Language has always been important in mental health. So much so, it can be difficult to avoid tripping over yourself. We all have opinions about how we might prefer to be described or discussed and when it comes to the notion of distinguishing one supposed cohort of people from another, a distinction around mental health is especially fraught. In my twenty-plus years working on this, I’ve known objections to various terms many would consider unavoidable, even if not benign – and I’m already knee deep the quagmire having used the term ‘mental health’ in the opening sentence. What we’re talking about here is not ‘health’, is it – it’s illness or poor-health, but then the comeback to that is some people with ongoing medical issues might say they’re having “problems with my health”. But I’ve done it again: some patients have objected to the term ‘illness’ when it comes to mental health. People sometimes categorise themselves as living with trauma after horrendous lived-experience rather than suffering diagnosable illness. And I’ve done it again, because some people don’t see themselves as ‘patients’ at all.
It depends which books you read and which social media accounts you follow or who you talk to.
Throughout writing this blog, I’ve attempted to navigate my way through this without igniting the debates and one way I found to do this is not ‘other’ people by making too much of the distinction. As we often see, all of us are trying to maintain or maximise or mental health and well-being, some of us have struggles of various kinds in that respect and whether that is down to the stresses and anxieties of ordinary life or whether it has become a clinically significant disorder or illness requiring treatment, often doesn’t matter too much for the points I’m trying to land in a blog. So I’ve often ended up referring to “those of us affected by our mental health” or “those of us who are sectioned under the Mental Health Act”, etc..
Those of us – because whoever we’re trying to define or discuss by the making of any distinction, they are still one of us.
DISTRESS
Some years back, I understood a training course at work which was dominated by alphabet to aid fast-communication in a fast-paced domain of policing. I qualified as a firearms commander because I was due to spend several years making decisions about which 999 calls justified an armed response and which did not. As part of that world of alphabet and three-letter acronyms was the example “EMD”. I’d seen this written in the pre-read materials for the course and I knew it related to a (broadly-defined) category of people who may be affected mentally or cognitively, for a range of reasons. I had assumed the ‘D’ may mean ‘disordered’, not least because the term ‘mental disorder’ is the legal term from s1(1) of the Mental Health Act 1983. In law, you are not ‘mentally ill’ or ‘mentally unwell’, but ‘mentally disordered’ and that instantly invites the kind of linguistic objections referred to above. It involves ‘othering’ and is pejorative, whilst simultaneously not always being an accurate reflection of a situation to which the MHA is being applied.
Imagine my relief to find out ‘D’ meant ‘distressed’ — emotionally or mentally distressed.
The more I thought about that word being used in that way, the more I was happy with it. It does get around many of the objections, above and is simply, a much more descriptive term, not taking any inherent position on a number of complicated legal factors or medical classifications that can’t always be known and aren’t always relevant to the police anyway. By contrast, have you tried, for example, understanding the medical difference between a ‘disease’, a ‘disorder’ or a ‘syndrome’? – it doesn’t usually matter to the police or the people they are aiming to help in that moment how those distinctions are drawn and I stopped caring because of that fact. I’ve used the term ‘distress’ for a long while now because people can be in mental or emotional distress for a range of reasons and in a range of ways.
EMD is a term which would be applied to a number of temporary cognitive states (eg, arising from drugs or alcohol), as well as to cognitive functioning affected by illness or injury (eg, head injury as well as mental illness, etc.). We see the term ‘distress’ used in a similar way in the Police Race Action plan, which again beautifully dodges the somewhat tangential questions that don’t need to immediately consume police officer responding to incidents and thinking through how to do so objectively and fairly.
Those of us … mental distress. Just my view.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2023
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 