I'm going to nitpick

Discussion in 'General Parenting' started by flutterbee, Aug 25, 2008.

  1. flutterbee

    flutterbee Guest

    I've said this before, but I don't think I've said it here. I don't know why I thought of it tonight, but I did so here goes.

    Behavioral Health

    What is up with that terminology? That implies that someone with a mental illness has a choice over their 'behavior'. I really hate that term. It describes symptoms, not disorders or illnesses.

    We can get into the semantics over the word 'choice' as used above, but someone that is mentally ill and is not stable has only limited control over their 'behavior'.

    Ok. Off my soapbox. I hated that term when I was in the psychiatric hospital....in the Behavioral Health Unit. Like I was just choosing to be bad or something instead of being severely depressed with psychotic features. Ugh.

    And I know some of you don't like the term mentally ill. I'm not interested in creating a debate or argument or any flame-throwing, but am curious as why you take offense to that term. Enlighten me, if you will. I might be missing something.
  2. meowbunny

    meowbunny New Member

    Sorry, I fnd nothing objectionable about either. I don't see Behavioral Health or Mental Health as implying there is a choice. To me it says there is an attempt being made to make someone healthy from behavioral or mental issues. Not everything is curable. Sometimes the best a doctor can do is stabilize a patient and possibly relieve some of their pain. Whether that pain is mental or physical is irrevelant. So, to my mind it makes sense in a hospital setting (sort of).

    Same goes for mentally ill -- it is what it is -- an illness of the mind. Maybe someone specializing in behavioral health can help someone with a mental illness, maybe not. What is tragic that this does seem to be one illness that cannot be cured, just helped.

    I will admit that I think the term behavioral health floor/room/center, etc. is kind of dumb, a prettying up of psychiatric ward. I don't see it as a form of political correctness but more of a gussying up of something that doesn't need it. But, then, I can remember when my father was in a cancer ward, not an oncology unit. So, maybe the gussying up is needed for some patients and their families.
  3. flutterbee

    flutterbee Guest

    But, even psychiatric outpatient facilities are using the term Behavioral Health. It's not Behavioral Health and Mental Health. Just Behavioral Health.

    For example, here we have Children's Behavioral Health. It's outpatient and patients see tdocs and psychiatrists. There is no distinction between behavioral disorders and mental health disorders. It's just Behavioral Health.
  4. meowbunny

    meowbunny New Member

    My take is that a mental illness causes behavioral issues. And, since so many have issues with mental problems, saying it is behavioral sounds better to them. I guess you could say it is a form of political correctness. As I said, I don't hav a problem with it. If it makes some more comfortable and more open to getting help for themselves and their loved ones and not rejecting those who need the help, let's go for it.
  5. Marguerite

    Marguerite Active Member

    It's interesting how we react to different terminology. A lot of it comes down to semantics - what the term means to me is often different, because my experiences differ to yours.

    Behavioural medicine - I'd never really thought of it, but Heather I think I do see what is bugging you. The "behavioural" bit, especially. The problem (as I see it) isn't the white coat brigade, it's the family, friends, general public viewpoints, based on what THEY perceive the title to mean.

    I was given a diagnosis of ME (myalgic encephalomyelitis) years ago (it's not accurate). The label was bad enough, an incomprehensible wheelbarrow of a name, but it was still far better than what the name got changed to in 1988 - "chronic fatigue syndrome". A lot of people kicked up a lot of fuss over that, but we had to lump it because the people who chose to change the name were the expert medicos, we were just members of the public who had to LIVE with the label. And for a lot of people, it began a change in attitudes (for the worse) from family and friends. "Fatigue" has a serious meaning in medical terms, but is common to a lot of conditions. However, the meaning to the lay person is much more trivial. "I feel a bit fatigued today" really has no bearing to true, medical fatigue (where you can barely lift your head off the pillow).

    "Oppositional Defiant Disorder" is another label I HATE! The implication is that the person (kid) is choosing to be deliberately defiant, as part of some brain disorder. This is an oxymoron - how can a person CHOOSE to be oppositional, and yet this be the result of a disorder? Generally a disorder implies that there is no choice, this is how they're made. I'm not saying ODD doesn't exist - only that I think the label itself causes a lot more damage and provides very little help. It's like the word "defiant" got shoved in there by a very frustrated diagnostician for whom the possible term "Oppositional Disorder" was simply insufficient.

    Heather, I wonder if the term "behavioural medicine" also has a different, more specific meaning to health professionals than the average lay person. "Mental illness" is perhaps too broad for health professionals to be happy about using it.

    I don't know. I'm just throwing in ideas here. But maybe.

    One thing I DO know - names of diseases, departments, concepts - change (or get applied) as fashions change. Not just in medicine but just about anywhere where jargon is used. Fashions change. New ideas come in, old ones go out. And I really hate such changes where they do not seem to have any real justification (other than maybe someone trying to either cover their rear ends or maybe coining a new term so they can promote sales of their new "how to" book).

    A current buzzword in education in Australia, is "resiliency". What the...? In MY dictionary, the noun for the verb "resilient" is "resilience". Where did that "Y" come from? Oh, I see - it's a new term, just invented by this person (who I won't name, he's only attention-seeking) to promote his business as a seminar presenter and speaker on educational topics. I read the bloke's papers on the topic (often handed to me by teachers at the local school, to justify their approach to bullying - ie do nothing) and found little of value and nothing new. I was again reminded of the term on Sunday when talking to a friend who is a Special Education teacher. She had just attended one of these seminars and was trying to discuss it with me, how we need to balance the need to protect our vulnerable children against the need to build their "resiliency". She talked for about ten minutes about how children need to learn to do things for themselves and not be spoon-fed; how they need to learn self-discipline and personal organisation - I had ONE response to it all which shot the lot down in flames. "The reason our kids often ARE Special Needs is because their brains just are not mature enough, yet, to be age equivalent. Trying to force capability in a kid who is just not yet capable, is cruel and damaging. For these kids, 'resiliency' is a dangerous approach."

    I remember the place where I used to work - among other things, I was a Safety Officer. But the organisation's Safety Department had a name change which I found not only ironic but offensive - they changed the name to Risk Management. I mean, surely they could at least PRETEND they were trying to do something constructive and call themselves Risk Minimisation? But no - Risk Management. But we were all still called Safety Officers and were at one point told, officially, that if any of us said "Accidents will happen" it could mean our jobs.

    "Mental illness" - I don't see anything wrong with the term in itself, but I do recognise that over the years it has become a label with a lot of stigma attached to it. But the stigma comes from society, not from the label. Change the label - and soon the NEW label will have the same problems, no matter what you make it ("smelling like a rose" department?).

    Heather, one thing I've learned that you need to do in such situations - if people are DETERMINED to change the name of something and you feel strongly about it, give them some alternatives. The reason we get foisted with terms such as"Behavioural Medicine" and "resiliency" is because the geniuses who got the brainwaves have no competition. Give people a viable alternative at the right time and chances are, you will have your way.

    So maybe we can have a think tank here, where we can come up with alternatives we are happier with?

  6. susiestar

    susiestar Roll With It

    While I don't like the term much either, I think it may have been a marketing tool. Lots of us have had problems with our spouse, and many others, accepting that their is a problem with our children. Our kids are mentally ill. I think many people were not willing to go for services, or take children for treatment, because they didn't want them to be labelled mentally ill. So the change to behavioral medicine may ahve been to broaden the acceptibility to the masses.

    I know I had trouble getting my husband to admit Wiz had problems, that he wasn't just a really smart kid who needed to "get with the program". I have heard MANY others in the family say this. If I had come out and said he was mentally ill the uproar would have been so great y'all would have heard it in your homes - even YOU, Marg.

    How many times do we have someone post that their are no mental illnesses, just depression and alcoholism here when we ask about the family tree?

    If we ask about mood disorders, many newbies say that there are none. But I, and dad, and all the grandparents have depression. (I have always found THAT to be interesting.) Isn't depression a mood disorder??

    How may parents would REFUSE to get help for a child from a Mental Health dept? I know a lot of dads, and quite a few moms who would.

    This probably is only part of the reason for the name change. But it probably is a factor.

    I object, while we are ranting about health care, to the separation of eyesight and dental from health. How is it that tooth problems are NOT health care?? That eye problems are NOT health care?? I realize this separation was done because of the almighty dollar, but it still seems idiotic to me.
  7. Marguerite

    Marguerite Active Member

    Susie, we have the same problems with dental not being included in health care in Australia. Our wonderful health care system has even allowed a block of various therapies (counselling and other psychology services, plus physiotherapy etc) but we STILL can't get ANY dental care under our public system. YOu have to be privately insured, or pay big bucks out of pocket. There ARE some exceptions, but the waiting list for free dental care for welfare recipients is miles long and you virtually have to be on the streets to qualify.

    I think to include dental would push the costs just too high, for a health system that is already a huge drain on our national budget.

    As for the mental health label being a stigma that can get in the way of vitally needed treatment - I think you've got a good point, Susie. I know it would make a huge difference to people in mother in law's generation, especially, if we had to deal with labels for ANY of our kids in the "mental health" area. It HAS, actually. In times in the past when I've needed to see a psychologist or psychiatrist (or any of the kids) we had to try and do it secretly, not telling my in-laws. The flak we copped if/when they found out was VERY unpleasant.

    But since the main presenting issue that people could see with the kids when younger was behaviour, then I understand why that is a label that "sells" the services more successfully.

    Blasted annoying that it has to be this way.

  8. Sara PA

    Sara PA New Member

    I've mentioned more than once that I have real issues with the term "mental health". What's a "mental", anyway? I have to say I like the "behavioral health" term better.

    Once again I'm going to say that's there is a real need to start using words like "neurobiological" to define the conditions which many of our children have. And, those with neurobiological conditions and those with psychological issues have to be separated and treated by different methods. While the behaviors exhibited by people with neurobiological and psychological problems may look very much alike, the causes are very different. Someone "acting out" (another term I loath) may have schizophrenia -- clearly a neurobiological condition -- or may have been severely traumatized -- clearly a psychological condition. The treatments aren't and shouldn't be the same. But what happens is that too often the "acting out" is treated, not the condition that caused it.

    I was listening to one of the NPR shows the other day when they were going through their mail. There was a letter from an irate mother of an autistic child who was outraged that one of the guest referred to autism as a "mental illness". Autism, she ranted, was a neurological condition, not a mental illness. I could only wonder what she thought ADHD/ADD, schizophrenia, bipolar, etc were? I could only wonder how she defined "mental illness" beyond "it's what other people have". I could only wonder how she felt about people identified as "mentally ill".

    Epilepsy use to be a "mental illness". It's time for the other neurobiological disorders to get out of the area of psychology and into the area of neurology. It's time we start applying what we know about brains and brain development to these disorders. It's time we figure out how to diagnose them besides looking at how someone acts and making guesses. With the new research being done we're starting to get a handle on it; it's coming but far too slowly. Maybe we need less research on which existing drugs can be marketed to treat behaviors and more research done on what's going on in the brain and why.

    When we start calling these disorders what they are -- neurobiological and psychological -- we won't need the euphemisms of "mental illness" or "behavioral health". When I was a baby, my grandfather had cancer. People didn't say "cancer" back then, they used euphemisms for it. That seems so old fashioned now but it's no different than using euphemisms for neurobiological and psychological conditions. Some day in the near future our terminology will seem old fashioned.
    Last edited: Aug 26, 2008
  9. Christy

    Christy New Member

    This make sense.
  10. Marguerite

    Marguerite Active Member

    Sara, your mention of autism and labels reminded me - in our school system here in Australia, autism is described as a psychiatric condition. But in our tertiary education system, it is categorised as neurological.

    The various departments within the disability education area in tertiary education are broken up into these categories -
    "Deaf/Hearing Impairment
    Intellectual Disability
    Neurological & Physical Disability
    Physical Disability
    Psychiatric Disability
    Vision Impairment"

    So even when you have a range of categories, the same disability can be put into a different pigeonhole, purely on the whim of some bureaucrat. Some people undoubtedly fall into more than one category - there is a general enquiries number to find out who is the most appropriate department for a student.

  11. crazymama30

    crazymama30 Active Member

    Neither bother me. A behavior is just how a person acts, to me it does not mean it is able to be controlled. An Autistic child cannot control their behavior anymore than an ADHD or BiPolar (BP) child.

    The term I do not like is Emotionally Disturbed. That to me sounds awful. I have difficult child classified as ED for his IEP, and it was hard for me to do that but I wanted to make sure he had all the safeguards an IEP could give him, and it was the best description of him.
  12. I think the term "Behavioral Health" is not meant to simply say behaviors like bad behaviors versus mental health. Our Behavioral Health Hospital deals with not only "behavior" problems, mental health problems, but it also deals with drug and alcohol problems for both adults and adolescents. I see it used as a distinction. A facility like that does not treat "physical" health, but it is a hospital none the less.

    I don't have a problem with the terminology because whether it is behaviors that are in someones control or behaviors that are because of a mental illness it all falls together. Doctors at regular hospitals don't treat the stuff, the Behavioral Health Hospital does.
  13. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I think they have gone from using the term "psychiatric" to "behavioral health" in recent years as more of a easy child term. Means the same thing when I have seen it used. There are behavioral health hospitals and units instead of psychiatric hospitals and floors. These are the same exact places that used to be called XXX psychiatric hospital or the psychiatric Ward on third floor. It doesnt really bother me. Call me what you want, just dont call me late for dinner!