Labels can be helpful in beginning to describe or define what we are talking about. For example, when we label something as “a sports car,” that gives us all an idea, a mental image, of what we’re discussing. Without going into lots of detail, it conveniently distinguishes it from, say, a minivan.
However, labels can also cause difficulties. When some people hear the label “sports car,” they may think of a classic open-top Corvette. Others may think of a Ferrari Testarossa. Labels can cause miscommunication and misunderstanding because they deal with generalities, not details.
That’s why considerable controversy has arisen over the label “mental illness” and whether or when such a label should be used. There’s no doubt that “mental illness” has become one of the most overused diagnoses today. It now covers everything from schizophrenia to alcoholism and even pedophilia. It is frequently used to minimize responsibility and to blame all events and actions on factors beyond our control.
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This overuse, in turn, has led some to underuse the label. If people are misusing it to excuse sin or evade accountability, then it’s a term we must avoid, they argue. Others even deny there is any such thing as mental illness, attributing everything to people’s wrong choices. The term has also been abused, especially in the media and in movies, to portray people as crazed lunatics or even demonic. Little wonder that many people are scared of this label or hesitant to use it.
Given its difficulties and complications, we must ask if there is any benefit in retaining the term “mental illness,” and, if so, how do we use it helpfully? Let’s navigate our way through the pros and cons of this label so that we can use the right label in the right way. We’ll begin by building awareness of its limitations.
The Label Has Limits.
Part of the difficulty that leads to both overuse and underuse of this label is the ambiguity in both of the words, “mental” and “illness.”
For example, “mental” suggests it’s just something to do with our thoughts, and therefore something exclusively to do with our brains. It can be, but it’s often experienced primarily in the emotions (e.g., sadness, anger, fear) rather than in our thoughts. Also, “mental” tends to distance the problem from any spiritual or “heart” component and therefore diminishes or even excludes pastoral and spiritual input. It also fails to account for situational or social factors.
“Illness” is helpful in that it points to a physical or biological problem requiring medical help. The National Alliance on Mental Illness (NAMI) defines mental illnesses as, “medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning” and “often result in a diminished capacity for coping with the ordinary demands of life.”
It can be this, but, unlike many medical conditions, mental illness can rarely be identified with medical tests and is rarely cured with medical input alone. “Illness” implies that it’s something just like diabetes or epilepsy, a disease or disorder that always just happens to us, that we have no control over, and that therefore we are not responsible for. This tends to turn the sufferer into a passive victim rather than someone with some responsibilities.
The term “mental illness” is also excessively broad, just like the label “sports car.” It gives us a broad, general idea of what we’re talking about, but it fails to give us any details. It’s like saying someone has an “orthopedic problem” without specifying whether it is a broken toe or a broken neck. “Mental illness” can be incapacitating for years, and can even lead to suicide, or it can be something that people get treatment for while continuing to function at a very high level.
So, if the label has such serious limitations, should we use it at all?
The Label Can Be a Helpful Starting Point.
Despite its limitations, “mental illness” is still the preferred label in the medical profession and in popular culture. Although it creates difficulties, it does direct us to a general category that distinguishes it from other issues. Just as the term “orthopedic problem” distinguishes it from “kidney problem” or “heart problem,” so “mental illness” serves a similar function.
As such, it can be a helpful starting point, a way of orienting ourselves to what area we are talking about. For example, if friends suggest a trip to Europe this summer, you will have a general idea of what kind of vacation they are proposing. You will know which part of the map to look at (i.e., not Africa or Australia), but you will then want to get a lot more detail about which country, which parts of which country, what activities are planned, and so on.
Just as we would be foolish to agree to a trip to Europe without asking lots of questions about the details, so it is unwise to use the label “mental illness” without asking many more questions. But it’s still a useful start-point, if we remain aware of its limitations and go on to ask for more details.
While offering compassionate help to those who suffer due to having fallen bodies and brains, or because of factors outside of their control (see Job 1), or because of direct divine intervention (John 9:3), we must also carefully identify where people have brought some of their suffering upon themselves due to sinful personal choices, and adjust our language, counsel, and help accordingly.
Having weighed the pros and cons, we’ve reluctantly decided to retain the use of the label “mental illness.” But, when we use the term, we want to be clear that we are not minimizing the spiritual component or the sufferer’s responsibility, nor are we denying that the suffering is frequently more in the feelings than in the thoughts. Although we often use the word “sufferer” because we want to communicate sympathy, we are not doing so to deny the involvement of personal sin in some cases or the need for the person to take some responsibility. So, should we use this label in everyday life? Here’s one change we can make right away.
The Label Applies to a Problem, Not a Person.
Just as it is no longer acceptable to say, “She’s disabled,” but rather, “She has a disability,” so we should avoid saying, “he is mentally ill,” or “I am mentally ill.” Rather, we should say, “He has a mental illness,” or “I have a mental illness.”
This important switch applies the label to the problem, not the person, and therefore defines the problem the person has, rather than defining the person as a problem. The switch of verb from “is” to “has” ensures that a person is not defined in their entirety by their problem. A person is much more than an illness, and recovery is not advanced if we inadvertently imply otherwise. It doesn’t help the sufferer, and it doesn’t help us. A person is much more than their diagnosis, even if their suffering impacts their whole life.
Content adapted from A Christian’s Guide to Mental Illness by David Murry and Tom Karel. This article first appeared on Crossway.org; used with permission.
