Letter to the editor: Use the right word

November 10, 2017


To the editor:

I would like to ask our community not to use the term “behavioral health” when referring to mental illness because it suggests that we who live with mental illness are making bad decisions and behaving badly.

Judging us by our behavior ignores the fact that mental illnesses are like Parkinson’s or epilepsy which affect brain-mind function, producing symptoms that also affect behavior. Science does not understand the biology of mental illness, nor does it understand what causes many other mind-brain disorders that society accepts as “real illnesses.” Stigma and discrimination still exist when disabilities make people appear different, but in mental illness they are rampant. While “mental health” is accurate, “behavioral health” feeds the stigma that discourages recovery because health providers for mental illness are under-financed by a society that believes mental illnesses are not real illnesses but simply bad choices. Most suicides are by people with a mental illness, especially bipolar, clinical depression or schizophrenia. Symptoms like physical or mental pain, hopelessness, failures, lost jobs, fractured relationships, hallucinations, confusion, isolation and voices or delusions saying terrible things can lead to suicide. Why would, and how could, anyone choose such a life?

Living with mental illness is made more difficult by avoidance, rejection, judgment and criminalization. Talk and listen about mental illness. Open your eyes and read. Open your hearts and minds to end stigma. We need your acceptance and support now.


Ron Holzwarth 5 months, 2 weeks ago

Good luck trying to get the Veteran's Administration to change from the usage of the term "Behavioral Health" at 153 VA hospitals, 773 outpatient centers, and 260 Vet Centers all over the United States. By general usage, it's too late to change that terminology.

But, at the VA, it includes not only mental health.
From: https://www.pittsburgh.va.gov/services/behavioral-health.asp
(I just grabbed Pittsburg, there are many other VA websites)

Behavioral health services at VA hospitals include:

In-patient Psychiatric Unit
Homeless Veterans Services
Treatment for Addictive Disorders, including residential rehabilitation treatment programs

Treatment addresses the following:

depression, sadness, grief
anxiety, worry, nervousness
addictive behaviors
relationship problems
stress from medical problems and/or pain
post-traumatic stress disorder and combat related stress disorder
emotional problems, such as managing anger
vocational issues
troublesome thoughts or ideas
confused thinking
aggressive or self-harming behaviors
memory problems

Ron Holzwarth 5 months, 2 weeks ago

I do not mean to say that I have no sympathy for mentally ill people. You mentioned that we should talk about it. OK, I can do that.

I was in the Behavioral Health clinic at the VA in Topeka only a couple days ago. Never crossed my mind that there was anything wrong with using that term, after all, it's what people see that they think of as behavior. They can't read your mind.

It was stressful for me because I'm starting with a new psychiatrist, after being with the one before for over ten years. How many psychiatrists have I seen? I don't know, but a lot.

I'm bipolar, and I also have ADD. A couple friends sure noticed that when they tried to watch a movie with me a while ago. I can watch a movie for about an hour, then my mind wanders and I can't focus on it anymore. (You know who you are!)

My symptoms are rather well controlled with a tailored mix of medications, which I take regularly, and so I can live an almost normal life. Or I like to think so, anyway.

And, I've been in the psych ward five times, and I hope that won't happen anymore, but there are no guarantees in life.

But, at no time was I ever a danger to others.

P Allen Macfarlane 5 months, 2 weeks ago

We all have our challenges - some less and some more troubling than others. I truly wish you the best.

Kendall Simmons 5 months, 1 week ago

My point of view is please don't use the phrase "mentally ill people". I mean, if you break your leg, do you expect people to call you a broken-legged person? Of course not. So why would you emphasize the illness when it comes to a mental illness???

Ken Lassman 5 months, 2 weeks ago

Where does mental end and behavior begin? I think that most if not all behavior based therapies and approaches no longer look at purely empirical behavior as the sole criteria for judging the psychological health of an individual; rather they also incorporate the biological and environmental underpinnings that support that behavior. In a similar manner, biological approaches to mental illness are almost always supplemented with behavioral and counseling strategies to inculcate a healthy sense of responsibility for one's own actions or behavior. Neither of the terms "behavioral health" nor "mental illness" does an adequate job of covering the increasing depth of understanding of the biological, environmental/trauma, social and behavioral mix that manifests itself in individual struggles with their surrounding social and cultural environment.

So yep, "behavioral health" is a potentially misunderstood, broken construct, but "mental illness" doesn't fix it, at least in my mind (or would that be my behavior???).

Harold Maio 5 months, 2 weeks ago

"Behavioral Health" when applied to mental illnesses is a return to the "pick yourself up by you own bootstraps" mantra!

It seems we make a few steps forward (never a sufficient number) in addressing mental health issues, and then a few steps backward, returning to old bad habits.

Calvin Anders 5 months, 1 week ago

It seems like the use of the term "behavioral health" is more a product of the clinical approach to diagnosis and treatment. I believe that in the United States especially, mental health professionals diagnose and treat mental illness almost exclusively at the behavioral level. They seek primarily to achieve an outcome of behavior which will be judged acceptable. And while that is certainly an important component to existence with society, focus on this as a primary goal makes treatment more about achieving outcomes for those around a mentally ill person than for the patient. I think the point in the letter is a valid one, but I think the problem with the use of this term is more a systemic problem within the mental health industry than it is a social issue. Nonetheless a good distinction to keep in mind.

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