The words we use: Why inclusive language in health care is about safety

Discharge notes, public health posters and so-called patient-friendly pamphlets often are the first points of contact between people and the health-care system. Too often, however, these materials rely on language that excludes more than informs – cold, clinical or carelessly stigmatizing words that can make a person feel more like a diagnosis than a human being.

Canada is home to hundreds of languages, and nearly half of Canadians struggle with health literacy. Medical speak can be exclusionary, with too much jargon.

The simple truth is, if your message can’t be understood, it can’t build trust.

That tension motivated us through the development of the Centre for Addiction and Mental Health’s (CAMH) new Clear and Inclusive Writing Guidelines, out next year. Together, we worked with more than 50 contributors across CAMH, from patients and caregivers to clinicians and community members, to inform how Canada’s largest mental health hospital communicates. This model reflected how inclusive communication doesn’t belong to one department – it belongs to all of us.

We learned through this process that language isn’t just a communications tool, it’s a trust-building tool. And when health-care institutions get it wrong, the consequences aren’t just stylistic, they’re structural. They’re personal.

Every group we spoke to during the consultation phase clearly stated that people often soften their words to avoid offending others, even if it means minimizing their own pain or lived experience. Not out of confusion, but out of caution.

Our biggest takeaway was that rather than using the one-size-fits-all rule, it’s best to ask people the language they prefer, and then use that language. For instance, some people who are autistic prefer to call themselves an “Autistic person,” capital A included. For others, a “person who has autism” is preferred. While patterns in language emerge in communities, no one person can represent everyone from an identity group.

To use language inclusively, you need to listen to who you are describing. It’s not about political correctness. It’s about accuracy and dignity.

But the language in many settings is still deeply stigmatizing. We heard example after example of outdated or harmful terms still being used in health systems today. For instance, people with substance use concerns are still regularly referred to as “addicts,” or “drug users.” These labels reduce people to their most vulnerable moment.

Alongside many hospitals and organizations, CAMH has adopted one small shift that can make a big difference – moving away from labels. Instead of saying “an addict,” say “a person with a substance use disorder.” This is called person-first language.

Many of our collaborators have heard terms that worsen stigma about mental health. Individuals experiencing psychosis are often called “unstable” or “psychotic,” despite the fact that these terms carry a long history of harm and misunderstanding. People living with bipolar disorder or schizophrenia may be harmfully described as “manic,” “dangerous” or “off their meds.” Clinical terms like “non-compliant” are used to describe patients who may be self-advocating or navigating trauma-informed care in their own way. And from people diagnosed with personality disorders, we heard labels like “difficult” or “unreliable” can even affect access to treatment.

Sometimes these terms are used out of habit. Sometimes due to ignorance. Sometimes with malice. But the effect is always the same: patients feel reduced, misrepresented or shut out entirely. This isn’t just about word choice – it’s about power, perception, and whether people feel safe enough to show up honestly in their care.

That truth alone reveals how urgently we need to shift how we communicate in care settings. If we want people to show up fully, they need to know they’ll be met with understanding – not assumptions. Our language needs to reflect this openness and acceptance. This was the approach we took with CAMH’s Clear and Inclusive Writing Guidelines because changing the language we use is a meaningful way to change how people feel in a system.

When planning this project, we knew that we couldn’t talk about inclusive writing without reflecting the principles in our own work. An inclusive writing guide needs to be shaped by the people it’s meant to serve, and that meant building a process rooted in co-creation.

We moved beyond fixed titles or traditional hierarchies. Whether someone was a patient advisor, caregiver, researcher or clinician, every contributor’s voice carried equal weight. Instead of labelling someone strictly as a “patient” or a “clinician,” we honoured all expertise – lived, professional or both. Our team approached our collaborators’ experiences with an openness to learning the language of inclusion while helping others feel seen.

This collaboration had a positive effect beyond the creation of the guide. Our collaborators spoke of the effect on their healing journey, how exploring the most sensitive and accurate language to describe their experiences gave them power. Collaborators spoke openly about substance use, mental health and disability in a way that often felt difficult in other settings. This was due to an effort to find the right words, a willingness to listen and learn, and to work toward respectful language together, even when it didn’t come easily.

We will be presenting our process at the Where’s the Patient Voice in Health Professional Education conference in Vancouver Nov. 12-15. We hope CAMH’s Clear and Inclusive Writing Guidelines will help to spark broader conversations across the country – and serve as a model for what’s possible when patients are not just consulted, but co-creators.

Inclusive language is a living practice. Let’s treat it that way – with care, intention and the humility to keep learning.

CAMH’s Clear and Inclusive Writing Guidelines is a digital tool and PDF document. This resource recommends inclusive practices and style guidelines for CAMH staff writing health materials and communications across the hospital, ensuring language is respectful, accurate, clear and consistent. Coming in 2026 through CAMH Education.