Language Matters

Many terms are used interchangeably when discussing mental health disorders and addiction. But some terms carry stigma which can rob people of opportunities for success. For example, words like “schizophrenic” and “abuser” suggest that mental health disorders and substance use disorders are personal failings, or that people lack the willpower to change—neither of which are accurate. Stigma can also prevent people from seeking or receiving appropriate care.

Upon review of the current lexicon and after consulting individuals with lived experience, we decided to use “mental health disorders” and “addiction” to broadly refer to the social impact issues addressed in this guide. We also use “substance use disorders” to refer to specific clinical considerations related to addiction. In addition, you may find the following glossary of terms useful.

Glossary of Terms

Addiction: A chronic, relapsing disorder manifested by compulsive substance use despite harmful consequences, due to long-lasting changes in the brain. It is considered both a complex brain disease and a mental illness. While addiction can refer to compulsive engagement in other activities, we refer to the term here only regarding the use of substances.

Adverse childhood experiences (ACE): Potentially traumatic events that occur before the age of 18 which can have negative, lasting effects on an individual’s health and wellbeing. Examples of ACEs include economic hardship, exposure to neighborhood violence, and living with someone who has a mental health disorder or substance use disorder.

Behavioral health: An umbrella term referring to both mental health disorders and substance use disorders.

Behavioral health care: A broad category of care that addresses the effect of behavior on health, including patient activation (having the knowledge, skills, and confidence to manage one’s health) and health behaviors (e.g. physical activity, eating behaviors), substance use disorders, and mental health disorders. In this sense, behavioral health care can be a part of all care settings, and can be carried out by clinicians and health coaches of various disciplines or training, including but not limited to mental health professionals.

Economic burden: The financial costs resulting from a specific disease or condition, including medical costs, non-medical costs (e.g. childcare), and productivity losses.

Impact investing: Investing that intentionally seeks measurable social and environmental benefits.

Mental health: An overall state of emotional, psychological, and social well-being. When an individual is in a state of positive mental health their potential is realized, they can ably cope with normal life stressors, work productively, and contribute to the community.

Mental health disorders: A wide range of conditions that affect mood, thinking, and behavior.

Serious emotional disturbance (SED): A diagnosable mental, behavioral, or emotional disorder in a person under the age of 18, which results in functional impairment that substantially interferes with or limits the child’s role or functioning in family, school, or community activities.

Serious mental illness (SMI): A mental, behavioral, or emotional disorder resulting in serious functional impairment which substantially interferes with or limits major life activities. Examples of SMIs include severe, major depression, severe bipolar disorder, and schizophrenia. This term is only used for someone over the age of 18. For individuals under 18, SMI may be referred to as serious emotional disturbance.

Substance use disorders (SUD): The recurrent use of alcohol and/or drugs causing clinically significant impairment, including health problems, disability, and failure to meet major responsibilities.

Stigma: Prejudiced, stereotyped, or discriminatory attitudes and behaviors. Stigma is often experienced by individuals with mental health disorders and substance use disorders. Stigma can be divided into three types: public, self and structural/systemic. Public stigma refers to the prejudiced attitudes that others have; self-stigma involves internalized stigma that the person with a disorder suffers from; and structural/systemic stigma refers to laws, regulations, and policies that inhibit individuals from accessing services or participating in activities available to others.

Trauma: An intolerable event or experience that causes the person to be overwhelmed physiologically and causes psychological harm.