STOP THE STIGMA

Advocating for Inclusive Language in Mental Health

Introduction: The Power of Language in Shaping Perceptions

Language is more than just a means of communication; it shapes our perceptions, fosters understanding, and promotes inclusivity. In the realm of mental health care, the words we use carry immense weight. As the profound impact of assistance dogs in supporting individuals with mental health conditions gains wider recognition, it's imperative that we engage in a meaningful conversation about the language we use to describe these invaluable companions.

At Veterans With Dogs, we've seen first-hand how the right language can empower individuals, reduce stigma, and promote a more supportive environment. That's why we're advocating for the adoption of more inclusive and contemporary language to enhance public awareness, education, and support for mental health assistance dogs. We believe that the time has come to move away from outdated terms and embrace a vocabulary that reflects the true essence of these incredible animals and the people they support.

The Current Landscape: A Muddle of Terms

Currently, a variety of labels are used to describe dogs that provide support and assistance to individuals with mental health conditions. You might hear terms like "psychiatric service dog," "PTSD service dog," or "mental health assistance dog," amongst others. This inconsistent use of language can lead to confusion and may not accurately reflect the full spectrum of assistance these dogs provide.

Why Updated Language Is Essential

The need for updated language is paramount for several compelling reasons:

Inclusivity: Using different labels can inadvertently create divisions or hierarchies amongst assistance dogs based on the specific mental health condition they are trained to support. However, the reality is that many of these dogs are remarkably versatile. They can offer support to individuals with a wide range of mental health conditions, from anxiety and depression to trauma and other challenges. Updated language can encompass the full range of their abilities and ensure that all individuals feel included and represented. We believe it is key to creating a more comprehensive and equitable approach to assistance dog support.

A Person-Centred Approach: Person-centred language puts the individual's needs and preferences first, rather than focusing solely on their diagnosis. Using labels that emphasise the individual's mental health condition (e.g., "psychiatric" or "PTSD") may inadvertently define them primarily by their diagnosis, rather than acknowledging their unique qualities and strengths. A shift towards person-centred language recognises the individual as a whole, fostering a sense of dignity and respect.

Reducing Stigma: Outdated or stigmatising language can contribute to negative perceptions of mental health conditions and the individuals who experience them. By adopting more sensitive and empowering language, we can actively combat stigma and promote understanding and acceptance. This shift in language reflects a broader societal commitment to destigmatising mental health and creating a more compassionate world.

Standardisation: The lack of standardised terminology leads to confusion and inconsistencies in public perception and policymaking. Updated and uniform language can create a clearer understanding of the roles and capabilities of assistance dogs in mental health care. By establishing a common language, we can ensure that policies are consistently applied, and that the public has a clear understanding of the vital role these dogs play.

Evolving Awareness: As awareness of mental health issues and the benefits of assistance dogs continues to grow, so too should the language we use to describe their role. Updated language can accurately reflect the evolving knowledge and understanding of mental health care and the contributions of assistance dogs. This adaptability ensures that our language remains relevant and respectful as our understanding of mental health deepens.

The Rationale Behind Our Advocacy

Let's delve deeper into the specific reasons why we believe this change is so crucial.

The term "psychiatric service dog" simply isn't reflective of modern language used within the mental health community. It carries echoes of a bygone era and can perpetuate stigma and misconceptions surrounding mental health conditions. Language evolves, and it's our responsibility to use terminology that aligns with current societal attitudes, fostering open dialogue and reducing the potential for discrimination.

Language is a powerful tool in shaping public perceptions. Using contemporary and inclusive terminology for assistance dogs can facilitate better understanding and acceptance of the vital role they play in supporting individuals with mental health conditions. Replacing "psychiatric service dog" with more inclusive terms such as "mental health assistance dog" can help destigmatise mental health and emphasise the valuable support and assistance provided by these remarkable animals.

When assistance dog organisations do continue to use outdated terminology, it can lead to inconsistencies and confusion when interacting with government agencies, regulatory bodies and service providers. By advocating for more inclusive language, we can work towards a unified approach in addressing the needs and rights of individuals who rely on assistance dogs. Encouraging collaboration will enhance educational efforts and raise awareness of the unique contributions these dogs offer in mental health care.

Educational resources are vital for promoting a deeper understanding of mental health assistance dogs and their role in health care. By using up-to-date terminology, educational materials can accurately represent the essential services these dogs provide, enabling better dissemination of information to the public, businesses, and institutions. This, in turn, can lead to increased acceptance and support for individuals with mental health conditions who rely on assistance dogs for support and assistance.

The term "psychiatric" has been historically associated with negative connotations due to the stigma surrounding mental health and mental health care. Some common negative associations with this term include:

Stigmatisation: The term "psychiatric" is often associated with psychiatric hospitals or institutions, which historically were places of confinement and mistreatment for individuals with mental health conditions. This association can perpetuate negative stereotypes and stigmatisation of mental health.
Institutionalisation: The use of the term "psychiatric" may evoke images of institutionalisation, which can be seen as dehumanising and isolating for individuals with mental health conditions.
Medicalisation: The use of the term "psychiatric" can emphasise the medical aspect of mental health care, potentially overlooking the importance of holistic approaches and social factors in mental well-being.
Diagnosis-centric: The term "psychiatric" is frequently linked to the diagnosis and treatment of mental health conditions, which may overlook the broader aspects of mental health, such as well-being, coping mechanisms, and emotional support.
Historical Context: In the past, individuals with mental health conditions were often treated poorly and were subjected to various forms of abuse and neglect. The term "psychiatric" may remind some people of this dark history and further contribute to negative connotations.

It is important to recognise that language evolves over time, and efforts are being made to use more person-centred, inclusive, and empowering terminology in mental health care. Many organisations and mental health professionals now advocate for person-first language that emphasises the individual rather than their diagnosis or condition.

The Power of Advocacy: Creating a More Compassionate Society

The language used in mental health care has a profound impact on how individuals perceive themselves, seek help, and engage in treatment. By using respectful, non-stigmatising, and empowering language, we can create a more compassionate and effective society that supports the well-being of everyone.

The language we use can either reinforce or challenge stigmatising beliefs and attitudes towards mental health conditions. Stigma can prevent individuals from seeking help and support, leading to untreated mental health issues. Using non-stigmatising and empathetic language can help break down barriers and encourage people to seek the help they need.

The language used in mental health care can empower individuals by emphasising their strengths and resilience rather than focusing solely on their diagnosis or struggles. Person-centred language that respects an individual's agency and autonomy can help them feel more in control of their mental health journey.

The use of sensitive and respectful language in mental health care can foster trust between mental health professionals and their patients. Trust is essential for effective communication, collaboration, and treatment outcomes.

Clear and non-judgmental language can encourage open and honest communication about mental health concerns. When people feel comfortable expressing their thoughts and feelings without fear of judgment, mental health professionals can better understand their needs and provide appropriate support.

The language used in mental health care impacts the way treatment plans are developed and communicated. Using precise and accurate language helps ensure that the right interventions are chosen, leading to better treatment outcomes.

Inclusive language acknowledges the diversity of mental health experiences and ensures that individuals from all backgrounds feel seen, heard, and respected. This is especially important in mental health care, where various cultural, social, and personal factors can influence a person's mental wellbeing.

Language plays a significant role in shaping public perception and policy around mental health. Advocating for accurate and compassionate language can lead to more supportive policies, increased funding for mental health services, and greater awareness of mental health issues.

Moving Forward: A Call to Action

Efforts have already been made to move away from outdated and stigmatising language related to mental health. For instance, there has been a shift towards using person-centred language that emphasises the individual first, rather than their diagnosis. This person-first language aims to reduce stigma and foster a more respectful and inclusive approach to mental health care.

Language is a dynamic and ever-changing aspect of society. As awareness of mental health and the importance of compassionate care grows, so does the recognition of the significance of language in shaping attitudes and perceptions towards mental health issues. Here in the UK we have made good progress in adopting more inclusive and sensitive language in mental health care to foster a supportive and understanding environment for individuals seeking help and support, and this needs to be reflected within the language used across all domains.

Mental health organisations and related professionals play a crucial role in driving these positive changes. They recognise the impact that language has on mental health care, and they actively continuously engage in efforts to update terminology and communication approaches. But we must all work to address outdated language that may inadvertently perpetuate stigmatising beliefs or reinforce negative stereotypes about mental health conditions.

By promoting person-centred language, mental health professionals and organisations aim to put the individual's experience and identity at the forefront, rather than focusing solely on their diagnosis or condition. This approach recognises the unique challenges and strengths that each person brings to their mental health journey, fostering an environment of respect and empowerment.

All organisations working with dogs and disabilities have a duty to contribute to this positive change. Organisations in the field of assistance dogs have the opportunity to be at the forefront of language advocacy. By reviewing and updating terminology to reflect current societal attitudes and the preferences of the individuals they serve, they can lead the way in reducing stigma and promoting a more inclusive approach to mental health recovery.

Through educational initiatives, we can also influence public perception and understanding of the vital role that assistance dogs play in mental health care. By using language that is accurate, sensitive, and free from stigmatising connotations, we can help shape a more compassionate and empathetic narrative around mental health and the valuable contribution of assistance dogs.

Veterans With Dogs: Leading by Example

For a number of years, Veterans With Dogs has been actively engaged in assisting various stakeholders, including policymakers, government-appointed bodies, veterans organisations, educational establishments, and service providers. Our efforts have focused on clarifying the scope and terminology of assistance dogs, particularly in relation to mental health.

We have been required to give clarity on the types and roles of assistance dogs, where clear and accurate terminology is essential for policymakers and service providers to make informed decisions regarding the inclusion and accommodation of assistance dogs in various settings.

The lack of standardised terminology has led to confusion amongst stakeholders, resulting in inconsistent policies and practices concerning the acceptance and access of assistance dogs. Our efforts have been to combat this confusion and promote a more coherent and consistent approach to assistance dog support.

Furthermore, accurate language also plays a crucial role in reducing the stigma surrounding mental health conditions and the use of assistance dogs. By promoting clear and respectful terminology, we have been able to contribute to more understanding and public access for individuals with mental health conditions. Our organisation's engagement with policymakers has also significantly influenced the development of policies that better support individuals with mental health conditions and their assistance dogs. By advocating for a clear understanding of assistance dogs, Veterans With Dogs has contributed to more inclusive policies that recognise the unique roles these animals play in mental health care.

By educating stakeholders, this knowledge benefits not only individuals but also service providers and the general public, leading to a more supportive and inclusive society that values and supports the mental health and well-being of individuals with disabilities.

A Future of Inclusivity and Understanding

Language is a powerful tool in shaping attitudes and perceptions towards mental health. The ongoing efforts of mental health organisations and professionals to adopt more inclusive and sensitive language in mental health care are commendable. By taking the lead in updating terminology and promoting respectful communication, assistance dog organisations have the opportunity to contribute significantly to reducing stigma and fostering a more supportive and accepting environment for individuals with mental health conditions and the assistance dogs that support them.

Initiating a discussion about the importance of language in mental health care, specifically regarding the terminology used to describe assistance dogs, is an essential step towards fostering inclusivity and understanding. By advocating for the use of more contemporary and inclusive terms, we can contribute to a more supportive and accepting environment for individuals with mental health conditions and their indispensable dogs.

Through collective efforts, we can raise awareness, promote education, and cultivate a society that values the significant contributions of these remarkable companions in mental health care.

References

1. Wahl, O. F. (1999). Telling is risky business: Mental health consumers confront stigma. Journal of Community Psychology, 27(3), 299-312.

2. Corrigan, P. W., River, L. P., Lundin, R. K., Penn, D. L., Uphoff-Wasowski, K., Campion, J., Mathisen, J., Goldstein, H., Bergman, M., & Kubiak, M. A. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27(2), 187195.

3. Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labelling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3), 400-423.

4. Nami, N. (2018). Reconsidering psychiatric language: Stigma and person-centred care. Journal of Humanistic Psychology, 58(1), 30-43.

5. Corrigan, P. W., Markowitz, F. E., Watson, A., Rowan, D., & Kubiak, M. A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44(2), 162-179.

Supporting Evidence for Terminology Shifts

1. Person-First Language Frameworks

NAMI Sonoma County emphasises avoiding labels like "psychiatric patient" in favour of "person with schizophrenia," aligning with Veterans With Dogs' push to move away from terms like "psychiatric service dog" 3.
Mental Health First Aid USA provides guidelines for non-stigmatising language, advocating for phrases like "person with a mental health condition" instead of "mentally ill" 4.

2. Impact of Language on Stigma

Corrigan et al. (2001) (cited in Veterans With Dogs) demonstrate how language influences public attitudes toward mental illness, supporting the need to retire terms like "psychiatric," which carry historical stigma 19.
Everymind highlights how phrases like "committed suicide" unintentionally reinforce blame, advocating for neutral alternatives like "died by suicide" 2

Organisational Advocacy & Policy Alignment

1. Standardising Terminology

Royal College of Psychiatrists developed an A–Z glossary of public mental health terms to ensure clarity and consistency, mirroring Veterans With Dogs' call for ADI/ADUK to lead terminology updates 8.
Centre for Practice Transformation defines person-centred language as critical for respecting individuality, directly supporting the article’s emphasis on terms like "mental health assistance dog" 5 13.

2. Institutional Collaboration

King’s College London stresses that anti-stigma campaigns must involve lived experiences to be effective, validating Veterans With Dogs’ engagement with policymakers and veterans 14.
RCSLT underscores the link between communication needs and mental health, advocating for speech therapists in mental health teams—a parallel to the article’s focus on interdisciplinary efforts 9.

Practical Outcomes of Inclusive Language

1. Reducing Social Barriers

Veterans With Dogs’ work in public education aligns with NAMI’s findings that inclusive language fosters community connections by challenging misconceptions 3 7.
PMC Research (2023) notes that growth-oriented language improves mental health outcomes, reinforcing the article’s argument for terms that emphasise resilience over diagnosis 21.

2. Policy and Legal Recognition

Equality Human Rights Commission clarifies protections under the Equality Act 2010 for assistance dogs, supporting the need for consistent terminology to ensure rights are upheld 15.

Key Organisational Resources

American Psychiatric Association: Actions to reduce stigma, including conscious language use 6.
Centre for Mental Health: Discusses how poverty-related language affects mental health policy, aligning with the article’s focus on systemic change 18.