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March 1, 2006
by Douglas J. Edwards, Editor-in-Chief
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A few months ago, I was editing one of William Anthony and Lori Ashcraft's Tools for Transformation columns and was surprised by their frequent use of the word “person.” I asked the authors if they might consider using “consumer” or “client” occasionally to avoid redundancy (as any good editor would suggest). But Lori told me: “The reason we use ‘people’ is that language is a huge factor in the recovery movement. People who used to be comfortable with the title of ‘client’ or ‘consumer’ no longer like to be referred to this way. They are trying to rise to the level of being a ‘partner’ in their treatment process. ‘Client’ infers that someone else is in charge; ‘consumer’ infers that the person is just taking, instead of participating, contributing, and taking responsibility for their recovery process.”

This was definitely an eye-opener for me, and Lori and Bill will expand on this concept in a future column.

As an editor, I won't be changing every mention of “patient,” “consumer,” or “client” to “person,” for I value an author's original language and understand that these terms are recognized and often deemed appropriate. But I think this discussion really drove home to me that the nuances of language affect how people receive behavioral health services. I have previously reflected on the use of language to describe the behavioral healthcare field itself (see the May/June 2005 issue of Behavioral Health Management, p. 49), and now I recognize how language can be important to individuals in recovery.

Because of my own struggles with mental illness, “recovery-based” language has particular importance to me. For a long time I thought mental illness would be something I would have to live with forever. But the concept that I am a person in charge of my own life and care who can recover—that a mental illness doesn't have to run my life—is incredibly uplifting. For people suffering from psychiatric conditions, recovery is indeed an incredible concept.

Behavioral health thought leader Ron Manderscheid, formerly with SAMHSA, sees his work of empowering people with mental illness to take a greater role in their care as one of his greatest achievements. You can learn more about Ron and his role in promoting these ideas in my profile of him on p. 20. And I'm pleased that we're featuring the Mental Health Center of Denver's award-winning recovery work with people who are homeless and have mental illnesses (p. 21). As the article points out, reimbursement systems often are not designed for recovery-based services, making this care even more difficult to deliver. This is one of the main problems facing recovery-based services and is one of the field's main challenges in the coming years. But clever leaders will find a way to make recovery acceptable to all behavioral health stakeholders. Or at least I hope they will, for people like me are depending on them.

Douglas J. Edwards, Editor-in-Chief
P.S. How can providers make recovery-based services more palatable to payers? E-mail me at