Perceptions and expectations of hospitalisation and attitudes towards mental illness : a study of first admission psychiatric patients in Edinburgh, Scotland and St John's Newfoundland
Attitudes and perceptions of patients admitted to a psychiatric facility
for the first time were investigated with a view to considering the
applicability of psychiatric/sick role and labelling perspectives to the
subjective experience of becoming a psychiatric patient.
In-depth semi-structured interviews were conducted with 100 first
admission patients admitted to the Royal Edinburgh. Hospital, Edinburgh,
Scotland, and Waterford Hospital and the General Hospital Health Sciences
Centre Psychiatric Unit, St John's, Newfoundland. The subjects were
interviewed within the first few days of their stay in hospital.
The thesis examines: these subjects' perceptions of the process
leading to their psychiatric admissions; their views of the causes,
course and nature of mental illness and of their own conditions; their
expectations and perceptions of the psychiatric facilities and their
understanding of their role as psychiatric patient; and their attitudes
towards the stigma associated with mental illness and psychiatric
hospitalisation and their plans to deal with this issue.
The following emerged: a majority of the subjects entered hospital
willingly, described mental illness and the mentally ill in an 'informed'
way or in a way not implying socially unacceptable behaviours or conditions,
and did not plan to actively conceal that they had been patients in a
psychiatric hospital. There was a relationship between some of the views
expressed. A core group of 32 held all three of these positions and
these subjects had a higher level of education, were older and more were
currently in employment compared to the rest of the sample.
The subjects responded differently to the label of mental illness.
However each response indicated an attempt to maintain a positive self
identity. In addition a wider range of disorders were identified as in
need of psychiatric attention than the literature would suggest.
Most subjects were satisfied with the hospital environment. A passive
view of the patient role was widespread but this did not indicate
resistance.
A psychiatric/sick role perspective better explains these subjective
experiences of becoming psychiatric patients than does labelling theory.
However there was a wide recognition of stigma. Almost half of those
advancing an 'informed' view of mental illness planned to conceal that
they had been in hospital because they might be stigmatised. This may
reflect a realistic appraisal of the existence of discrimination