Language Matters: Non-compliant

This post is a part of the Recovery 101 blog series. The series will explore ideas, philosophies, language, tools, and questions about mental health recovery. Submit any ideas for topics in the comments section of any tagged post.

We in social services know the importance of language. We know that words can hurt or empower. We know that labels may stigmatize. And yet so often our work comes from a place, system or history that promotes these very problems. As one part of the Recovery 101 series I want to explore the language and word that hurt the work we do, as well as the people we work with.


One of my greatest pet peeves is the term “non-compliant”. Direct from the medical and clinic model of treatment, it is usually used to refer to someone who stops taking their medication against medical advice. It may also refer to refusal to participate in other forms of treatment.

When I hear non-compliant I hear:
1) that medication is the sole or primary method of improvement
2) that the treating physician knows what is best
3) that the patient or person is doing something WRONG or even deviant
4) that the patient or person does not have the right to determine how they want to recover
5) the reasons the person has for not taking medications are insignificant compared to what professionals or others perceive as the benefits of the medication
6) the patient or person is sick and must be made better

What alternatives exist to these words:
1) person has decided not to take the prescribed medication
2) person does not find the medication effective, or finds the side-effects unpleasant and is seeking alternative methods
3) the person is comfortable/prefers not taking medications at this time
4) the person has difficulty taking their medications consistently and may need help in this area

How do you view or support clients or others in their decisions around taking medications? Do you use the term non-compliant or have an alternative to suggest? Have you as a patient or person dealing with mental illness felt you have agency or decision making power with regards to medical treatment?

Who Are the People (with Mental Illness) In Your Neighbourhood?

Source: http://bit.ly/qASsuQ

There are a lot of stereotypes and assumptions out there about “who” mental illness sufferers are. No matter how many celebrities write books with “revelations” of suffering bipolar or PPD, or how many families contain at least one Crazy Aunt Mary many persist in believing that mental illness is the domain of the poor, stupid, homeless and criminal.

There is plenty of critical thinking and anti-oppression analysis we could do to figure out why people think this way (and why many with mental illness are vulnerable to becoming poor, homeless etc) but I haven’t the energy/time for that right now.

If any one needs proof that mental illness is something which affects people from all walks of life, they should spend just 5 minutes hanging around the local out-patient centre or treatment clinic.

I accompanied a client to his psychiatrist appointment today at Local Hospital out-patient clinic (I know! I said I’d never go there again, but reality bites). Someone who didn’t know him would see that he is a family man (his wife was with him) is middle aged, and might guess that he is an immigrant (English is his second language).

While we were there I spotted a familiar face that took me a second to place. A woman I recognized from my old neighbourhood - she spent a lot of time hanging around the back alley, lived (sometimes) in a nearby crack-house, and often stopped people to ask for change on the sidewalk. I used to try talking to her sometimes, but it was difficult because her tongue was always protruding (possibly a med side effect or a symptom) and she would usually walk away when I didn’t have any change to offer.

On the way out of the office I recognized a woman I know from my family’s church. She’s a white, upper middle class professional who goes to bible study with my mom. I have actually run into her once before in a psychiatrists office when there with another client. We nodded to acknowledge one another and she seemed happy to leave it at that. We did this once again, adding a smile, when encountering each other at the hospital.

In the span of that five minutes I came across people from a wide cross-section of my own life, and who covered a good range of social locations.  And I know it’s not just me.

Alternative Medicine...Sweet, Sweet Medicine...

Any changes to your medication recently?

-Well, my doctor says my cholesterol is high. He prescribed me something for it, but I don't think I'm going to take it because of the side effects.

My friend had high cholesterol and his doctor told him to start eating walnuts. He ate a whole bunch and his cholesterol came right down in a week! So I already went to the grocery store and picked up a big box of walnut brownies.