As part of Mental Health Awareness Week, Communications Officer, Lauren Redpath, reflects on the importance of language in how we approach the topic of mental health – and explains what Healthcare Improvement Scotland is doing to deliver improvements to mental health care services.

“Sticks and stones may break my bones but names will never hurt me.” 

When I was little, I used to chant this saying in the playground when other kids would poke fun at my curly hair.  I remember one of my primary school teachers proudly teaching us the saying as if she believed she was providing us with a fool-proof coping mechanism against name-calling.  It wasn’t until I got a bit older – and perhaps less resilient – that it dawned on me that names and labels do hurt and they have an unwelcome way of sticking too.

Bill Clinton once said: “Mental illness is nothing to be ashamed of, but stigma and bias shame us all.” This quote resonates with me on so many levels, but it’s a stark reminder that although we have made significant progress in reducing the stigma surrounding mental health and mental ill-health, we still have a very long way to go in ensuring it has no place in our society.  Mental health stigma has existed for decades and the hurtful, inaccurate labels often given to people living with mental health issues are still swirling around – they’ve found a way of sticking.

Progress – but still a way to go

Over the past 10 years, mental health has become less of a taboo subject – we’ve seen more stories in the media and heard more conversations about mental health than ever before.  Governments are also making it a priority.  Mental health is a key theme in our organisation’s work and we have a broad portfolio of mental health redesign and improvement programmes, plus clinical guidelines to support diagnosis and care.  For example, Early Intervention in Psychosis (EIP) is highlighted as a priority in the Scottish Government’s Mental Health Strategy (2017-2027) and Mental Health Transition and Recovery Plan (2020).  As a result, they commissioned us to undertake a detailed exploration of current EIP services across Scotland, the findings of which were published in March.  Engaging with people with lived experience of psychosis was a key part of this work, with the findings highlighting that stigma prevents people from seeking help early.  Stigma doesn’t only present itself as hurtful labels, it’s also a barrier to people seeking help when they need it most.    

According to research carried out by See Me in 2019, 79% of people in Scotland think that public perception of mental health problems has improved over the past 10 years.  However, 56% of people with a mental health condition have experienced stigma and discrimination and only 55% of us would feel confident challenging mental health stigma if we saw it.  Being a glass half-full kind of girl, I like to think the other 45% perhaps don’t feel confident in challenging mental health stigma because they don’t know what it looks like – and not because they’re willing to turn a blind eye as it’s not their problem.

The view from Down Under

Before joining Healthcare Improvement Scotland at the start of 2021, I lived and worked in Melbourne for six years – making the most of that big, round, yellow hot thing in the sky that us Scots only get to experience for one week of the year – if we’re lucky.  Ok, ok, maybe that’s a glass half-empty statement but I’m sure you wouldn’t disagree.

I worked for an organisation called SANE Australia – a national mental health charity providing support and advocacy for Australians affected by complex mental health issues such as schizophrenia, bipolar, eating disorders, OCD, complex PTSD and trauma.  I managed their StigmaWatch programme which promotes responsible reporting of mental ill-health and suicide in the Australian media.  The programme team monitors and responds to reports of inaccurate or inappropriate stigmatising media portrayal of mental ill-health and suicide.  They also work with the media to provide constructive feedback and advice on how to responsibly report stories touching on these issues.

Mind your language

Studying journalism at university and choosing a career in communications, it’s no surprise that language and how we communicate with each other fascinates me.  Add to that my passion for raising awareness of mental health and breaking down the stereotypes and myths associated with it, working on the StigmaWatch programme couldn’t have been a better fit.

I’m hoping I can now use what I learned in Australia to help our vital communications work around mental health in Healthcare Improvement Scotland.  I’m passionate about educating and supporting people and organisations on how to talk about mental health safely and responsibly.  The language we use when talking about mental ill-health often plays a big role in keeping stereotypes, myths and stigma alive.  But what does stigmatising language look like when talking about mental ill-health? Well, terms you might hear every day such as ‘nutter’, ‘crazy’ ‘lunatic’, ‘psycho’, ‘schizo’ and ‘mental patient’ are not only offensive and hurtful, they’re problematic and sensationalise mental ill-health.  The preferred language would be a person is ‘living with’ or ‘has a diagnosis of’ a mental illness.  It is also stigmatising to label a person by their mental illness.  We shouldn’t refer to someone as a ‘schizophrenic’ – instead we should say, ‘a person has a diagnosis of’ or ‘is living with schizophrenia.’  Think about it this way – we wouldn’t label someone by the type of cancer they have so why should it be any different when someone is living with mental ill-health?

A weapon that keeps people apart

During my time at SANE Australia, I worked closely with many of our peer ambassadors who had lived experience of mental ill-health.  While filming a promotional video to explain what StigmaWatch is and does, we asked one of them to tell their story.  He turned to look in to the camera and said:

“Stigma is a permanent part of my life.  After my diagnosis, many people just left.  The negativity just came from decades of misunderstanding – in the media, in medicine.  People were afraid.  When I was given my diagnosis, it was stigma that told me that I was never going to have a home, I was never going to have a job, I was never going to have a family and I was never going to have a life.  It took me 15 years to realise that that is all completely wrong.

“Stigma is a weapon that keeps people apart.” I think if I’d asked him about the sticks and stones saying from my childhood, he would simply have said “the sticks and stones and words just never stop coming – or hurting.”

Lauren Redpath is a Communications Officer for Healthcare Improvement Scotland.  In her spare time she sits on the Advisory Group for See Me, Scotland’s programme for tackling mental health stigma and discrimination.

More information

Find out more about our mental health improvement portfolio

For anyone looking for support in a crisis, the Samaritans helpline is 0116 123 and is open 24 hours, 7 days a week.

Rethink Mental Illness offers support and advice for people living with mental illness. 
Phone 0300 5000 927 (Monday – Friday, 9.30am to 4pm)