Most people have, at some point, worried about saying the wrong thing when it comes to mental health language. A friend is struggling, a colleague has been off work, someone in the family has started to withdraw, and you want to say something kind and useful, but the moment arrives and the words feel clumsy. So, you either reach for the familiar phrases, “stay strong”, “you’ll get through this”, “things could be worse”, or you say nothing at all.
For Steve Gilbert OBE, that hesitation is understandable. But it can also send people looking in the wrong direction. “There is no script,” he urged. “It’s not about the magic words.”
That might sound like a warning, but Gilbert meant it as something more hopeful. If there are no perfect words, then the task is not to perform expertise or prove how emotionally fluent you are. It is to be honest about what you do not know, thoughtful about the person in front of you, and clear that you care. Sometimes, he suggested, the most helpful thing you can say is also the simplest: “I’m really crap at talking about these sorts of things, but I just wanted to let you know that I’m thinking of you.”
For Mental Health Awareness Week 2026, that is a useful place to start, not with a list of words to remove from our vernacular, but with a more difficult and more generous question: what does our language tell someone about whether it is safe to be honest with us?
Language has consequences
Gilbert first became more conscious of language after being diagnosed with bipolar disorder in 2010. Like many people receiving a diagnosis, he started trying to understand what it meant, why the term had shifted from “manic depression”, what the clinical markers actually were, and how different words helped different people make sense of their experience. At the same time, he began noticing how casually those same words were used in everyday life, with people describing themselves as “a bit bipolar” because they couldn’t make a decision, or claiming to be “so manic” when they were simply busy.
The problem, he said, wasn’t simply inaccuracy. It was that these phrases took words he needed and made them less usable. “Being manic is a clinical symptom. It means something.” When terms like depression or mania become shorthand for moodiness or indecision, they lose their precision, and that matters when someone needs to use them seriously.
Labels can help, but they can also shrink people
None of this means mental health language should be stripped of categories. Labels can be necessary, and in healthcare they help people access the right support and connect with someone who understands a specific condition. The difficulty comes when the label starts to overtake the person.
After his diagnosis, Gilbert found that everything he did passed through an additional filter. If he laughed, people wondered whether he was becoming manic. If he was low, they read it only through the diagnosis. He is also wary of the long-running debate about terms like “patient” or “service user”, not because the question doesn’t matter, but because even a room full of people who access mental health services it rarely reaches consensus.
When crisis changes everything
The stakes around language shift sharply when someone reaches crisis. Gilbert recalled being assessed in a police station following use of Section 136 of the Mental Health Act, then being detained under Section 2 and conveyed to hospital by police. The officers got lost on the way and, though he knew the route, they ignored him. “I don’t even necessarily think it was about stigma,” he said. “I think it was about when you are labelled, that positions you in a way, and depending on who labels you, it has such power.”
In crisis, the language around someone changes very quickly, and a person who was being supported by a friend, partner or colleague is suddenly discussed about in terms of risk, capacity, assessment and detention. These words may be clinically and legally necessary, but they carry real weight. Gilbert described the experience as a shift from being a person to becoming either “a patient to be cared for or a problem to be contained,” and whether it feels like one or the other depends heavily on the environment, the staffing, and whether someone has been through crisis care before.
What makes it distinct from a physical health emergency is the locked door, the removal from familiar people and places, the language you hear spoken about you in the third person. Families and individuals may remember what decision was made, but they often remember more vividly how it was explained, or whether it was explained at all.
Genuine empathy, not performative sympathy
For people outside clinical settings, Gilbert’s message is not that they need to become experts. In fact, he was wary of conversations where the real purpose is for one person to demonstrate how compassionate or informed they are. “It’s not about you,” he said, with some emphasis.
What matters is context. Are you a close friend, a colleague, a neighbour? Has the person made it clear they want to talk, or have they signalled that they don’t? Gilbert drew a sharp distinction between empathy and sympathy: “I need your genuine empathy. I don’t need your performative sympathy.” One sits alongside someone and says, I may not understand, but I care. The other keeps them at a distance while performing concern from a safe remove.
This is why authenticity matters more than eloquence, and Gilbert was frank about his own history here. Before his diagnosis, he was one of the people who used language carelessly, who made things harder for others without realising it. “There was nothing virtuous about me,” he said. “I had to learn. And I had to unlearn and relearn.” By the time he needed to ask for help himself, he was partly reaping the environment he had contributed to, which is not a comfortable admission, but it is a generous one, because it makes the point without placing the burden entirely on other people. Most of us, he suggested, are somewhere on that same continuum.
Humour has its place in all of this, and Gilbert was clear that he is not fragile. British awkwardness can be useful, allowing someone to say honestly that they are not very good at this while still showing up. What it cannot be allowed to do is harden into the stiff upper lip that tells people to keep going when they are not okay. “It’s only okay to be vulnerable,” he said, “if in your community, in your space, we’ve created the environment to do so.” That is the real work, and it belongs to all of us, not just the people who already have the right words.
Steve Gilbert OBE has spent more than a decade working across mental health, race and public policy. Living with bipolar disorder and drawing on his own experiences of crisis care, he served as Vice Chair of the Independent Mental Health Act Review, helping shape recommendations to improve outcomes for Black African and Caribbean communities. He also works with Thalamos as a lived experience advisor as part of our Responsible Innovation Group, helping ensure patient and family perspectives inform how mental health services are designed and delivered.
If you or someone you know needs help
If someone is in immediate danger, call 999 or go to A&E. For urgent mental health support, call 111 and choose the mental health option, or visit NHS urgent mental health support. You can also contact Samaritans free, 24 hours a day, on 116 123.
If you want to learn more about mental health
If you want to better understand mental health, support someone else, or explore lived experiences in more depth, Rethink Mental Illness and the Mental Health Foundation both offer practical guidance, personal stories and evidence-based information.
