My Argument for Referring to the People I Work With as “Patients”

June 26, 2019

Mental health clinicians have specific, legal guidelines as to what we may call ourselves. “Psychiatrist” is reserved for someone who completed medical school, while “psychologist” is trademarked for professionals with a doctorate (PhD or PsyD) in clinical psychology. “Professional Counselors” and “Social Workers” are identified by the license they hold as well as the master’s degree they hold. There are also generic terms such as psychotherapist, therapist, mental health clinician, and the one I’m still shaking my head at (as suggested by one of my professors in graduate school) – “helper.”

But what’s not clear-cut is the term we use for the people we work with.

There are no legal or ethical guidelines to follow and, for the most part, it’s left up to the individual provider. The two most common terms are client and patient, with honorable mentions for “therapy partner” and “therapy collaborator” (as suggested by the same grad-school professor).

I have always used the term “patient,” much to the discontentment of many others – both in and out of the field of mental health. I even had a family friend tell me that if she heard her therapist refer to her as a patient she would be offended and never return.

Here’s my argument for why “patient” not only isn’t an offensive term, but in fact wields much power.

1. Patients are People Seeking Treatment

Raised in a family of medical doctors, I heard the term “patient” nonstop. I always knew it to be a term for someone under the care of a clinician. As a child I took this to mean medical doctors, but as I came to learn about nurses, physician’s assistants, radiologists, and all of the other people who encompass health care providers, I realized that identifying treatment-seekers as patients is more accurate. “Patient” comes from the Latin word patientem, meaning “bearing, supporting, suffering, enduring, permitting.” This description is accurate for anyone seeking health care, regardless of the provider.

2. Mental Health is Part of Health Care

Although it’s improving, there is still a social stigma about mental health. When patients tell me they need to cancel their appointment because they’re too busy or can’t take time off work, I ask if they would make the time if it was a broken leg or a nagging cough. Unfailingly they say yes. So, what’s the reason your physical health is more important than your mental health? I still haven’t received a good answer, because there isn’t one. I believe that when I describe the people I work with as patients this is one way I can advocate for mental health parity, or equal recognition and treatment of physical and mental health conditions.

3. Medicine Still Rules

Whenever I have a patient with physiological symptoms that are either unusual or common but more severe than typical, I always strongly encourage a patient to get a medical evaluation. This doesn’t mean I’m not going to address their mental health concerns; it just means we need to rule out physical issues before assuming they are psychosomatic. A few years ago, I started seeing a patient for emetophobia (fear of vomit). She described severe stomach aches, which could have been due to her anxiety or food restrictions to avoid throwing up. I referred her to a gastroenterologist and tests concluded she had gastroparesis. The condition was addressed with medication and she was able to engage in treatment without her severe physical symptoms interfering. A colleague recently discussed a case of a patient with Generalized Anxiety Disorder who had a recent uptick in the frequency and severity of violent thoughts as well as more issues with anger. A neurologist confirmed she had encephalitis, a diagnosis that if untreated could have been fatal. These are only two examples of people who had physical and mental health issues that required treatment. It doesn’t make sense to refer a “client” for a medical evaluation, or to ignore either the physical or mental health symptoms.