Erasing Stigma Is Much More Than Changing Words

Some have argued that giving schizophrenia another name—“dopamine dysregulation disorder” or “youth onset conative, cognitive and reality distortion”—will erase stigma. “I admire the spirit of these efforts,” writes the author of this month’s Open Forum, “but their focus may be problematic.” In fact, he argues, diagnostic relabeling places the responsibility for stigma change with mental health professionals rather than where it belongs, squarely in the control of people with lived experience. After all, he said, it was people of color—not well-intentioned outside groups—who tore down racism.

Some opinion leaders and mental health experts have called for replacing diagnostic terms such as schizophrenia with words that are less stigmatizing and that more clearly reflect recovery. Although the author notes that such efforts are laudable, he describes three concerns in regard to diagnostic relabeling. It gives the task of changing stigma to mental health professionals rather than anchoring it among people with lived experience. Proponents of diagnostic relabeling misunderstand the enduring force of prejudice and discrimination. The focus on relabeling makes stigma change look easy, which undermines the stigma change agenda. The author points to lessons that can be learned from other efforts to promote civil rights.