the wider world.”

And, she insists, it’s not banter.

“Lots of things get dressed up as banter, and people can be accused of not being able to take a joke.

“But actually they’re not appropriate jokes to be making. It’s not appropriate to label it as banter and it’s not a veil that people should be hiding behind anymore.”

Aspinall makes the comparison with the language of sexism and racism. “Most of us wouldn’t dream of using words that were considered perfectly okay 50 years ago,” she points out.

It is when such words and phrases are used in a judgmental, trivialising or belittling way to another person, that it becomes a problem, she explains.

“When people are frightened of things, they tend to belittle or tame them in some way.”

She uses the example of the word ‘fragile’. “For me it has a sexist, belittling feel to it. But if you say ‘I’m feeling a bit fragile today’ about yourself, then that’s okay.”

The ‘right’ language

Many would argue that no-one wants to use inappropriate or harmful language, but may struggle to find the right words. So what sort of language should we be using?

Rimmer says: “At Lawcare, we’re very conscious about language, and use appropriate, respectful terms when describing mental health issues.

“So if we were writing about somebody’s experience of mental health, we would not say they were ‘suffering from’. We would say they are ‘living with’ or ‘experiencing’ (unless a person who is suffering from a mental health issue has used that term themselves).”

Everymind advises using language like ‘wellbeing’, ‘wellness’ or more relatable terms such as ‘stress’ to gain initial attention as opposed to ‘mental health’.

“When we speak about things in an open and empathetic way, that helps to empower or enable people who are struggling.”
— Elizabeth Rimmer, Lawcare

Thursfield explains: “We want to make sure that we’re using language that people are comfortable with, and avoid generalisations.”

A lot of the nervousness around this, she says, comes because people don’t know what is appropriate.

She advises: “Have a conversation with somebody and ask: ‘how do you feel about it?’ We should just be dealing with people as people and not using labels.

“It shouldn’t be a conversation where you go, ‘the world’s gone mad—I don’t know how to talk to you’. It should be, ‘Tell me a bit about yourself and how you view things and the language that you prefer’. So it gives somebody some control over it rather than having a label put on them.”

Rimmer agrees, emphasising that people are not defined by a mental health issue.

“A big challenge is that people don’t know what to say and they’re frightened of saying the wrong thing. So they either say nothing, or make a glib remark or joke, and [perhaps] use inappropriate language.

“You don’t want to be labelling people as if they’re broken somehow or not up to the job,” she continues. “What you want to be doing is speaking about issues and people in a way that recognises they might be having a difficult time.”

Changing times

Aspinall adds that the more people can be open about and normalise the language surrounding mental health, the better.

[Mental health issues] “can happen to everybody and don’t have to be wrapped up in shame and secrecy,” she says, adding that the more people realise this, the more comfortable people will be in talking about it in respectful terms.

“Sometimes things might feel clunky at first. I remember back in the ’70s, when ‘person’ was substituted for ‘man’, and there were lots of jokes made about ‘Personchester’ [to describe the English city Manchester] among others, and at first it was ridiculed.

“Now, it’s just completely acceptable. You don’t talk about the human race as being men. You talk about it as being people.”

But we’re not quite there yet when it comes to using the right language for mental health.

“I don’t think we’ve found [the alternatives] yet,” reflects Aspinall. “And I suspect there might be some people [who would say] ‘oh, don’t be so ridiculous’. But then we might have said that a few years ago when gay people, women, people of colour or disabled people were talked about in terms we would never use now.”

For Thursfield, adapting to the way language evolves is not a big ask.

“The world is allowed to change—it doesn’t mean it’s necessarily changing in the wrong way and there is nothing wrong with updating ourselves and our behaviour in line with being respectful to other people, which is the minimum that we’re asking for.

“If you make a genuine error, and you mean well and you’re not intentionally trying to be offensive, people usually know the distinction.”

Tick-box exercise?

The good news is that more companies are now being more proactive with mental health support.

“When I talk to my peers, it is actually seen as something that adds value,” says Thursfield, “rather than being a tick-box exercise or something to say to people when you’re recruiting them.

“If you can retain staff, they’re going to operate to a much higher level and without that risk to their health.”

Rimmer adds: “Certainly I’ve seen some good examples where I think organisations are genuinely committed to tackling these issues, and want to create the best environment for their people.”

But while there is much greater awareness and interest in mental health, Rimmer believes there is “still an element of values-washing”—“organisations wanting to tick a box—we’ve done X, Y, and Z, therefore, we’ve dealt with mental health”.

Thursfield agrees that while strides have been made, she believes there is “definitely work that can still be done”—particularly in the way we either talk to or about people.

“There are some real positives going on at the moment in terms of educating people and the language that they use, not only from a cultural perspective but also from a legal perspective,” she explains.

As an employment law specialist, Thursfield adds: “If people get it wrong, it could result in employers being liable for harassment claims under the Equality Act.”

Work pressures

Looking back to the findings of Lawcare’s Life in the Law study, why are factors such as burnout and psychological safety such a challenge for the legal sector—particularly with more information and data than ever before about mental health?

For Thursfield, awareness about mental health is one thing, but the correlation between that and workload and work pressure is another matter.

“We often see employers investing in wellbeing initiatives but lacking in consultation with employees to define what it is that is actually wanted and needed,” she explains.

“I don’t believe it is the terms causing confusion, more that there needs to be a willingness to actually address the cause of things like burn out, rather than turning to quick fixes that could be perceived to be less effective in the long run.”

For Rimmer, the issue is partly a post-COVID one. “With the exception of burnout, I think these expressions have emerged to describe people’s feelings and experience of work in the current economic climate and post-pandemic world,” she reflects.

“They tell us that the expectations we have from our workplaces are higher and that we are no longer prepared to tolerate working environments that don’t align with our values and need for fulfillment.

“It’s a message to employers that it’s important to understand and nurture the culture in your organisation, to make people feel happy and engaged.”