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“I Am Not a SCUT (or “Nuts” or “Daffy” or “Schizo”)” – personally speaking

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(Feb. 25, 2013) My antipathy to the linking pejorative terms to those of us with mental illnesses has a long history.

fred_freseI spent 20 years working as a psychologist/administrator in what was arguably then Ohio's largest state psychiatric hospital. Upon arriving there, just out of graduate school, I noticed it was customary to refer to the majority of patients as "SCUTs." From the view of the professional staff, SCUT was an acronym for "schizophrenia, chronic undifferentiated type." In the Webster’s dictionary a “scut” was defined at the time as either the rear end of a rabbit or a "despicable person."

I did not approve of the use of this term for our patients, but I did not seriously raise the issue until the data processing department came out with the hospital's official listing of our patients and officially categorized some 60% of them with the abbreviation, "SCUT."  When I saw this I "hit the wall", sending memos to the CEO with copies to everyone of influence I could think of, short of the governor. The resistance I received from the professional, as well as the administrative, staff for my outrageous act of rebellion was extremely intense. In the end, I was able to get the CEO to produce a “cease and desist” order concerning the official use of the term, SCUT, for the patients, but many on the staff never forgave me.

A few years later, the hospital was reorganizing and created "The Committee to Re-arrange Patients," commonly referred to by staff by its initials (the "CRAP" committee). When this came to my attention, I again launched into a ferocious campaign to condemn this reference to our patients as "crap." I, of course, also won this battle, but I heard that I started to develop as reputation among the staff as being "pro-patient." Needless to say, in the state hospital at that time, being thought of as pro-patient was not considered a compliment.

A few more years later, I found myself serving on the board of directors of the Ohio Psychological Association. One day, I found myself listening to the board members having a joyful time referring to the patients in the local "loony bin" as being "wacko." At one time these psychologists happened to have a small stuffed animal which, when beat on the head, would yell out "WACKO … WACKO" and would dart around the table. The psychologists were having great fun.

At that time, I was not open about my having been hospitalized for schizophrenia. But I did muster the courage to suggest that there was a fairly new organization for family members of mentally ill persons, called NAMI, and indicated that those folks might be offended by the psychologists’ activities and their use of the terms, "loony bin" and "wacko." One very senior member of the group immediately snapped, that if that is the case, then "some people are just too sensitive."

In my interactions with various fellow mental health advocates, I have developed a habit of going into "attack mode" whenever one of them uses a pejorative term for the mentally ill. They will usually say something like: "That drives me crazy" or "that's insane." When I hear mental health professions use these pejorative terms, I go on automatic “sham” rage and publically dress them down as though I had become their drill instructor in a boot camp somewhere. Usually they try to defend themselves, but I counter with something like, "And do you use the ‘n’ word as well –as in "N-U-T-S?"  

A few years ago I constructed a list of well over 100 terms I had heard mental health professionals use that I think most of us with mental illness would find objectionable. Read “Dr. Fred Frese’s Avoidable 111.” From “addle-brained” to “wacky,” what’s sobering is that the words and phrases all made the list because a mental health professional somewhere, sometime used them. 

FRED FRESE, Ph.D. 

Psychologist, advocate and Treatment Advocacy Center board member

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