From Where I Sit
EDITORIAL COMMENT Mentally what?
tripping through the minefield
If it was not so serious the confusion over the use of semi-psychiatric terms would be almost funny. Time and again over the past few months, in the Press, on the radio, and on television, there have been people tying themselves in all kinds of knots with vaguely understood words like ‘disturbed’, ‘maladjusted’, ‘deprived’, ‘disordered’ and ‘defective’.
There are almost as many shades of mental disorder as there are degrees of what we choose to call ‘normality’?but, having used the expression ‘mental disorder’, the trouble has already started. ‘Mental disorder’ is a shorthand way of gathering both mental illness and mental handicap under the same umbrella and, once you start lumping them together, enormous care is needed when making any kind of generalisation. ‘The mentally disordered can never get better’? no, the mentally handicapped (who are mentally disordered) cannot get better but the mentally ill (who are mentally disordered) can and usually do get better.
‘Disturbed children are mentally subnormal’?no, well, they can be but that’s another story; by and large disturbed children are mentally ill. But can you really call a disturbed child mentally ill? Don’t you have to be grown up before you can have the sombre label ‘mentally ill’ attached to you? How did ‘subnormal’ creep into that last paragraph? Subnormal and handicapped are virtually synonymous but, for the best of reasons, Richard Crossman when Secretary of State for Social Services decreed that ‘subnormal’ was an insidious word implying ‘sub-standard’ and ‘second best’ and that it should no longer be used. ‘Handicap’ was a much more humanitarian and sympathy-evoking word and should be adopted henceforth. The trouble is that it takes longer than two years to ‘kill off’ a word in common usage, a word sprinkled all over the place in official publications, textbooks and records?so, people who have used it all their working lives go on using it. ‘You can’t teach an old dog, etc, etc.
Fitting the use of the word ‘handicap’ to its new limited role has taken it out of the socio-medical vocabulary in another context and an important concept has been lost in the process. That concept is that it is perfectly reasonable to talk of a mental illness and its consequences ‘handicapping’ the person who has been ill?a professional man who develops a schizophrenic illness is almost certain to be handicapped by it during the rest of his life since he will probably not be capable of returning to his profession, he will no longer be up to it. Apart from earning capacity being lost, the illness may leave someone unable to make good social relationships. Is that a handicap? Yes, of course it is.
But tell someone who isn’t used to walking delicately through the terminology minefield that a woman with severe agoraphobia is handicapped as a result and you run the risk of getting the reply, ‘You mean she’s become subnormal?’ At that point you may as well stop all calls for an hour, cancel appointments and settle in for a hard explanatory climb.
The really basic bugbear is the word ‘mental’ which carries with it a whole host of preconceptions, old wives’ tales and fearful ignorance. Once most people hear the word ‘mental’ or see it on a printed page the little red light goes on in their heads, a shortcircuit takes place and, virtually regardless of what words follow, what they dimly half-understand about ‘being mental’ takes over. ‘Mental’ means men in white coats who come and take you away, it means straws in the hair, it means institutions where the doors clang shut and they throw away the key. It really means ‘of the mind’ or ‘done by the mind’?that’s all, it doesn’t even mean ‘mad’ (whatever that may mean).
So the MIND Campaign has got its work cut out to implant a widespread reasonable, compassionate, informed response to the words ‘mental anything’, perhaps when people know enough to care they will care enough to use the words properly.
In the meantime, any public education campaign can be set back years by one or two sloppy uses of terminology in a newspaper read by 2 million people or a television programme watched by an audience of 30,000. A slip of the tongue or pen can be enormously damaging to a family with an adolescent mongol son who have just established good, supportive contact with their new neighbours only to have the morning paper tell them and their neighbours that the man who enticed a little girl into the wood was mentally handicapped rather than mentally ill.
Reporters have a duty to get it right and to do that they have to learn what is right. Alright, there are not that many specialist reporters, a general reporter may cover an animal story, a fire and a case of industrial pollution in the space of a couple of days and he or she can’t hope to know all about animals, fires and pollution either. But a mistake in description in those three stories is unlikely to do any long-term harm, a similar (apparently small) mistake in a story about mental illness or mental handicap might and does cause long-term harm. At best it perpetuates a state of confusion and bewilderment in the public mind. A growing number of reporters do know the pitfalls and are very conscientious about getting it right, checking back, taking the trouble to be sure?and this in the most rushed and chaotic job imaginable?but even the best and most careful story can be sabotaged on the sub-editor’s table.
One recent glaring example of this was in a headline placed above a good clear report of a conference which was solely on the subject of mental handicap. The reporter was exact throughout, he had used the word ‘handicap’ perhaps ten times in the story yet the headline proclaimed ‘Plea for more money for the mentally ill’.
A sub-editor’s working life is spent under enormous pressure, there is never enough time and perhaps his own red light and short-circuit were activated on this occasion. But there is still the lingering thought that ‘handicap’ would not fit in the headline and ‘ill’?a nice short word?would fit and therefore would ‘do’. Obviously there was no intention to confuse?a subeditor spends his life making things clearer for the reader?but there could well have been a genuine lack of understanding about the difference between ‘handicap’ and ‘illness’ and a belief that they were more or less synonymous.
It could be argued that the medical and social work professions are responsible for adding to the confusion by the constant creation of new terminology?descriptions, definitions and diagnostic labels fly about in all directions. But, for the moment, it’s all we’ve got so we’ve got to come to terms with it and use it properly.
Clearly lobby groups and public education programmes like the MIND Campaign need to involve newspapers and the broadcasting services in their work of changing public attitudes. But because of their enormous influence (It’s in the paper, so it must be true’, ‘They said it on television so it must be right’) perhaps reporters, sub-editors and broadcasters owe it to the MIND Campaign to become familiar with the terminology.
It could be their incalculably important personal contribution to the MIND Campaign?and it wouldn’t hit them in their pockets.
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