A New Zealand language guide rewrites "resistant to treatment" and "lacks insight" as what the person chooses and sees

"Tony lacks insight," reads the left-hand column. The right-hand column offers "Tony has his own different view of things than we do." The comment beside it: "Insight is subjective. Tony may not see what you see but he has insights of his own. He doesn't lack insight; he has different ones."

The row comes from Words can heal, a seven-page guide Te Pou published on 9 April 2025 for kaimahi, the people who work in New Zealand's mental health and addiction services. The table opens with a reason: these words "place judgment and blame on the individual and generalise their actions", and describing the specific situation a person faces is more helpful than "generic and potentially punitive seeming clinical terms".

Resistance, compliance, insight

"Mele is resistant to treatment" becomes "Mele chooses not to…", "Mele prefers not to…" or "Mele is unsure about…", and the comment says to remove the blame. "Rawiri is non-compliant" becomes "Rawiri is choosing not to…" or "Rawiri is looking for other options", and the comment asks whether Rawiri has the lead in the treatment or recovery plans the service initiates. "Tom is very difficult" turns into "I am finding it challenging to work with Tom", since the judgment may rest on the clinician's unmet expectations.

The word metaphor appears nowhere in Te Pou's text; the reading that follows is mine. "Resistance" is a picture of a struggle. One force presses, another pushes back, and whoever writes the word has already placed the clinician on the pressing side. "Insight" is a picture of sight, so "lacks insight" describes a person blind to what the observer can see. Te Pou's replacements make one grammatical move: the patient becomes the subject of a verb of choice or view – chooses, prefers, is unsure, has a view – and the struggle and the blindness leave the sentence together with the blame.

Risk and control

Tāngata whai ora Māori, Māori who use services, are 6.5 times more likely to be secluded than non-Māori. Te Pou cites that figure, from a Ministry of Health regulatory report for July 2022 to June 2023, in a companion evidence update dated 29 April 2025, The importance of language in least restrictive practice. The update argues that staff attitudes and workplace culture bear on least restrictive practice, so how staff talk about seclusion and restraint can influence how likely they are to be used. "How do we manage Michael's risks?" and "How do we maintain control of the situation?" become "What could help Michael feel safe and supported?" and "What is Michael's wellness plan or advance directive?", with a request to avoid language that implies control and coercion.

"Manage" and "maintain control" belong, to my ear, to the vocabulary of equipment. In "How do we manage Michael's risks?" Michael is a hazard, and the question is asked about him without him.

Words can heal says that what is written in a person's notes dictates how the next worker sees and interacts with them. Before signing a note, search it for the words of struggle, sight and control – resistant, non-compliant, lacks insight, manage, control – and replace each with what the person did, said or declined and the reason they gave. Te Pou also suggests writing the note together with the person.