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U.S. Department of Health and Human Services Department of Health and Human Services
Substance Abuse and Mental Health Services Administration

Substance Abuse & Mental Health Services Administration

Last Updated: 3/17/2011

SAMHSA’s Resource Center to Promote Acceptance,
Dignity and Social Inclusion Associated with
Mental Health (ADS Center)


Guidance on Transformational Language

“Words have power. They have the power to teach, the power to wound, the power to shape the way people think, feel, and act toward others.”

—Otto Wahl

Transformation in services and supports for adults, and children and youth with behavioral health problems, requires a complementary transformation in the language we use to describe the people we serve. Quite literally, we should seek to employ “people first” language, prefacing our descriptions of the people we serve as people first, such as, people with mental health or substance use problems or challenges rather than mentally ill people or addicts. None of us should be defined by our problems or diagnoses, or by a single aspect of who we are; we are people first and foremost.

The following list contains examples of transformational language.

Transformational Language

Outdated Language

Tom has a mental health or substance use problem or challenge.

Tom is mentally ill/emotionally disturbed/insane/crazy.

Dick has a diagnosis of bipolar disorder. He experiences mood swings.

Dick is (a) bipolar.

Jess experiences symptoms of psychosis. He hears voices.

Jess is (a) psychotic.

Susie is a person who receives help/
treatment for mental health or substance use problems. She is a recipient of behavioral health services.

Susie is a patient.

Harry is a person with co-occurring mental health and substance use problems.

Harry is mentally ill chemically abusing (MICA).

Jane is a person with a disability.

Jane is disabled/handicapped.

Bonnie is a child without disabilities.

Bonnie is normal/healthy.

Rebecca has a brain injury.

Rebecca is brain injured/damaged.

Ralph has asked for accessible parking/hotel room.

Ralph has asked for handicapped parking/hotel room.

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This Web site was developed under contract with the Office of Consumer Affairs in SAMHSA’s Center for Mental Health Services. The views, opinions, and content provided on this Web site do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS. The resources listed in this Web site are not all-inclusive and inclusion on this Web site does not constitute an endorsement by SAMHSA or HHS.