The Language of Illness

Chris Bouneff

You once again presented an enlightened argument on your editorial page as to why Oregon needs to do more to provide quality mental health care. Yet, you manage to promote prejudice and fear by using language straight from the Dark Ages.

Hello, editors and reporters at The Oregonian. I hope you forgive that we’re writing to you indirectly today. See, those of us who live with or have a loved one with mental illness have tried to reach you directly via email or voice mail. But you never seem to return or even get the message.

Today provided another example of why we want to talk with you. You once again presented an enlightened argument on your editorial page as to why Oregon needs to do more to provide quality mental health care in the Oregon State Hospital and in our communities. Yet, you manage to promote prejudice and fear by using language straight from the Dark Ages. Worse, you are oblivious that because of your language, you are hurting your case -- and our cause -- to get people out of the hospital and into community care where they belong.

You do this by once again painting people who committed a crime while suffering with untreated mental illness as “the criminally insane.” The fact is, there’s nothing insane about people in the state hospital. They are there because they suffered a real illness -- bipolar disorder, schizophrenia, and others -- that interferes with their ability to perceive the world around them. They committed a crime because that illness was untreated. There is nothing criminal about them, which is why as a society we chose treatment over incarceration.

You also continue your habit of defining everyone with an illness as “the mentally ill,” as if it is this characteristic alone that describes us and how we function in the world. We are not the mentally ill just as people with heart disease are not “the diseased of the heart.” We have conditions that respond very well to treatment. The problem is that some people can’t access treatment, which can lead to dramatic results.

The fact is, we are people first. We’re your neighbors. We’re mothers, fathers, sons and daughters. We’re your friends. We’re your co-workers. We’re liberal and we’re conservative. We are all around you living lives that reach varying degrees of success, just like everyone else. You do not define others in your pages by their illness. Why is it still acceptable to you to do so with a mental illness?

The irony of all this is clear in our eyes, and we wonder why you can’t see it. You are an institution built upon language and its evolution. Yet, your reactionary language is straight from a time when people’s irrational fears of mental illness made it acceptable to lock people away.

By perpetuating prejudicial and inaccurate language, you continue to spread the stigma that prevents people from accessing treatment. You also hurt the cause you profess to aid. There is a reason that the Psychiatric Security Review Board is inept and that some communities react hysterically when a treatment facility is proposed in their vicinity.

It’s because of fear. Fear of the “criminally insane” and “the mentally ill.” Unjustified fear that your institution, which should know better, willingly spreads.

Our request is simple. Change your language. Describe us as we actually are or stop trying to describe us at all. Because you are causing us as much harm as you are helping.

Comments

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    Chris, I take your point about the use of the term criminally insane, although I will say that the term "forensic patient" means nothing at all to most of our readers.

    I have written many words about the state hospital and Oregon's system of mental health over the past decade. I'm sorry that you find my work so offensive to those who suffer from mental illnesses.

    I do find it interesting that you feel compelled to channel your criticism at the one (and only) media institution in this state that has devoted literally thousands of hours of reporting, editing and writing time to persuade lawmakers to replace the state hospital, create a respectful place for the cremains stored there, enlarge the network of community beds and change the law to require the PSRB to let people out of the hospital.

    Finally, I take personally the last sentence in your piece, and think it is dead wrong.

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    People with mental illness should not be defined by their illness. Mainstream media needs to balance their reporting. It would be good to see included in stories involving someone with mental illness a brief list of resources of where to find help. And in stories about suicide, a brief statement about the National Lifeline for those who are feeling suicidal. So often these days we see the media fall short on the value of their news content. How or who will it effect.

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    As a retired clinician with 30 plus years in the Oregon Community Mental Health system, your polemic is just that, a polemic. Those patients who are under the supervision of PSRB in large part are there because they refused treatment, and committed crimes as a result. These patients are dangerous, not only because of an illness, but because they chose to refuse treatment and committed serious crimes. On occasion I supervised PSRB community release patients. PSRB's oversight and monitoring is terrible, and their primary concern is keeping patients out of the hospital for cost reasons rather than protection of the public. One of my supervisees had shot a man in the forehead, another had burned down a house. Patients under the jurisidiction of PSRB are dangerous. They are not the same as patients who voluntarily participate in treatment and obey the law. The public has a right to protection, and the idea that a visit to a community mental health clinic once a week or twice a month constitutes any kind of protection, or guarantee of participation in treatment is ludicrous. Quibbling over the legal term, "criminally insane", is a distraction and about political correctness. Criminal insanity is not a reference to their illness but their legal standing. In "fairness" we should probably define them by their criminal acts rather than their legal status. I would give the Oregonian points for advocacy in mental health, and criticism for its refusal to address the funding needs of the mental health system.

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