What’s in a Name?

There is a trend around the country to use the words “behavioral health” when referring to mental health and substance use disorders. We read about a new behavioral health center, the behavioral health division inside a department of human services or the behavioral health workforce.

The rationale behind the use of this phrase is that it includes prevention and promotion of good health. It includes addressing behaviors that help people manage illnesses such as nutrition, exercise and sleep. But lately it’s used more broadly with even SAMHSA using it in this sentence: “Behavioral health treatments are ways of helping people with mental illnesses or substance use disorders. For example, counseling and more specialized psychotherapies seek to change behaviors, thoughts, emotions, and how people see and understand situations.”

I am not comfortable using the word “behavioral” when we are talking about treatment for mental illnesses. The word “behavior” implies that it can be changed through willpower. The dictionary lists the definition of “behavior” as the manner of conducting oneself or the response to the environment. Where else do we use the word “behavior”? Criminal behavior. Adolescent behavior. Human behavior.

What we are really talking about are “symptoms’ that need to be treated. I think using the word “behavior” adds to the misunderstanding and discrimination that people with mental illnesses already face. How many times have people with depression been told “snap out of it” or “you’re not trying” or worse? We don’t use the word “behavior” with other types of illnesses and yet we still look to promote prevention and good health.

Many years ago, there was a short national discussion as to what terms should be used. There was online voting, but frankly there wasn’t a firm conclusion. Despite this, the term “behavioral health” is being used with increasing frequency. I think it’s time we have this discussion again.