This Week in Mentalists – What’s in a Word Edition

I’ve been a bit disorganised with regards to the TWIM rota over the last few weeks, hence why it’s me doing it for the third week in a row. However, next week it’ll revert to the normal pattern of it being a different blogger each week. It’ll also be in the new home for TWIM over at MentallyWealthy.Org. Don’t forget to take a peek over there in the next few days when the This Week in Mentalists Awards 2013 will be kicking off. In the run-up to Christmas, we’ll be selecting the best of mental health blogging, and asking for your help in order to do it.

And since this is the last TWIM ever to take place at World of Mentalists, I think I’ll use it as a bit of a meditation on words and their meanings.

This week has been a rather hectic one for social media, due to a Twitter furore over a fancy dress costume advertised on the Asda website.

“Everyone will be running away from you in fear in this mental patient fancy dress costume… it’s a terrifying Halloween option.”

Well, this will not end well.

There seems to be an interesting backstory as to how the story went viral. It involves staff from Leeds and York Partnership NHS Trust, which for some reason seems to be something of a trailblazer when it comes to the use of social media by mental health services. Victoria Betton, who works for the trust and whose research project is linked to this blog, gives us the details on how it emerged.

Where it all started

When I sneaked a peak at my emails (ironically in the middle of a Time to Change Leeds steering group meeting) and clicked on an Asda link from one of our consultant psychiatrists, my heart started palpitating. I couldn’t believe the image in front of me. Surely this Halloween costume was a wind up? But the URL was legit. I shared it with colleagues around the table. We all gasped.

My first thought was that it had to come down quickly – it was going to upset and offend so many people. Asda’s headquarters are in Leeds and Dom, Head of Social, has been fantastic in supporting myself and my comms team in our use of social media. He’s even blogged about mental health taboos himself – you can read it here.  So I sent him a DM. Dom got it straight away and put things in motion to get it taken down. Unfortunately for Asda the web page remained up.

Going viral

Later that morning our chief executive (who also received the email) tweeted Asda with the link, and a response came quickly: ‘Thanks for your feedback. We agree. Our George colleagues had already picked up on this and are taking action. #timetochange’. There was no further interaction until the ChrisButlernhs tweet was re-tweeted by MrsGracePoole in the evening and at this point the topic went rapidly viral over the next 24 hours, resulting in prime time national TV and radio coverage plus print media the next day.

The first I noticed of it was when I had a tweet from @cariad_mawr pointing it out. I dashed off a tweet of my own.


Even at this early stage in the twitterstorm, there were plenty of other people making the same point. Even so, it’s one of the most heavily retweeted tweets I’ve ever sent. Large numbers of people were clearly outraged. There was also the occasional response along these lines.


To quote the hotel receptionist in This is Spinal Tap, I’m just as God made me, sir.

Asda have since apologised, removed the item from the website and made a £25,000 donation to Mind. From Victoria’s analysis, there’s probably a strong degree of sincerity to the apology, and it sounds as though their head of social media is a decent guy who does care about mental health issues. Even so, I’m sure the board of directors at Asda will have their gigantic Walmart profits to console them.


But that wasn’t the end of the story. People started tweeting pictures under the hashtag #mentalpatient to show off what a “mental patient costume” really looks like.

mentalpatient7 mentalpatient6 mentalpatient5 mentalpatient4

For more of these The Fementalists have a Storify. I’m actually very impressed by the way this row has been turned around into what’s actually a very positive message. The message being that “mental patients” do not look like blood-splattered zombies waving a meat cleaver. They look like nice, normal people, because that’s exactly what they are.

But should we be talking about “mental patients” at all? Rufus May is a clinical psychologist who disagrees with the use of the term “mental illness.”

I agree it’s good to talk about a taboo subject but only if that talk – as well as encouraging empathy – uncovers new ways to see problems and find solutions. I recently challenged Time to Change about how much they use terms like ‘mental illness’ – and diagnoses -because I think, used rigidly, they can add to stigma and misunderstanding. Even the concept that 1 in 4 people have a mental illness encourages a conceptual division – between those thought to be sane and those thought to be insane – that may make empathy more difficult.

If we replace the illness model with one that sees suffering and confusion on a continuum, then it is easier for us all to relate to each others’ predicaments. This feels more inclusive, rather than separating off the ‘ill’ from the ‘well’ in an artificial and compartmentalised fashion. A group of us are planning to write to Time to Change about the language they use. This article is about an alternative way of looking at what gets called mental illness. But first I will share a few reflections on this tension between wanting to embrace this phenomenon many call mental illness and the desire to re-frame it so we can embrace it more wholeheartedly.

My impression is that many people accept the term mental illness and find it useful in their lives. I don’t want to offend them, I don’t want a war of ideas with them where I hope to get them to convert to my way of thinking. I do want to suggest that many people may wish to hold the term mental illness very lightly or not even use it at all. In my eighteen years working as a psychologist I have generally found non-medical terms to be more helpful in trying to help people find more peace and agency in their lives.

This begs an interesting question. In order to challenge stigma, do we change the words, as Rufus May suggests? Or reclaim the existing words by changing the meaning, as those who made use of the #mentalpatient hashtag did?

It’s also important to recognise that words take place in a context. Another regular to these pages, Charlotte Walker aka Purple Persuasion, was interviewed by the BBC in the wake of the #mentalpatient furore.

Recent campaigns like Time to Change have tried to reduce the stigma around mental health and say that it’s fine for us all to talk about how we feel. But are we still too casual with our use of the word mental?

“I’d rather people didn’t use the word like that but I don’t think it’s meant in a hostile way,” says Charlotte Walker, who has bipolar disorder and blogs as Purple Persuasion.

“I get more upset when people misuse clinical terms, like using ‘psychotic’ to mean either insanely obsessive or insanely violent.”

There is a rich vocabulary of terms that could be seen as unhelpful or disrespectful. Some are perhaps so far below the radar that they might surprise you.

“I don’t really like it when people say work was ‘manic’,” says Walker, “because being manic was one of the worst things that ever happened to me.”

She notes that there is humour in the community with these borderline words, and says people quickly refer to themselves as mental or “a mental” so they don’t have to call themselves a “patient” or a “service-user”.

Charlotte’s latter point leaves me thinking about the title of these roundups and of this blog. I’ve often wondered about the use of the word “mentalist” and whether it might be inappropriate. I was therefore surprised when the blog got renamed and when I asked people what they thought it should be changed to, people repeatedly insisted that the word “mentalists” should be left in.

If anyone’s interested, I think “mentalist” first got used on the Alan Partridge show. Then the Manic Street Preachers heard it and jokingly started referring to their hardcore fans as “mentalists”. I believe it was then Seaneen (who is a Manics fan) who started calling herself a mentalist on her blog. The word then seems to have spread as something of a mini-meme, so there’s Notes From A Gay Mentalist and The Fementalists, for example.

On that note, the words will continue over at MentallyWealthy.Org next week. Don’t forget to drop by so you can give your input to the TWIM Awards.

Here is the final TWIM Wildcard to take place on this blog. It’s a slightly cheesy one, but it continues with the theme of words.


About Phil Dore

Trained as a nurse, currently working in Child and Adolescent Mental Health Services (CAMHS). All views expressed are in a personal capacity and not necessarily the views of my employer.

4 Responses to “This Week in Mentalists – What’s in a Word Edition”

  1. It was a strange day for me: working nights, I got in from work to hear all about it in the morning headlines but was too knackered to join the conversation; by evening, when I re-emerged from the land of nod, it was more or less all over. Good to get this overview: ta.

    On using the word ‘mental’ – reminds me of a conversation I had back in June. Seems to me it’s a matter of reclaiming/rehabilitating the word: stigma will remain as long as we remain offended by it, but if we embrace it as part of our identity … water from a duck’s back comes to mind…


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