There is nothing quite like the field of mental health for polarising views and extreme opinions. One topic in particular that seems to generate debate and controversy is in the words that are used to describe both psychological distress and the people who experience it. Should we refer to people who become debilitated by psychological distress as “patients”, “clients”, “service users”, “consumers”, or maybe just “people”? Similarly, should we refer to psychological distress as “mental illness”, “mental health disorder”, “craziness”, “being psycho”, “losing your mind”, or some other term?
A lot of people are feeling very strongly about the use of the word “mad” in the SBS show How ‘Mad’ Are You? in which I take part in an on-screen role as one of the expert panel. The fundamental purpose of this show is to tackle the stigma associated with severe psychological troubles. It’s a funny old world we live in when people can use “mental illness” as part of everyday conversation, and yet, become very annoyed at the use of the word “mad”.
Personally, I find the term “mental illness” to be derogatory and pejorative. It’s my least preferred term when discussing psychological suffering even though I do use it in defined contexts for specific purposes.
Other people find the term “mad” offensive. Despite this, there is a large global movement that has been on the march since 1993 called “Mad Pride”, to reclaim the word “mad”. You can read about it here. The movement was started in response to community prejudices towards people with a psychiatric history. Members include people who use, or have used, mental health services, and other people who are committed to the general ethos. Mad Pride activists are seeking to rescue terms such as “mad”, “nutter”, and “psycho” from misuse and to reclaim them as a boast.
Apart from this initiative, there are other examples. Robert Whitaker’s book, Mad In America, about the mistreatment of people with a mental illness in the US, spawned an organisation of the same name (www.madinamerica.com) which is a meeting place for anyone who is interested in improving our understanding and treatment of those people who seek help with psychological problems. These are the first two sentences of the Mad in America Mission Statement: “Mad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.”
In these contexts, as it is with the title of the SBS’s How ‘Mad’ Are You?, use of the term “mad” is not intended to belittle or demean. Quite the opposite – its use highlights just how fine the line is between those who have been diagnosed and those who never have. People experiencing psychological anguish might be terrified, conflicted, traumatised, and confused but they are not ill, or broken, or somehow inferior. We can all experience madness. For some people it’s fleeting and inconsequential; for others it’s enduring and life-changing. It’s time to stop the “them and us”. We are all trying to make sense of our experiences so that we can forge lives that are important and meaningful. When we can do more for each other that is experienced as helpful, and less that is experienced as obstructive, we will have genuinely begun to come to terms with what it means to be mad.
How ‘Mad’ Are You? airs over two weeks, starting Thursday 11 October at 8.30pm on SBS and SBS On Demand: