It’s time for California to replace harmful language

OPINION – In our society, words matter. They’re how we define ourselves and others. She’s a successful doctor. He’s a savvy businessman. But for too many, words used to describe us cast an unfair stigma on who we are. She’s a drug addict. He’s a mentally ill person. When such words also carry the force of law, they have even greater weight, robbing people of their humanity and their agency. It’s time California stop using such stigmatizing language in our laws.

Two bills currently in the state Legislature, AB 2119 by Assembly member Akilah Weber, M.D. (D- La Mesa) and AB 2995 by Assembly member Dr. Corey Jackson (D-Perris), both sponsored by the County Behavioral Health Directors Association of California, follow the lead of many in the disability rights movement by bringing California’s codes up to date with person-first language where appropriate. For instance, should these bills become law, state code would no longer refer to someone as a “drug abuser,” but as a “person with a substance use disorder.” A person would no longer be defined as “mentally disabled,” but as someone “with a mental health disability.” For anyone who has personally dealt with seeking mental health or substance use disorder treatment, we know that we are more than a diagnosis, and certainly more than our most challenging moments.

“The terminology we use for people with substance use disorder (SUD) needs to reflect empathy, understanding, and respect rather than condemnation,” said Assembly member Jackson. “California law has used stigmatizing language for far too long, especially when we know the words we use have real and negative impacts on many Californians.”

Stigma contributes to larger societal impacts as well. For example, stigmatizing language can lead to judges and juries prioritizing punishment rather than treatment, which then reinforces stigma around mental health conditions and substance use disorders. Societal-wide stigma around these topics can also lead to discrimination in obtaining housing, access to health and mental health services, and education and employment opportunities. The discrimination is compounded for people who are Black, Latinx, and/or Asian, Native American or Pacific Islander, and also experiencing behavioral health challenges.

“Communities of color not only seek mental health services at lower rates – but when they do, it is increasingly difficult to find providers of color,” said Assembly member Weber. “We need to ensure that all individuals facing a mental or behavioral health issue, feel empowered to seek treatment.”

The ironic thing about stigmatizing language is that while it defines people as “different,” the reality is that struggling with mental health and substance use disorder is common.

According to 2022 data from the California Health Care Foundation, roughly one in ten Californians met the criteria for a substance use disorder within the last year, while nearly one in seven California adults experience a mental health condition at a given time. One in 26 has a serious mental health condition that makes it difficult to carry out daily activities. One in 14 children has an emotional disturbance that limits functioning in family, school, or community activities.

There are already so many barriers to accessing quality care and treatment, including inadequate insurance coverage and unlawful denials of care, too few specialists to meet our communities’ growing needs, and not being able to take the time away from work and family to get help. We do not need discriminatory language and attitudes to add to the challenges.

What if, instead of applying negative words to people who are coping with health conditions, including those that impact their mental health and social connections, we approached them with the same compassion we would a cancer or diabetes diagnosis? What if we acknowledge that substance use disorders and mental health conditions illness are conditions, and not something the people choose. What if we empowered people to seek help and make changes, rather than live in fear of being judged, discriminated against or shamed? What if we lifted up the countless stories of individuals with mental health and substance use disorders living full, meaningful lives in recovery with the support and love of their friends, family, and neighbors?

We might create a state better prepared to connect individuals to the services and interventions that quite literally improve and save lives. The language we use demonstrates the values of our society. It is time California updated our outdated codes and demonstrate that we value all of our citizens, regardless of their diagnosis and one that ends the stigma of unfairly labeling those with behavioral health conditions.

Dr. Ryan Quist is Sacramento County Behaviorial Health Director, Board President County Behavioral Health Directors Association of California