Sociolinguistics of naming in Mental Health: ethics, identity, and the politics of labelling

This article explores the ethical, sociological, and linguistic dimensions of naming within mental health discourse, focusing on the tension between person-first language (PFL) and identity-first language (IFL). While PFL (e.g., “person with schizophrenia”) is promoted in clinical contexts to reduce stigma, IFL (e.g., “autistic person”) is increasingly embraced by neurodivergent and Deaf communities to affirm identity and autonomy. This divergence reveals a deeper conflict between institutional linguistic prescriptions and lived expressions of self-definition. Drawing on interdisciplinary frameworks - including labelling theory, discourse theory, affective psychology, and the philosophy of language - the article argues that psychiatric naming is never neutral. Diagnostic terms shape subjectivity, legitimise institutional power, and delineate the boundaries of inclusion and exclusion. Naming can produce stigma and shame or foster recognition and empowerment depending on context. A historical overview traces the evolution of psychiatric terminology - from early eugenic classifications to Kraepelin’s dementia praecox and Bleuler’s schizophrenia - revealing how language reflects shifting medical and political ideologies. Contemporary usage of psychiatric terms in popular discourse (e.g., “I am so OCD”) is critiqued for trivialising diagnosis and reinforcing stereotypes. Through cultural case studies, such as Disney’s renaming of the Seven Dwarfs and the institutional adoption of “Latinx,” the article highlights the risk of symbolic inclusion without participation. It introduces the concept of euphemistic erasure to describe how sanitised terminology can inadvertently marginalise the communities it aims to include. In response, the article proposes an ethical model of medical linguistics grounded in reflexivity, contextual appropriateness, and community agency. Rather than prescribing universal terminology, it calls for dialogical practices that treat naming as a relational and participatory act that must centre lived experience and epistemic justice.