Our words matter: Glossary of terms

Someone with personal experience of mental ill-health, suicide or distress.¹

‘Living experience’ may be preferred by some people to indicate that the personal experience is current and not in the past.

Use upper case letters (Lived Experience) when writing about a person with a specific Lived Experience role or when referring to the Lived Experience workforce. Use lower case when writing to describe a person’s lived or living experience.

Alternative terms include:

• Personal experience
• Consumer (sometimes used to describe specific experiences within health services or in advocacy roles)
• Survivor/bereaved/carer (sometimes used in suicide prevention to describe specific experiences)

Usage guide:

• She has a living experience of alcohol dependence
• He has a lived experience of an eating disorder
• They have a lived experience of caring for a family member who attempted suicide.

Having experienced suicidal thoughts; survived a suicide attempt; cared for someone through suicidal crisis; or been bereaved by suicide. ²

‘Living experience’ may be preferred by some people to indicate that the personal experience is current and not in the past.

Alternative terms include:

• Personal experience
• Consumer (sometimes used to describe specific experiences within health services)
• Survivor/bereaved/carer (sometimes used in suicide prevention to describe specific experiences)

Usage:

• He has a lived experience of suicide attempt
• They have lived experience of suicide

The Aboriginal and Torres Strait Islander Lived Experience Centre (Black Dog Institute) developed the Aboriginal and Torres Strait Islander definition of lived experience.

A lived experience recognises the effects of ongoing negative historical impacts and or specific events on the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples. It encompasses the cultural, spiritual, physical, emotional and mental wellbeing of the individual, family or community.

People with lived or living experience of suicide are those who have experienced suicidal thoughts, survived a suicide attempt, cared for someone through a suicidal crisis, been bereaved by suicide or having a loved one who has died by suicide, acknowledging that this experience is significantly different and takes into consideration Aboriginal and Torres Strait Islander peoples’ ways of understanding social and emotional wellbeing.³

The act of purposely ending one’s life.

Suicide is complex and can have many contributing factors.

Alternative terms:

• Took their own life
• Died by suicide
• Ended their own life

Usage:

• Their colleague died by suicide
• They took their own life.

Any non-fatal behaviour aimed at purposely ending one’s life.

Thoughts about suicide.

These thoughts may vary in intensity and duration from fleeting thoughts to a complete preoccupation with wanting to die.⁴

While not all people who have thoughts about suicide will attempt or die by suicide, thoughts about suicide can be very distressing and should be taken seriously.

Alternative terms:

• Suicidal thinking
• Suicidal ideation (a clinical term that may be less understandable for a general audience)

Usage:

• They have thoughts of suicide

Thinking about or planning taking one’s own life (suicidal ideation) or attempting suicide. ⁵

Refers to a state or situation where someone is seriously contemplating ending their life or is planning to do so. ²

Deliberately injuring or hurting oneself, with or without the intention of dying.⁶

Self-harm is a complex interaction between an individual and the context they are in.

Alternative terms:

• Self-injury
• Self-harming behaviour

Usage:

• They self-harmed
• She was self-harming

The actions we take to prevent suicide and suicidal behaviours and to support people who have been impacted by suicide. These actions are focussed on reducing risk factors and enhancing protective factors.⁷

Activities or interventions occurring after a death by suicide to reduce the risk of further suicidal behaviour and to support and assist those bereaved or affected (family, friends, professionals, peers, responders, community) to cope with stressors and manage the experience of loss and grief. ⁷

Services that provide support to people following suicide attempt with the aim of increasing access to and engagement with care in order to prevent repeated self-harm. ⁸

Mental health is a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. ⁹

For some culturally and linguistically diverse groups, the word ‘mental’ may be taboo or have a negative connotation. A focus on wellbeing may be preferred.

Alternative terms include:

• Mental health and wellbeing

• Mental health and emotional wellbeing

• Social and emotional wellbeing

• Wellbeing of the mind

Usage guide

• I am looking after my mental health

• Eating well is a way of maintaining good mental health and wellbeing

In broad terms, social and emotional wellbeing is the foundation for physical and mental health for Aboriginal and Torres Strait Islander peoples. It is a holistic concept which results from a network of relationships between individuals, family, kin and community. It also recognises the importance of connection to land, culture, spirituality and ancestry, and how these affect the individual.¹⁰

Usage guide:

• Social and emotional wellbeing is the preferred term for many Aboriginal and Torres Strait Islander people and communities to describe the states labelled elsewhere as mental health and wellbeing, mental health concerns or mental illness.
• Social and emotional wellbeing may also be a preferred term for other people or communities.

Wellbeing encompasses the health of the whole person – physical, mental, social and emotional. A person’s wellbeing can change moment to moment, day to day, month to month and year to year. It can be influenced by what’s happening in a specific moment and the actions that people take.¹¹

Wellbeing may be preferred terminology when communicating with culturally and linguistically diverse audiences.

Distress has been used to describe non-specific symptoms of stress and concerns that affect someone’s thoughts and emotions. ¹²

First-person accounts have detailed the intense physical and emotional experiences associated with distress.¹³

Despite the intensity of these experiences, distress is often seen as ‘less serious’ in the eyes of the broader community and the service system, creating a disconnect between people who experience distress and what the word indicates to health professionals and others

Single words that may be used to describe this experience may be:

• Anxious
• Helplessness
• Pain
• Unrelenting

Terms used to describe ‘feeling’ experiences may include:

• Rising panic
• Feeling of dread or impending doom
• Spiralling
• Feeling out of control or like everything is falling apart
• Intense emotion
• Persistent worry
• Racing thoughts

Terms used to describe physical experiences may include:

• Being frozen or paralysed
• Breaking down in tears
• A rock on my chest
• Churning stomach
• Heart racing
• Hands shaking
• Limb weakness
• Can’t concentrate
• Lack of sleep.

A state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life.¹⁴

A clinical term used to describe the negative stress response, often involving negative affect and physiological reactivity: a type of stress that results from being overwhelmed by demands, losses, or perceived threats.

Alternative terms include:

• Mental distress
• Emotional pain

Usage guide

• They were experiencing psychological distress

The term “trauma” refers to experiences that cause intense physical and psychological stress reactions. It can refer to a single event, multiple events, or a set of circumstances that is experienced by an individual as physically and emotionally harmful or threatening and that has lasting adverse effects on the individual’s physical, social, emotional, or spiritual wellbeing.¹²

Alternative terms include:

• Trauma experience

Usage guide:

• Be hesitant about labelling others' experiences of trauma
• The situation contributed to their experience of trauma.

Mental ill-health is an umbrella term often used in policy documents and prevention work to describe both mental health concerns and mental illness.

While it is currently used by governments and organisations, it is not a preferred term to be used in community or with people who have personal or lived experience.

As the term is used differently by different stakeholders, it is necessary to consider the context in which it is used and check preferences of your audience. If used, the term ‘mental ill-health’ should be used as an umbrella term rather than to refer to mental health concerns or mental illness individually.

For some culturally and linguistically diverse groups, the word ‘mental’ may be taboo or have a negative connotation. A focus on wellbeing may be preferred.

A mental health concern can interfere with how a person thinks, feels and behaves, but not to the extent that it meets the criteria for a mental illness diagnosis.¹⁴

Mental health problems are more common and likely to resolve in time, but if a mental health problem persists or increases in severity, it may develop into a mental illness.

Alternative terms include:

• Mental health challenges
• Mental health issues
• Mental health hurdles
• Mental health difficulties.

A mental illness is the most commonly used term to describe conditions diagnosed by a medical professional that significantly affect how a person thinks, feels and interacts with other people.

Mental illnesses, such as depression, anxiety, schizophrenia and bipolar disorder are diagnosed according to standardised criteria.

Alternative terms include:

• Mental disorder
• Mental health diagnosis

Usage guide:

• A person living with mental illness
• He has a mental illness diagnosis

The word psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. When someone becomes ill in this way (experiencing delusions and hallucinations) it is called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed, and the individual may have difficulty understanding what is real and what is not.

Psychosis may be a symptom of a mental illness, such as schizophrenia or bipolar disorder. However, a person may experience psychosis and never be diagnosed with schizophrenia or any other mental disorder. It can occur as a result of both mental and physical health conditions.

Other causes of psychosis:

• Sleep deprivation
• General medical conditions
• Certain prescription medications
• Misuse of alcohol or other drugs

Usage guide:

Psychosis tends to be overly and incorrectly associated with mental illness and violent or anti-social behaviour.
Psychosis is not a permanent thing and can be referred to as an ‘episode’.

• They were experiencing psychosis
• They have lived experience of psychosis
• They have symptoms of psychosis
• The person was having a psychotic episode

Use of AOD that leads to immediate or long-term harm, resulting in changes in perception, mood, consciousness, cognition or behaviour.¹⁵

This includes use of:

• Alcohol
• Tobacco
• Illegal (known as illicit) drugs including cannabis, cocaine, heroin and amphetamine-type substances
• Pharmaceuticals and other drugs that alter brain function.

Alternative terms include:

• Alcohol and other drug use
• Substance use
• Non-prescribed use
• Non-medical use

Usage guide:

• Person who uses alcohol and other drugs
• Person currently using drugs/alcohol

Substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences.¹⁶

Alternative terms include:

• Substance use disorder
• Dependence
• Addiction (a clinical term used to describe a condition where someone continues to engage in a behaviour despite experiencing negative consequences)

Usage guide

• Person experiencing addiction
• Person with a dependence on drugs or alcohol

Disordered eating is a disturbed and unhealthy eating pattern that can include restrictive dieting, compulsive eating or skipping meals.¹⁷

Disordered eating behaviours, can be a pathway to an eating disorder. There is a wide spectrum between healthy eating behaviours through to a clinically diagnosed eating disorder.

Usage guide:

• I have a lived experience of disordered eating that progressed into an eating disorder.

Eating disorders are complex mental illnesses with serious physical consequences. The term ‘eating disorders’ covers a range of distinct disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, atypical presentations of each and avoidant/restrictive food intake disorder (ARFID).^{17 18}

Body image is a combination of the thoughts and feelings that you have about your body. Body image may range between positive and negative experiences, and one person may feel at different times positive or negative or a combination of both. Body image is influenced by internal (e.g. personality) and external (e.g. social environment) factors.¹⁸

The disapproval of, or discrimination against, an individual or group based on characteristics that serve to distinguish them from other members of a society. Stigma is complex and can result from negatively stereotyped characteristics, attitudes and responses that harm a person’s day-to-day health and wellbeing by excluding, devaluing or shaming them.¹⁴

Self-stigma – The process in which a person with personal lived experience becomes aware of public stigma, agrees with those stereotypes, and internalises them by applying them to the self. The person comes to believe these negative messages or stereotypes about mental ill-health and applies these to themself.¹⁴

Negative thoughts, feelings and behaviours held or expressed by individuals towards people who experience mental ill-health. As a result of public stigma, people living with mental ill-health are negatively categorised, othered, and lose status and power in society. This leads to widespread discrimination against people with mental ill-health, which limits a range of life opportunities.¹⁴

The non-medical factors that influence health and wellbeing outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider systems that shape the conditions of daily life. This includes economic policies and systems, social norms and policies, as well as political systems.¹⁹

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress. This may include family and relationship problems, serious health problems or workplace and financial stressors.¹²

The process of a person actively asking for help or support in order to cope with adverse circumstances or problems. Help-seeking behaviour involves being able to recognise and express symptoms or problems as well as an understanding of how to access support and a willingness to do so.

Alternative terms:

• Seeking help or support
• Accessing support

While there is no single description or definition of recovery because recovery is different for everyone, recovery often refers to being able to create and live a meaningful and contributing life in a community of choice with or without the presence of a mental health or AOD concern.

Central to all recovery paradigms are hope, self-determination, self-management, empowerment and advocacy.

A person’s right to full inclusion and to a meaningful life of their own choosing, free of stigma and discrimination is also vital.¹⁴

Harm reduction refers to public health measures designed to reduce the negative individual or social effects associated with drug use.

According to the International Harm Reduction Association, it’s defined as policies, programmes and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. The defining features are the focus on the prevention of harm, rather than the prevention of drug use itself, and the focus on people who continue to use drugs.

It includes needle and syringe programs, opioid substitution therapy, medically supervised injecting spaces, decriminalisation of personal use and drug checking (pill testing) services. ²⁰

A process whereby traditional experts work in equal partnership with people with lived experience to ‘design’ a service or service improvement. The core co-design principle of power sharing is especially significant in the context of suicide prevention where people with lived experience have been disempowered by their experiences of stigma and discrimination.²

Refers to an organisational or practice approach to delivering health and human services directed by a thorough understanding of the neurological, biological, psychological and social effects of trauma and its prevalence in society. It is a strengths-based framework that emphasises physical, psychological and emotional safety for consumers, their families, carers and service providers. ^{14 21}