By Colby Itkowitz
February 19, 2016
When Donald Trump disparaged Mexican immigrants, women, prisoners of war, Muslims, and briefly even Pope Francis, his comments were roundly dissected and critiqued. While many would argue he ultimately “got away” with them, there were plenty of expressions of outrage.
But when Trump attacks people using demeaning slang long associated with mental health, there is no similar outcry.
He has called Jeb Bush a “basket case,” Bernie Sanders a “wacko,” Lindsay Graham a “nut job” and Ted Cruz “nuts” and “unstable” and has repeatedly referred to Ben Carson’s “pathological disease.”
And on the subject of gun violence, he often conflates mental illness with crime. He said in October 2015 that gun-free zones are “target practice for the sickos and for the mentally ill.”
That statement received some minor backlash. The Atlantic wrote that he had offended the 61.5 million Americans who in a year will experience some kind of mental illness. A few other media outlets fact-checked his accuracy: No, Mr. Trump, most people with mental illness are not murderers.
But the problem with Trump’s comments, and the carelessness with which he denigrates adversaries, highlights a larger societal issue. Such language is so pervasive in our culture that many people don’t register it as offensive. Few think twice about throwing around words like “crazy” and “insane” to describe an individual’s out-of-the-ordinary behavior or mental state.
Telling a friend they are acting crazy or saying you feel like you’re losing your mind or describing your coworker as manic is ingrained in our vernacular. It’s used casually, flippantly, but the denotation is always negative.
And so it perpetuates the social stigma that people with mental illness are inferior.
“This is the legacy of mental illness,” said Gail Saltz, a psychiatrist in New York City. “When we knew nothing about brain wiring and causes of mental illness and we believed it was a moral weakness rather than an illness and it was scary to people to see more extreme cases of it – that is where those words come from. Those words still hold that meaning. It is a way of deprecating your behavior, it’s a way of dismissing you.”
It’s been 17 years since the surgeon general’s office issued its first and only comprehensive report on mental health. It highlighted stigmatization as a public health issue that can “deter the public from seeking, and wanting to pay for, care.” It is estimated that two-thirds of Americans with a mental illness do not seek treatment, according to the National Association on Mental Illness.
While women or racial groups might rise up in solidarity, trying to empower themselves against prejudice, people with mental illness will often internalize the negativity, and that may make them less likely to “come out,” said Patrick Corrigan, a psychology professor at the Illinois Institute of Technology whose research focuses on overcoming mental health stigma.
“This is not petty or trivial,” Corrigan said of the stigma issue. Trump “is not a cause of it — he’s just another representation of it.”
In 2007, a Centers for Disease Control study found only 24.6 percent of people with mental health symptoms “believed that people are caring and sympathetic to persons with mental illness.”
New York songwriter Rachel Griffin, who is open about her own depression and anxiety and started a social media campaign to encourage people with mental health issues to tweet #imnotashamed, said the type of language used by Trump adds to the “shame.”
“It shows a lack of knowledge about mental health, and that is what we should be frightened of,” she said.
NAMI urges communities to talk about mental illness with the same sensitivity they would use to discuss cultural diversity, religious beliefs, physical disabilities or sexual orientation.
“A person diagnosed with mental illness absorbs that disparagement themselves,” said Bob Carolla, spokesman for the association. “It’s a loss of self-esteem, self-devaluation, and creates a barrier to recovery. People in general come to recognize and feel the stigma that exists, and if they think they might need help, they don’t seek help because they don’t want to be isolated or rejected.”
Weeding out these words will be viewed by some as another example of political correctness overreach. And ceasing use of certain common words is not going to end long-held stigmas.
But mental health experts say language choice matters. That few flinch when those words are used as insults is indicative of how discrimination persists.
“Stigmatizing words, stereotypes and portrayals end up helping to shape society’s attitudes,” Carolla said. “You can’t say it’s harmless, because it isn’t.”