Is It Time to Drop the Term ‘Behavioral Health'?

As a youth living with mental health conditions, the child and adolescent behavioral health units at a local hospital were a space where I spent more time than I ever would have wanted to. As I struggled for my well-being and watched others fighting for their lives as we faced conditions associated with mortality by suicide, the term "behavioral" felt somewhat hurtful. Were we all misbehaving? Could we stop the act at any time if we wanted to? I only wished that were the case.

More Than Behavior

Today, the term "behavioral health" is commonly used as a synonym for mental health, particularly in inpatient treatment settings and spaces that service youth. Yet, often, conditions falling under the umbrella of behavioral health, including schizophrenia, bipolar disorder, ADHD, and others, involve much more than behavior. A person's entire experience of reality can be altered.

Compared to other branches of medicine, our understanding of mental health is mysterious. Despite mental health conditions like depression being the leading cause of disability worldwide, funding for mental health research has been lacking (Mahomed, 2020). This may make it easier to focus on what is easily observable from the outside: one's behavior. Nonetheless, reducing a person's psychiatric condition to behavior is in ways equivalent to reducing asthma to gasping for air: inaccurate, incomplete, and encouraging a dangerous understanding of what can be serious conditions.

Scapegoating Kids

Language shapes how parents, practitioners, and other adults interact with children diagnosed with mental health conditions. When something is described as behavioral, there is an implication of choice. Referring to mental health conditions as behavioral creates a framing that focuses on managing how a child is acting as opposed to improving their well-being.

A study utilizing the Attitudes About Child Mental Health Questionnaire (ACMHQ) revealed negative perceptions of the community toward both youth with mental health conditions and their families (Heflinger et al., 2014). The term behavioral health may only further these negative beliefs, particularly among individuals who are not aware of the complex biological, psychological, and social aspects of mental health. In addition, the term "behavioral health" places a spotlight on a child's behavior, which may present a risk of scapegoating the child when more complex dynamics may be at play.

At the very least, the term "behavior disorder" does not acknowledge the suffering of young people living with mental health conditions, and by highlighting behavior, it is likely to spotlight instead the comfort of adults with behaviors that may or may not be freely chosen: for example, by considering a child's pacing rather than the anxiety, trauma, or sensory needs that are driving the pacing.

Closing

Perhaps it is time that we drop the term "behavioral health." Today, we have more precise language, including mental health, psycho-social well-being, mental illness, psychiatric conditions, and neurodivergence, to explore the same