Language, Stigma and Political Correctness: How We Talk about Mental illness

NAMI recently engaged in a dialogue with National Public Radio (NPR) over language, stigma and mental illness. It in turn led to discussion of what is meant by “political correctness.”

It started with NPR’s coverage of a pending Supreme Court case in which a man is appealing a conviction for falsely claiming to have received the Congressional Medal of Honor. In an interview with the man’s lawyer, NPR reporter Nina Totenberg asked whether his client, a habitual liar, was a “nutcase.”

NPR received many complaints. In consultation with NAMI, the NPR Ombudsman column on its website launched discussion  about language, stigma and mental illness.

NAMI pointed them to the U.S. Surgeon General’s Report on Mental Health, which frames stigma as a public health issue. We also acknowledged that assessing stigma can involve “balancing” several considerations. Particularly in entertainment media, NAMI’s “red flags” of stigma include:

• Overall context
• Inaccuracy
• Stereotypes
• Disparaging language
• Devaluation (trivialization) of mental illness as a concern
• Using mental illness as the butt of a joke
• People with mental illness portrayed only as an antagonist or villain
• Linkage of mental illness to violence
• Offensive or insensitive symbols (e.g., straitjackets)

In the case of the NPR interview, “nutcase” waved at least three red flags. First, the context: it was used to describe a person (Description of a legal argument as “nutty” for example would not have been as great a concern).” Second, the word is often used to describe people disparagingly—with at least a suggestion that they live with mental illness. Finally, the word has an almost cartoonish impact that tends to trivialize mental illness, devaluing it as a social concern.

One of the best strategies in fighting stigma is to turn protest into dialogue. Dialogue does not necessarily lead to agreement, but it does heighten awareness and potentially connect to broader social concerns.

That’s exactly what happened in this case.

One NPR listener complained: “I’m sick to death of political correctness rules … we use words like 'nutcase,' there's no reason to avoid them."

NPR’s Ombudsman replied: “Political correctness can surely get out of hand, but stop and think for a minute: It is highly likely that you or a family member or friend has at some point had some kind of mental illness.

“We often stigmatize it in ways that we no longer do with physical ailments, or race, or any of a number of human conditions. Calling someone a "nutcase" for something they can't help and others may share is out of bounds.”

The mention of “political correctness” led to a second discussion in the next NPR Ombudsman column.

And then a third.

One can empathize with people who sometimes feel that there’s too much “political correctness” today. But what does the phrase actually mean? Shouldn't we always try to do the right thing? Shouldn’t there be civic dialogue about language and attitudes? In many respects, invoking political correctness is only a way to duck an issue, rather than consider it.

What do you think? What do you consider most stigmatizing? Language, stereotypes, offensive symbols or something else?

Does the mental health community’s concern about stigma ever reach a point of too much political correctness?