5. Using language

Language is an indicator of the current social and political climate for people with disabilities. We heard that terminology can perpetuate inequality or promote acceptance and inclusion. ARCH Disability Law Centre (ARCH) told us, “beyond reflecting particular ideologies, language can transform how we conceptualize mental health.”

Terms describing people with mental health issues have evolved based on medical developments, people’s experiences with the psychiatric system, and the activism arising out of the anti-psychiatry ex-patients’ movement for civil rights.[19] The medical model assumes that mental health concerns reside within the person and may be overcome by medical experts assessing and attempting to “fix” the impairment leading to disability.[20] In our consultation, many people rejected being defined  by a medical condition or in relation to the psychiatric system, because it did not capture their experiences as whole individuals. Although many used medical language to describe their disabilities, some people saw medical labels as victimizing.

Some participants did not identify as having a disability or a psychiatric disability. This occurred in part because they did not experience barriers that negatively affected them; they did not identify with the label; they felt the description implied that they are chronically unwell, which removed a sense of hope; or they generally rejected the concept of “mental illness.”

I have a diagnosis but don’t consider myself disabled; the person next to me could have the same diagnosis and be disabled. At what point is it a disability? – Representative from Ontario Peer Development Initiative (OPDI)

During our 2009 consultation we were told that any terms used should:

• Reflect domestic and international human rights protections for people with disabilities
• Appeal to people who may or may not seek treatment
• Be the ones used by the consumer/survivor movement
• Reflect a social versus medical approach to disability
• Reflect health (instead of emphasizing impairment).

During our consultation, people identified themselves in many different ways. There is still debate on how best to describe people with mental health or addictions.[21] After consulting with disability groups, the Government of Canada recommended using the term “person with a mental health disability.” [22]

Internationally and in the academic literature, the term “psychosocial disability” has started to gain acceptance. The World Network of Users and Survivors of Psychiatry (WNUSP) has adopted this term as a move away from a model of individual pathology, noting:,

The psychological component refers to ways of thinking and processing our experiences and our perception of the world around us. The social/cultural component refers to societal and cultural limits for behaviour that interact with those psychological differences/madness as well as the stigma that the society attaches to labelling us as disabled.[23]

This term is consistent with a social or human rights approach to disability.

Taking these principles into account, we will refer to individual consultees with the terms they used to describe themselves. For identifying people as a group, we will use the terms “mental health disability,” “mental health issues,” “psychiatric disabilities” and “consumer/survivors.” We will also refer to “addictions,” “addiction disabilities,” “people with addictions,” and will use “psychosocial disabilities” to refer to both mental health issues and addictions.