Why you should not call mentally ill person crazy

Changing the language we use to describe mental health persons matters

In Summary

• Cultural diversity and language have a bearing on how mental health is handled 

Mental illness
Mental illness

We all come from societies or communities with different ways of doing things. Our cultures are unique, and they help us identify with each other, or with particular groups. This is based on our shared understandings, common language, art, customs or world views.

In Kenya, we have 43 ethnic groups (of which 13 are major groups), which all speak different languages, inhabit diverse ecological zones and differ significantly in cultural practices.

Our culture, beliefs, values and languages all affect how we perceive and experience health, including mental health. Cultural differences can influence what treatments, coping mechanisms and supports work for us.  

For many decades, anthropologists have shown that cultures including people’s history, economies, social realities and politics are important in providing meanings to health or illnesses.

For instance, the perceptions that people have towards the cause of their illnesses can vary across cultures. In Kenya, some cultures ascribe the onset of disease to curses, witchcraft or the “evil eye” (from a neighbour or a relation), black magic or the breaking of taboos. Others, talk about the “jini” (evil spirits) as underlying their poor health or suffering.

But the cultural meanings of health and illness have real consequences in health-seeking behaviours. Individuals who believe in non-medical causes to their ill health will most likely seek care from non-medical providers, such as traditional healers or faith healers, because these providers share similar world views, language and cultures with the ill person.

It is not uncommon to see posters advertising the services of traditional and faith healers in both small rural towns and big urban cities in Kenya. These healers claim to address various problems, such as HIV, diabetes, cancers, asthma, low libido, missing persons and stolen property.

Understanding these cultural variations and practices is important to help us understand why people do things the way they do, and this can help us to tolerate each other.

Language is linked to culture. We use language not only as a tool for communication but also as a symbolic system, which helps us to create and shape our social realities, perceptions or identities. The language we speak to ourselves, or to others, may trigger our brains to respond in specific ways. On one hand, people may feel emotionally uplifted when appropriate language is used. Phrases such as, “Najivunia kuwa Mkenya”, loosely translated as “I am proud to be a Kenyan”, can create a positive vibe, integration and social cohesion.  

However, in Kenya, it is common to see people using inappropriate language in public spaces or in some sectors. For example, in the health sector, mental health is one area that is not well understood. Use of inappropriate words or language to label people suffering from mental disorders is common.

Stigmatising words such as mwendawazimu or chizi, loosely translated as mad or crazy, are often used to describe people with mental disorders.

Sometimes, Swahili verbs such as kujinyonga or Kujiua, loosely translated as committing suicide, seem to relegate blame to individuals who die by suicide. Other diseases that are highly stigmatised and labelled include HIV-AIDS and obesity.

Moreover, it is common to observe or hear Kenyans using inappropriate language or words during the electioneering period. For the past three decades, ethno-political hostilities in Kenya are influenced by political elites who manipulate and incite long-held divisions along ethnic lines, economic imperialism and cultural practices that are deep-rooted and radicalised. In this context, hate speech is at the core of such violence which, over the past, have led to loss of lives, property and threatened the ability by the state to protect the citizens.

Using inappropriate words, including hate speech, not only stigmatises and creates unrealistic assumptions about other communities but also can undermine serious mental health conditions. Further, stigma can cause people to feel so ashamed, lead to low self-esteem or can make individuals with mental disorders to hide their symptoms and not seek treatment until their issues becomes severe.

On this World Day of Cultural Diversity, let us embrace cultural relativism by respecting other people’s cultures and values. This may promote tolerance, understanding, acceptance of diversity, and create a peaceful coexistence.

Changing the language we use to describe mental health issues in Kenya can make a significant and immediate difference for the people experiencing these disorders.

By Dr Edna Bosire is a medical anthropologist with the Brain and Mind Institute, Aga Khan University

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