Bias toward the mentally ill – the last acceptable prejudice?

The myth of the crazed, violent killer. (Photo:

By Jenny Westberg
Portland Mental Health Examiner

After years of inequality and hatred, many minority groups have won some respect. You would never, for instance, talk about your African American friends using a certain word starting with “N.”

But even in our enlightened age, many people refer to those with psychiatric disabilities as “crazies,” “nutcases,” “loony tunes,” “whack jobs,” “head cases,” “sickos,” “retards,” “flakes,” “schizos,” “weirdos” – and the list goes on.

Dehumanizing slang still has a place in society – as long as you’re talking about mental illness. And it’s not merely tolerated, it’s defended. If a reference to “the crazies” hurts someone, that person is being overly sensitive. They can’t take a joke. It’s just a word. They’re getting upset over nothing. They’re – well, they’re nuts.

And if someone defends the dignity of persons with psychiatric disabilities, she must be one of them.

If people aren’t busy mocking mental health consumers, they’re expressing fear.

The myth of the “unpredictable, violent” mentally ill person persists, despite clear evidence that there is no significant link between mental illness and violence, unless a person also abuses drugs or alcohol. But even for people with substance abuse issues, risks are about the same whether they have a mental illness or not. (See, for example, S. Fazel et al, August 2009, PLoS Medicine, for a systematic review and meta-analysis of studies from 1970-2009.)

Recently a columnist for The Oregonian, in an otherwise sensitive article, used the phrase “the cops and the crazies.” Not long before that, the newspaper referred to an “insane killer.” And in an article about a violent incident, the writer quoted a local resident: “Oh my God, you’ve got to be careful. There’s a lot of crazies out there.” Another article said, “Police early this morning captured a dangerous mental patient…”

Movies like “The Crazies” capitalize on people’s fears. You can even kill the crazies in an interactive game, with the following teaser:

“Will you have what it takes to outlast the onslaught and survive against the waves of incoming hordes of the crazies? You against the crazies: One will emerge victorious. Play and see which it will be.”

Otto F. Wahl, Ph.D. writes, “It is emotionally painful to see yourself or those you love consistently portrayed as villains and buffoons… It is offensive to see trivialized the conditions that devastate your life.”

One way to change attitudes is to change the words we use. Among people with mental health conditions, there is general agreement that words like “weirdo” and “psycho” are offensive. But what do we say instead?

See Part 2: Using respectful language