Changing the Conversation

The choice of words we use to identify people with experiences of mental illness, trauma, substance use, and homelessness frames our thinking and guides our actions. Our language reflects how we view other people and honor their diversity. Those served in mental health or substance use services and those who are homeless represent a heterogeneous group. The use of non-discriminating and non-stigmatizing language respects the unique strengths of people using services as well as their diversity of choices, preferences, and rights (Learn more about the importance of language in human service settings.)

The commitment to “getting it right” and arriving at a consensus on language that is accurate, non-stigmatizing, and unifying is a heartfelt goal of providers and many people participating in programs. Sometimes vigorous discussions erupt and can become contentious leading to conflicts that divide rather than unify. These controversies can lead individuals, even those with good intentions, to get so angry that they use language that results in opposition to others and start cycles of the blame game. Finding the right language is important so that we avoid unnecessary divisions and strife. We have more in common than our differences. 

Many people who have been homeless have lived through neglect, isolation, and multiple traumas. Because of these experiences, many are distrustful when they begin to engage in services. Are we as service providers prepared to bridge the chasm between our position of security and their position of multiple losses and wounds?

It is very difficult to live on the edge, the periphery of being housed while others make life and death decisions based on available dollars—focusing primarily on money rather than safety and quality of life. An exclusive group of federal legislators allocate funds for services and supports to end homelessness. Being dependent on housing subsidies subject to periodic budget cuts while the elite holders of the purse strings are economically secure is very hard to digest and tolerate.

More than two thirds of U.S. adults are considered to be overweight or obese (NIH). Nearly one in four suffer form mental illness each year, with one in 17 living with a serious mental illness such as schizophrenia, major depression, or bipolar disorder (NAMI). The relationship between obesity and mental health is complex. Research shows higher rates of depression and anxiety in obese people (Katz, et al. 2000; Scott et al., 2008). Obesity may also trigger eating disorders, distorted body image, and low self-esteem. Similarly, obesity and being overweight are more prevalent among people with serious mental illness (Parks & Radke, 2008).