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Over the last decade or so there has been a landmark move away from names like "crazy," or "nuts" to designate mental disorders and toward an "illness" model instead. While this step has been inordinately helpful in ridding mental disability of the stigma from which it has suffered, the medical community may have gone too far by "destigmatizing mental illness by showing that they are brain disorders." (Rex Coudry, M.D., NAMI, Medical Advisor, NAMI Advocate, Aug/Sept.) The illness model separates the disabled from the rest of the family, for example, by serving as the "identified patient," providing an easy victim for family problems when the struggle is system-wide. It also fosters an attitude of helplessness and passivity toward an "illness" that needs treatment or a cure rather than an intellectual, emotional and/or spiritual struggle that requires help integrating within himself or with others in society.

If one is "ill," technically one doesn't have to "do" anything. One is treated, one is cured. A sick person also lets others off the hook. I could quote people, and myself, who have literally been met with the response, "Oh, he is just sick, don't listen to him; his opinions don't matter" -- and I experienced the stigma of my father who, when I was angry at him, said, "Have you been taking your medication?" (which sentiment goes of course in a circle of helpless rage, increasing it even more).

Admittedly, there is some truth to the label of mental disability -- "crazy" and "nuts," as well as mental "illness" -- i.e. the very real perceptual difficulty of psychosis, anxiety disorders, OCD and more. Some individuals need to be confined and protected and most can use medication. Only by being viewed nonjudgmentally can these patients receive the treatment they need, with kindness instead of some of the barbaric treatments of the nineteenth century, or the abuses of medication.

Mostly, however, the mentally disabled need to be coaxed to function in society -- a riddle which even the "healthiest" find difficult -- and also to be taken seriously; and to participate in their treatment as much as possible, both in their therapy and their medication.

We gave up the model of "mentally crazy" to "mentally ill" to avoid the stigma the former term created for the "client" (even the word "patient" is too charged). Now, with what do we replace the term, "mentally ill?" Until we find a way to encapsulate "human being striving to find a model for his struggles toward self-actualization -- to move beyond incarceration and medication" -- we must find out who we can be, and be it.