Describing people with physical and mental conditions
This is an extract from the longer post ‘Am I allowed to say that? A no-nonsense guide to political correctness’.
People with a physical or mental condition
Describing people who have certain physical and mental conditions can be very tricky indeed. But there are two golden rules that will help you no end.
- Firstly, don’t mention a person’s physical or mental condition unless it’s relevant to what you are writing or speaking about.
- Secondly, if you are talking about an individual, don’t hesitate to ask them how they would prefer to be described. If they cannot speak for themselves, ask their parent, personal assistant, carer or the person closest to them. Don’t be shy about doing this. It shows respect for their feelings and preferences, and they will prefer being asked to later reading a description that they will interpret as patronising, insulting or inaccurate.
Here are a few more guidelines:
Avoid using general phrases to lump people together as a homogenous group defined solely by a particular condition. For example, terms such as ‘the deaf’, ‘the blind’, and ‘the disabled’ should be avoided. Anyone with a particular condition should not be defined as that condition. Never write, for example:
He’s an epileptic.
No he isn’t. He has epilepsy. Read more on this, including the views of the charity, Epilepsy Action.
Avoid phrases such as ‘victim of’, ‘suffering from’, or ‘afflicted with’.
Avoid calling disabled people ‘brave’ or ‘special’ – unless you would have described them in this way if they had not been disabled.
Being described as ‘brave’ or ‘special’ because you use a wheelchair, or are deaf or blind, is astonishingly patronising as well as a lazy cliché.
Be aware that ‘carer’ can be a tricky word – the term ‘personal assistant’ or ‘enabler’ is often now preferred. Also, some people object strongly to this label (and that of ‘enabler’ or ‘personal assistant’) when they are first a parent, husband, wife, friend, sister, brother, son or daughter.
Don’t describe people who use a wheelchair as ‘wheelchair-bound’ or ‘in a wheelchair’. Prefer ‘wheelchair user’, or use phrases such as ‘he uses a wheelchair’.
It is true that some disabled people don’t mind how they are described, and have no objection to words such as ‘handicapped’, for example. However, some disabled people object very strongly to such terms, and it’s advisable to avoid them completely.
See this excellent must-read discussion about various terms used to describe disabled people.
A while back, a columnist in the Sunday Mirror referred to a child with Hunter Syndrome as ‘handicapped’ and also used the phrase ‘handicapped kids’. I’d argue that it’s best not to follow such examples.
I used to think that ‘people with disabilities’ was a better phrase than ‘disabled people’ because it puts people first. However, I’ve since learnt that ‘disabled people’ is usually preferable, as disabled people can feel they are ‘disabled’ by an unsuitable physical environment and the negative attitude of society which holds them back, rather than their own physical condition. (This is to do with a concept referred to as the ‘social model of disability’.)
Don’t get too bogged down in all of this. All you need to know is that the phrase ‘disabled people’ is fine and should not cause offence. However, do note that there will always be disagreement about this issue (see the discussion relating to this under ‘Describing people with physical and mental conditions’). This underlines my advice above – to ask the person concerned how they would like to be described (if a description is needed at all).
Never use the word ‘invalid’ as this can suggests that someone is in-valid or without worth. It almost goes without saying that words such as ‘cripple’ – and others I won’t insult your intelligence by listing – should never be used.
It can be problematic to refer to someone who is not a wheelchair user as ‘able-bodied’. If you need to differentiate in this way, the term ‘non-disabled’ may be a better choice. This is because ‘able-bodied’ may imply that someone who uses a wheelchair is not able.
Deaf and not so dumb
Unbelievably, the phrase ‘deaf and dumb’ still appears in newspapers and magazines, and is still used by broadcasters. It makes me cringe every time I see or hear it. The phrase is both insulting and inaccurate. The terms ‘stone deaf’, ‘deaf-mute’ and ‘mute’ are also best consigned to the dustbin.
If a deaf or hearing impaired person does not speak, be aware that they may be a sign language user (not ‘deaf and dumb’, or a ‘deaf mute’).
As a slight complication, the word ‘deaf’ should sometimes take an upper-case ‘D’. You should write ‘Deaf’ when referring to the Deaf Community, or members of the Deaf Community. Members of the Deaf Community in the UK usually have British Sign Language (BSL) as their first language, or have adopted it as their main language. They share a culture and heritage, and BSL is at the heart of their community. In comparison, deaf people (with a lower-case ‘d’) live more in the ‘hearing world’, and depend far more on lip-reading. Again, do not be afraid to ask respectfully how someone would prefer to be described (if it’s necessary to refer to their deafness at all).
Don’t automatically assume that people who are deaf, hearing impaired or members of the Deaf Community can be described as ‘disabled’. People who are deaf or hearing impaired can deeply resent this description. I shall never forget the deaf teacher who demanded of her (hearing) sign language pupils: ‘Would you describe me as disabled?’. Be aware that this attitude may be shared by others with physical conditions which are commonly described as a ‘disability’.
This same woman was deeply angry about a lot of newspaper coverage of deaf or hearing impaired people. One story in particular, which described the ‘miraculous’ way in which a deaf woman was able to care for her new baby, struck her as being particularly ludicrous and patronising (she was herself a mother).
As a side issue, do bear in mind that British Sign Language is not a form of pidgin English (a patronising and insulting assumption that many people seem to make). It is an independent language, as sophisticated as spoken English, and with its own grammatical rules. NEVER refer to British Sign Language as ‘deaf and dumb language’.
Remember the golden rule – if in doubt about how to describe someone, ask them.
Phrases such as ‘blind people’, people who are blind’ ‘partially sighted’ ‘sight impaired’ and ‘people with a visual impairment’ are all acceptable.
When referring to blind and visually impaired people generally, prefer the term ‘visually impaired’ as not everyone with a visual impairment is completely blind.
Learning disability? Or learning difficulty?
I was told off by a very kind but very po-faced council employee that my use of the term ‘learning disability’ was no longer acceptable. ‘Learning difficulty’ was the phrase du jour and I should start to use it forthwith. The very next day I was listening to a radio phone-in. A mother rang in to say how deeply angry she was that officials in various professions had started to refer to her son as having ‘learning difficulties’. He had, she asserted, a learning disability; there were many things he would never learn to do, and many obstacles he would never overcome. Things were not ‘difficult’ for him: they were impossible.
‘Mentally handicapped’ is now an outdated term and in many quarters no longer acceptable. You will still see and hear it used, but that doesn’t necessarily make it OK. In 2006, I heard a BBC World Service newsreader refer to ‘mentally handicapped children’ and on the same day a radio play synopsis in the Radio Times described one of the characters as ‘mentally handicapped’. In both these cases, ‘learning difficulty’ or ‘learning disability’ would have been preferable.
Nonetheless, it’s very important to note that some people believe the terms ‘mentally handicapped’ and ‘severely mentally handicapped’ are not only acceptable, but actually preferable to other phrases such as ‘learning disability’. This debate was aired a while back in the Independent newspaper when columnist Dominic Lawson defended his right to refer to his daughter, who has Down’s syndrome, as ‘mentally handicapped’. He argued persuasively against ‘fashionable catch-all phrases such as “having learning disabilities”’ and posited that such language has the pernicious knock-on effect of denying the reality of some people’s lives. Some people believe this has led to a reduction in financial and social support for those who are severely affected by a mental and/or physical disability.
Nevertheless, I would argue that the term for someone with Down’s syndrome is just that. Upper-case ‘D’ lower-case ‘s’. Obviously, terms such as ‘mongol’ and ‘mongoloid’ should never be used. Don’t use phrases such as ‘Down’s baby’, prefer ‘a baby who has Down’s syndrome’. ‘Down syndrome’ is also used in the US.
Remember the golden rule – if in doubt about how to describe someone, ask the person concerned, or if this is impossible, those closest to them. And remember to always ask yourself if it’s necessary to mention the person’s condition at all.
If someone insists that they or someone they care for should be referred to as ‘mentally handicapped’, make this clear in your text. For example: ‘Mr Brown, who describes himself as mentally handicapped’.
By doing this, you are showing your respect for the wishes of the person concerned, as well as your awareness of and respect for the views of those readers who object strongly to such terms.
Mental health issues: Bonkers Bruno locked up
This 2003 Sun newspaper headline about the boxer Frank Bruno’s hospitalisation was changed in later editions following an outcry from mental health organisations and the public.
But words that convey a negative image of mental illness and distress still saturate our media and everyday language.
Don’t confuse mental health issues with learning difficulty/disability issues.
As a general rule, put the person first when writing. For example: ‘Michael has a mental illness’, ‘Anne has a mental health problem’, ‘They have mental health difficulties’, ‘George has experienced mental/emotional distress’. Avoid phrases such as ‘Mary is mentally ill’, or ‘Paul suffers from a mental illness’.
Avoid using any clinical terms for particular mental health conditions (especially those frequently bandied about such as ‘psychopathic’ and ‘psychotic’) unless you are absolutely sure you are using the correct one. A while back, the Sunday Mirror columnist mentioned above referred to a murderer as a ‘psychotic piece of scum’, a ‘freak’, the ‘devil’s child’ and ‘filth’. It’s that casual, non-clinical use of the word ‘psychotic’ there that bothers me. People diagnosed as psychotic should not be associated in this inaccurate and highly damaging way with a murderer who is also described as a ‘freak’, ‘filth’ and the ‘devil’s child’ (and may or may not have been diagnosed as psychotic).
Don’t use the word ‘schizophrenic’ to describe anyone or anything unless you are writing about someone who has the specific and diagnosed condition of schizophrenia. Casual references to ‘schizophrenic’ opinions, attitudes or behaviour should be avoided. This is because the word is frequently and inaccurately used to describe a type of ‘Jekyll and Hyde’ behaviour, and perpetuates a negative and fear-inducing image of people who live with this condition.
Never say someone is in a ‘mental home’: they are in hospital.
I would far rather be called a nutter…
There is no denying that the use of language in relation to people with mental health problems is very tricky indeed. Just look at this range of opinions published a while back on the charity Rethink’s website:
‘I would far rather be called a nutter, crazy, or a mentalist than a service user. It’s an absolutely ridiculous term, alongside ‘client’ which indicates some sort of business relationship…’
‘I actually went to see some mental health worker and when I said to her: “And then I went mad,” she actually told me off. I accept the fact that I am mad.’
‘Words are only words, we attach too much meaning to them. I refer to myself as mental, mad, crazy, loony – I don’t take offence at these words, they are only words. I’ve removed the power of such words in my life.’
‘I do not give a damn whether I am called a client/patient/service user or whatever. What matters to me … is that I receive the help I need when I need it…’
‘We have all heard the cry: “I do not care what I am called it is how I am treated that matters.” Well I do care, and I care very much because how and what I am called has at least as much to do with how I am treated…’
All we can do when writing is be aware of this range of opinion, and do our best to ensure our prose is accurate and respectful, and does not fuel negative assumptions and attitudes to mental illness.
Update: February 2013
Rachel Whitehead, press officer at the charity Rethink Mental Illness, argues in The Independent that:
The language used in the media around this (taking medication for mental health problems) is very telling. There is a clear dividing line between those who simply ‘take’ medication, such as people with diabetes, and those who are ‘hooked’ on it – people with mental health problems. Antidepressants in particular are often written about in the context of someone trying desperately to ‘give them up’ as if they’re some kind of bad habit. Read the full article.
According to the National Health Service here in the UK, autism is defined as a serious and lifelong developmental disability. On its own, autism is not a learning disability or a mental health problem.
People with autism usually have difficulties with:
- social communication
- social interaction
- social imagination
However, some people with autism have an accompanying learning disability, learning difficulty or mental health problem.
Autism update: December 2012
Latest from the Diagnostic and Statistical Manual (DSM) of Mental Disorders, the American publication that is one of the most influential references for the profession around the world:
The term ‘Asperger’s disorder‘ will not appear in the DSM-5, the latest revision of the manual, and instead its symptoms will come under the newly added ‘autism spectrum disorder’, which is already used widely. That umbrella diagnosis will include children with severe autism, who often do not talk or interact, as well as those with milder forms.
Read more on this update in the Guardian.
From John Rentoul in The Independent’s Errors and Omissions column:
On Monday, in a report about possible explanations for the inexplicable, namely Adam Lanza’s murder of 26 people in Connecticut, we said: “His brother, Ryan, reportedly told police he thought his brother had a personality disorder, possibly Asperger’s, a form of autism.” Asperger’s syndrome is indeed a mild form of autism. It gives people difficulties with social interaction and can make them come across as odd. But it is not a personality disorder, and it is not associated with violence. We should avoid relaying, without clarification, erroneous speculation of that kind.
Are you looking for an easy-to-understand guide to punctuation, grammar and writing well?
– easy-to-understand explanations of many aspects of grammar and punctuation that commonly cause confusion;
– clear instructions on the correct use of possessive apostrophes, commas, speech marks, hyphens, and semicolons;
– definitions of commonly used foreign words and phrases;
– clear explanations of word classes, including nouns, adjectives and verbs; and
– a brief guide go politically correct writing.