Changing the language around mental health disorders in T&T

By Malika Grant

The way she actin’ I feel she bipolar.”

How often do you hear people say something along these lines? Or maybe you make similar comments at times. In this piece we will explore ways that we can all change our language around mental health and mental illness within Trinidad & Tobago with hopes of destigmatizing the topic.

First, let’s look at some quick definitions

According to the WHO, mental health is a “state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. This definition is quite extensive but very comprehensive. It addresses several aspects of this very important topic which should not be overlooked.

Armed with this definition, we can then delve into mental health disorders/ mental illnesses. These are health conditions that involve a change in emotion, thinking or behaviour. They can be either chronic (for example: schizophrenia) or acute (for example a bout of depression after a life event).

In terms of statistics, as mentioned in the previous article by Chikara Mitchell, The Numbers Around Us’, it can be difficult to find accurate and updated statistics regarding our population. However, in this newspaper report, Dr. Samuel Shafe, director of St. Ann’s Psychiatric Hospital, mentions that the Caribbean depression and anxiety rate is approximately 25%. Though I am unsure of the original report, this source seems credible and the number is significant! He then goes on to say that men tend to ignore their mental health and the suicide rate among them is higher.

There are several services available offering treatments and management plans for those with mental illnesses in T&T. Unfortunately, many people in today’s society remain reluctant to utilize them. There is no doubt that stigma plays a huge role in this hesitation.

Stigma surrounding mental health

Stigma is when someone is viewed negatively or discriminated against due to a certain set of characteristics. It is thought to comprise of three main elements: lack of knowledge, negative attitudes and discrimination towards that person. There are two main types of stigma when it pertains to mental health disorders: ‘social stigma’ and ‘self stigma’.

Social stigma is due to the public’s stereotypes and language surrounding mental health as well as the discrimination enacted. This then leads to self-stigma as individuals begin to internalize these stereotypes that society feeds them, resulting in feelings of shame and guilt. It is a combination of these two types of stigma that makes it even more difficult to get help. As a consequence, there is a further delay in treatment which can sometimes cause a progression of their illness.

There are many different attitudes which need to be changed and language is probably the simplest one to start with.

Adapting our language

As Trinbagonians, we love to talk. But there are some terms within our vocab that we should start omitting. To begin, ‘St. Ann’s Hospital’ is a psychiatric hospital or you can even call it a mental health institution, both are acceptable. ‘D Mad House’ is not. I am not entirely sure which generation started referring to it as such but our generation could make the change. Additionally, in reference to my opening line, irrational thinking or behaviour does not equate to bipolar disorder! We can dissect symptoms of various mental health disorders in a future article, for now, just know that the terms are not synonymous.

Now, the following terms are slightly more nuanced but I am sharing them with you to increase awareness. Globally, there has been a push by mental health advocates for us to replace the term ‘committed suicide’ with ‘died by suicide’. The former originated from a time when suicide was considered a crime or a sin (hence you committed suicide in the same way that you commit murder for example). In today’s society we know better and can discuss it in a more compassionate way.

Another way we show compassion is by not defining people by their illnesses. Mr. X is not a depressed man but rather a man that has depression. There are many more examples but you get the gist. We refer to this as people first language. It is emphasized within the healthcare field and is seen as a conscious method of placing people before their conditions, in order to avoid marginalization.

Further information

I am sure that there are even more terms that should be adjusted. This is just a start but remember that the onus is on all of us. Let us be more mindful of the terms we use and work towards ending this stigma within our twin island republic. Talk to your friends about mental health and listen without judgement.

If you or anyone that you know may be at risk, visit your nearest General Hospital. Additionally, Lifeline is a local service available 24/7 for anyone experiencing an emotional crisis. Their number is 800-5588. Other services can be found in this document.

References Trinidad%26Tobago_Country_Report_Final.pdf OFFICIAL VERSION 2021.pdf