My “Mental Health” Problems

Normally I write about important issues i feel passionate about. This time I’m writing about something that in the greater scheme of things is absolutely meaningless, but seems to annoy me intensely. If you’ve followed me on twitter (@keirwales), you’ll have seen me banging on about people saying “Mental Health”, when what they mean is “the absence of mental health”. When people are using words to mean the opposite of what they are supposed to, it’s interesting to think about why. It’s also interesting to think about why it annoys me so much. I know I love words, and I know I use them a lot. Normally a bit of experimentation with the language doesn’t bother me too much but every time I hear someone refer to mental illness as mental health, it’s like my brain is being scoured by a scrubbing brush.
I first heard the use of the term about 4 years ago. I was working with someone in a community mental health team (CMHT) and they would regularly tell me how they had mental health, their family didn’t understand mental health and the bizarre things that happened at night which meant the police came round were again, because of mental health. I managed to let this go and think little of it, but since then I keep hearing people saying the same thing. I hear them not just in the clinics and the waiting rooms, but also on Radio 4 who I see as guardians of the English language.
Let s have a look at what Health means –

“the state of being free from illness or injury”

This is what comes up first. Here we see that health is a positive term. Specifically, it implies the absence of illness. Therefore health is the top of the ladder and things can only go down from there. “Aha!“ you may argue “But health is a spectrum. We all have health to some degree”. Well possibly, but I don’t think anyone* ever uses the word health to imply anything other than robust and hearty vigor. You might ask someone “How is your health?” but by this you tend to mean “Have you been ill?”. Lets have a look at some examples:
Most recently Theresa May was on Radio 4 talking about “the injustice and stigma associated with mental health.” Now this is obviously a ludicrous statement as people with health don’t face any injustice or stigma at all. Those with mental illness, mental disorder or mental health problems face bucket loads of both and its in this direction Mrs May needs to be looking.  Which she is.  She just said the opposite of what she meant.
Its not just prime ministers who make this mistake. Prince Harry said in January “In the past, the phrase ‘mental health’ would be translated as mental illness”. Obviously not in the dim and distant past because 6 months later in July he said “Anyone can suffer from mental health”. Again, this is just bobbins. No one suffers from health. People suffer from the absence of health.
As a third and final example lets call in the police. In August last year when a man was running around London stabbing people with a knife the police announced that “Mental health was a significant factor”. What would he have done if he didn’t have such health? Once more what they meant was “The absence of mental health was a factor”.

While all the above is a bit silly, (terrorism aside) it is interesting that Mental Health, despite Harry’s best efforts, is being used to imply illness. What is it about the word ‘mental’ that has this power? Health is associated with athletes and fitness gurus, but Mental Health is a reason to assault people. Health is something you can rest assured you have – “At least I’ve got my health” – but mental health is something to be suffered. People with health can lead active fulfilling lives while those with mental health suffer stigma and injustice. We need to stop using the words mental health when we mean the opposite.
One of the reasons I think this is important is that there’s a load of people bobbing around talking about how ‘we all have mental health’. We really don’t. The guy locked on the ward crying as he’s tortured by his paranoia does not have mental health at all. While I applaud people like Harry and Dr Llan Ben-Zion for their efforts to get mental illness and mental heath problems talked about more, the repetition of “I have mental health” reads to me as a bit boastful. I don’t want everyone to talk about how they have health, I want people to talk about how they’ve had problems, issues, breakdowns and worries. “I went to the GP because I was struggling” “I’ve been depressed” “I thought about killing myself” – These are the conversations that reduce stigma. These are the conversations where we feel accepted. These are the conversations that save lives.
1 in 4 people will have some form of mental health problem in their lives. I’ve had pills from the Dr and sat with a counsellor twice in my life. I can absolutely assure you that during these times “I have mental health” was the furthest thing from my mind. I had issues. Worse than issues, I had problems. The stigma around mental health problems is bad enough as it is without us twisting and tearing our language to sidestep around it. Lets speak plainly and if you really want to challenge some stigma, next time someone tells you they have mental health, tell them about the problems you’ve had with yours.

Keir provides training, consultancy and therapy to help people and organisations manage complex mental health problems at


*anyone, apart from the people who get this wrong.


2 thoughts on “My “Mental Health” Problems

  1. Reblogged this on Off the Clock Mindreader and commented:
    In a nutshell, this is why I dislike “i have mental health”. It seems bizarre to think this approach is helpful. We don’t support the unemployed by hashtag..ihavemployment and talk about the varying levels of employment, different roles and how stigma will just be reduced if we all just accepted that employment is a spectrum.

    It would be blooming confusing, and it is! We can see this by how interchangeable and therefore meaningless the terms have become. Both stigmatised. There should be a distinction and within psychology there is a distinction between positive psychology and clinical/forensic psychology. The former focuses on positive characteristics and resilience. Character strengths. The latter works at the end of the spectrum where those characteristics have become dysfunctional i.e they’re creating problems for that individual.


  2. The 1948 World Health Organisation definition:
    “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
    Given the recent move towards Parity of Esteem then the focus will move towards mental wellbeing, providing a ageless mental wellbeing service 24 hours a day similar to physical health.
    In my experience the requirement for universities (As required by NMC & BPS, doctoral programmes) to provide core competencies around the Ten essential shared capabilities for students on the three year undergraduate Mental Health Degree course should be also be demonstrated by student OT’s and Social Workers wishing to practice in mental health, unlike MH Students who have to undertake 2,300 placement hours in Mental Health, OT’s undertake 1,000 hours and Student social workers 1,200 practice hours, of course Post CPD learning and hours can be achieved but is this the same as Mental Health nurses.

    To often Mental Health Trusts advertise Practitioner roles where a qualification in MH/OT/SW is specified, I am to be convinced that this approach can lead to the improvement in the ‘absence of mental health.


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