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We are still way behind in our attitudes to mental health

Dr David Turner

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While teaching mental health to undergraduates recently it struck me how stuck in the past our attitudes are. Take the phrase ‘committed suicide’. Suicide has not been illegal since 1961 so why do people still talk about it this way?

On the one hand we use language to describe a desperate person’s attempt to kill themselves as if it were a crime. Yet, paradoxically, on the other, we do not treat their attempt on their life seriously enough.

The medical profession, to be fair, are not the worst offenders by far and you would not expect to find the phrase ‘committed suicide’ in a contemporary medical publication, but it is not uncommon to hear this outdated expression bandied about in the lay media.

I teach my students that suicidal ideas are to psychiatry what chest pain is to general medicine, yet despite there being several thousand deaths by suicide in the UK every year, suicidal thoughts are very often not treated as the psychiatric emergency they are.

It is up to us, the medical profession, to take the lead in destigmatising mental illness

There is no government funding to set up dedicated rapid access suicide assessment units. Nobody is suggesting post-suicide attempt rehab units would be a good idea.

I find it hard to reconcile the extreme levels of political correctness we have adopted in some areas of medicine with how far behind the times we are in mental health. For example, I was once at a meeting where we were told not to us the phrase ‘brain storming’ for fear of offending sufferers of epilepsy.

The truth is psychiatric problems are not ‘sexy’; nobody wants to talk about mental illness or suicide. Despite the work of charities and various celebrities to destigmatise and increase awareness of mental illness, psychiatry remains the Cinderella speciality.

The general public are not going to change their views about mental illness of their own volition, so it is up to us, the medical profession to take the lead in starting the very slow process of destigmatising what is a very common and serious cause of mortality and morbidity in our society.

Changes need to start small and I would suggest that along with completely abolishing the phrase ‘committed suicide’, we also make use of terms like ‘nutter’ and ‘bonkers’ unacceptable.

At times of course, this may require a lot of self-control, particularly when NHS England launches a new initiative or Jeremy Hunt opens his mouth.

Dr David Turner is a GP in north London

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Readers' comments (5)

  • Most stigmatized of all are doctors with mental illness. I know GPs who have been severely depressed and suicidal, yet their partners describe them as skiving or inadequate, even subjecting them to a practice meeting where their mental health was assessed, like a nightmarish occupational health appointment. Start with our own stigma about our own mental health: self-care and self-compassion to begin with. GPs are emotionally drained and exhausted, so how can they deliver mental health support to their patients?

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  • I suggest the word "psychotic" needs to be replace, as too many people confuse it with "psychopathic"...

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  • Dylan, so instead of educating the ignorant, you suggest word-policing those of us who know the difference?

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  • AlanAlmond

    I don’t think you change things by making particular phrases ‘off limits’ ..you just confuse people. What is the current PC way of saying someone died as a result of an episode of self harm? What does it really matter? Does using the right phrase indicate I understand the underlying issues? No it doesn’t. Words exist to convey meaning and ideas. It’s the underlying meaning and ideas that need to be addressed, not the superficial words people use. That means education, so people understand what mental health issues are. When you teach students not to say ‘committed suicide’ the beneficial part is your explanation why, the words themselves are a side issue.

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  • @Ho

    Easier to change a word in DSM4, ICD10 etc than to stop all thriller writers / reviewers / publicists everywhere referring to a "psychotic serial killer" etc etc...

    And this particuar issue isn't about the stigma attaching to a diagnosis psychosis (which no doubt is a problem but which would be unchanged by changing the name), its about two very similar words being continually confused.

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