17/09/2026
https://www.facebook.com/share/p/19CWRvvx52/
How should we refer to people with mental ill health, disability, or neurodivergence?
Terminology should be respectful, apt and avoid carrying stigma. It’s also important to listen to people’s preferences about how they refer to their condition. But how much consensus is there and how has terminology changed?
Our new study – the largest of its kind – explores how this language has evolved over the past 45 years to reflect our shifting views of mental illness and disability.
We found preferences can depend on the condition, and whether we are talking about individuals or groups.
𝐑𝐞𝐦𝐢𝐧𝐝 𝐦𝐞, 𝐰𝐡𝐚𝐭’𝐬 𝐩𝐞𝐫𝐬𝐨𝐧-𝐟𝐢𝐫𝐬𝐭 𝐥𝐚𝐧𝐠𝐮𝐚𝐠𝐞?
In the 1980s, disability activists argued common expressions such as “disabled person” equated the person with their disability.
Instead they proposed “person-first” language. Referring to someone as a “person with disability” puts their personhood in the foreground and doesn’t define them by their impairment.
Professional organisation soon adopted person-first language as preferred terminology. Guidelines for academic publishing and media reporting followed.
𝐓𝐡𝐞 𝐦𝐨𝐯𝐞 𝐭𝐨 𝐢𝐝𝐞𝐧𝐭𝐢𝐭𝐲-𝐟𝐢𝐫𝐬𝐭 𝐥𝐚𝐧𝐠𝐮𝐚𝐠𝐞
More recently there has been a backlash. Critics argue person-first language presents disability or mental illness as a devalued and peripheral aspect of the person.
US psychologist Louis Sass expresses this beautifully:
"𝘐𝘴 𝘴𝘤𝘩𝘪𝘻𝘰𝘱𝘩𝘳𝘦𝘯𝘪𝘢 𝘣𝘦𝘴𝘵 𝘤𝘰𝘯𝘤𝘦𝘱𝘵𝘶𝘢𝘭𝘪𝘻𝘦𝘥 𝘢𝘴 𝘢 𝘥𝘪𝘴𝘦𝘢𝘴𝘦 𝘦𝘯𝘵𝘪𝘵𝘺 𝘵𝘩𝘢𝘵 𝘤𝘰𝘮𝘦𝘴, 𝘢𝘴 𝘪𝘵 𝘸𝘦𝘳𝘦, 𝘧𝘳𝘰𝘮 𝘰𝘶𝘵𝘴𝘪𝘥𝘦, 𝘢𝘯𝘥 𝘸𝘪𝘵𝘩 𝘸𝘩𝘪𝘤𝘩 𝘵𝘩𝘦 𝘴𝘶𝘧𝘧𝘦𝘳𝘦𝘳 𝘮𝘶𝘴𝘵 𝘤𝘰𝘯𝘵𝘦𝘯𝘥, 𝘢𝘴 𝘸𝘪𝘵𝘩 𝘢 𝘣𝘶𝘳𝘥𝘦𝘯 𝘰𝘳 𝘢𝘯 𝘦𝘯𝘦𝘮𝘺? 𝘖𝘳 𝘪𝘴 𝘪𝘵 𝘣𝘦𝘵𝘵𝘦𝘳 𝘴𝘦𝘦𝘯 𝘢𝘴 𝘢 𝘮𝘰𝘳𝘦 𝘪𝘯𝘵𝘪𝘮𝘢𝘵𝘦 𝘧𝘢𝘤𝘵𝘰𝘳: 𝘴𝘰𝘮𝘦𝘵𝘩𝘪𝘯𝘨 𝘵𝘩𝘢𝘵 𝘦𝘮𝘦𝘳𝘨𝘦𝘴 𝘧𝘳𝘰𝘮 𝘸𝘪𝘵𝘩𝘪𝘯, 𝘱𝘦𝘳𝘮𝘦𝘢𝘵𝘦𝘴 𝘵𝘩𝘦 𝘷𝘦𝘳𝘺 𝘤𝘰𝘳𝘦 𝘰𝘧 𝘰𝘯𝘦’𝘴 𝘣𝘦𝘪𝘯𝘨, 𝘢𝘯𝘥 𝘮𝘶𝘴𝘵, 𝘱𝘦𝘳𝘩𝘢𝘱𝘴, 𝘣𝘦 𝘶𝘯𝘥𝘦𝘳𝘴𝘵𝘰𝘰𝘥 𝘢𝘴 𝘢𝘯 𝘢𝘴𝘱𝘦𝘤𝘵 𝘰𝘧 𝘵𝘩𝘦 𝘴𝘶𝘧𝘧𝘦𝘳𝘦𝘳’𝘴 𝘷𝘦𝘳𝘺 𝘴𝘰𝘶𝘭?"
Proponents of “identity-first” language say expressions such as “autistic person” recognise that some conditions are not external visitations but integral aspects of the individual.
The American Psychological Association endorsed identity-first language in 2020, and surveys show many neurodivergent people prefer it.
But more broadly, is person-first or identity-first language preferred?
𝐖𝐞 𝐬𝐭𝐮𝐝𝐢𝐞𝐝 𝐡𝐨𝐰 𝐩𝐫𝐞𝐟𝐞𝐫𝐞𝐧𝐜𝐞𝐬 𝐜𝐡𝐚𝐧𝐠𝐞𝐝
In our new study, we assessed the relative popularity of person-first and identity-first expressions for 15 mental health, disability and other conditions over 45 years.
We examined two vast English-language databases: the Google Books database (1980–2019) and the 23-billion-word global News on the Web collection of newspapers and magazines (2010–2025).
For each condition and year, we counted the frequency of four expressions: person-first or identity-first terms for individuals or groups of people.
For autism, for example, we counted “person with autism”, “autistic person”, “people with autism” and “autistic people”.
We then computed the relative popularity of person-first versus identity-first language when referring to individuals or groups.
𝐖𝐡𝐚𝐭 𝐝𝐢𝐝 𝐰𝐞 𝐟𝐢𝐧𝐝?
Despite increasing advocacy, there is currently no widespread preference for identity-first language.
At most, advocacy has slowed the rise in person-first language promoted by an earlier generation of advocates.
𝐖𝐡𝐞𝐭𝐡𝐞𝐫 𝐭𝐞𝐫𝐦𝐬 𝐫𝐞𝐟𝐞𝐫 𝐭𝐨 𝐢𝐧𝐝𝐢𝐯𝐢𝐝𝐮𝐚𝐥𝐬 𝐨𝐫 𝐠𝐫𝐨𝐮𝐩𝐬 𝐚𝐥𝐬𝐨 𝐦𝐚𝐭𝐭𝐞𝐫𝐬
When describing individuals, identity-first expressions have generally been more common. But person-first expressions are now equally popular.
When describing groups, person-first expressions now more common.
Mental health problems and disabilities are typically understood as aspects of personal identity rather than group identity. So it’s not surprising identity-first language is preferred when referring to individuals.
It makes sense to use “psychotic person” rather than “person with psychosis” but also use “people with psychosis” rather than “psychotic people” if we see psychosis as a personal experience, not a basis for shared identity.
𝐃𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞𝐬 𝐚𝐦𝐨𝐧𝐠 𝐜𝐨𝐧𝐝𝐢𝐭𝐢𝐨𝐧𝐬
These findings, based on averages, conceal large variations across our 15 conditions.
Identity-first language was consistently preferred for some conditions, such as alcoholism, anxiety and obesity.
Person-first language was consistently preferred for others, such as anorexia, bipolar, diabetes and epilepsy.
The conditions also show diverse patterns of change. In recent years, identity-first terminology has risen for autism and dyslexia, but person-first terminology has risen for bipolar, anorexia and obesity.
These findings indicate that terminological trends are quite specific to the condition.
𝐖𝐡𝐲 𝐦𝐢𝐠𝐡𝐭 𝐢𝐭 𝐝𝐞𝐩𝐞𝐧𝐝 𝐨𝐧 𝐭𝐡𝐞 𝐜𝐨𝐧𝐝𝐢𝐭𝐢𝐨𝐧?
Some conditions have become the focus of identity claims more than others.
The neurodiversity movement, for example, has promoted the view that neurodevelopmental conditions are inherent and valued aspects of the person. The rise in identity-first language for autism and dyslexia supports this possibility.
More broadly, whether we favour identity-first or person-first language for different conditions may depend on our beliefs about them. Do they represent identities or attributes: who we are or what we have?
Conditions that people see as biologically caused and enduring are more likely to be viewed as part of someone’s “true self”. We might expect identity-first language will be preferred for these conditions.
The language we use in this domain is not a collection of inert labels. It’s contentious and ever-evolving.
✍️ by Jemima Kang, PhD Candidate, School of Computing and Information Systems, The University of Melbourne
Alsa Wu, PhD Candidate, School of Psychological Sciences, The University of Melbourne
Naomi Baes, PhD Candidate and Computational Social Science Researcher, The University of Melbourne
and Nick Haslam, Professor of Psychology, The University of Melbourne
👉 Read more from The Conversation AU: https://theconversation.com/au
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