This study examines the attitudes and difficulties that junior medical staff, working in the emergency department of a teaching hospital, have in relation to psychiatric disorders.
Method:
Systematic textual analysis of nine in-depth interviews.
Results:
Three major categories identified were emotional difficulty with patient interaction, uncertainty and pessimism.
Conclusion:
Those doctors able to self reflect and adjust their level of emotional distance appropriately had less emotional difficulty interacting with psychiatric patients. They were also more comfortable in dealing with the issue of uncertainty associated with psychiatric disorder. There was a worrying level of pessimism regarding prognosis in psychiatric disorder.
Commonwealth Department of Health and Family Services.Community attitudes to mental illness: Quantitative research report.Canberra: AGPS, 1993.
2.
SivakumarK, WilkinsonG, TooneBK. Attitudes to psychiatry in doctors at the end of their post-graduate year: two-year followup of a cohort of medical students. Psychological Medicine1985; 16: 457–460.
3.
FarinaA, HagelauerH, HolzbergJ.Influence of psychiatric history on physicians' response to a new patient. Journal of Consulting and Clinical Psychology1976; 44: 499.
4.
GoffmanE.Stigma: Notes on the management of the spoiled identity.London: Penguin, 1963.
5.
WhatleyD.Social attitudes toward discharged mental patients. Social Problems1959; 6: 313.
6.
ZahnM.Incapacity impotence and invisible impairment: their effects upon interpersonal relations. Journal of Health and Social Behaviour1973; 14: 115.
7.
BoyseyM.Impression management by parents with disabled children. Journal of Health and Social Behaviour1975; 13: 80; and StraussA. Chronic Illness and Quality of Life. C.V. Mosby, St Louis, MO: 1975.
8.
RichardsonS.Attitudes and behaviour toward the physically handicapped. Birth Defects Original article series. 1976; Hopper S. Diabetes as a stigmatizing condition: the case of low-income clinic patients in the United States. Social Science and Medicine1981; 15: 11.
9.
BeckerG.Coping with stigma: lifelong adaptation to deaf people. Social Science and Medicine1981; 15: 21.
10.
DavisF.Deviance disavowal: the management of stained interaction by the visibly handicapped. Social Problems1961; 9: 121.
11.
PollackS, HuntleyD, AllenJ, SchwartzS.Dimensions of stigma: the social situation of the mentally ill person and the male homosexual. Journal of Abnormal Personality1976; 85: 105–112.
12.
JonesE, HesterS, FarinaA, DavisK.Reactions to unfavorable personal evaluations as a function of the evaluator's perceived adjustment. Journal of Abnormal and Social Psychology1959; 59: 363–370.
PhillipsD.Rejection of the mentally ill: the influence of behaviour and sex. American Sociological Review1964; 29: 679–687.
15.
LawnerP.Unfavorable attitudes and behaviour toward those bearing mental illness stigmas. Unpublishe. MA thesis. University of Connecticut, 1966.
16.
RayneJ.The effect of perceived attitudes on expectancy for punishment by psychiatric patients. Unpublished doctoral dissertation, University of Connecticut, 1969.
17.
WeinsteinR.Stigma and mental Illness: theory versus reality. Orthomolecular Psychiatry1982; 11: 87–99.
18.
StraussA, CorbinJ.Basics of qualitative research: Grounded theory procedures and techniques.California: Sage, 1990.
19.
BrittenN.Qualitative interviews m medical research. British Journal of Psychiatry1995; 311: 251–253.
20.
FontanaA, FreyJ.Interviewing: the art of science. In: DenzinN, LincolnY, eds. Handbook of qualitative research.London: Sage, 1994; 361–376.
21.
RabkinJ.Public attitudes toward mental illness: a review of the literature. Schizophrenia Bulletin1974; 1: 9–33.
22.
WeinsteinR.Labelling theory and the attitudes of mental patients: a review. Journal of Health and Social Behaviour1983; 24: 70–84.
23.
ScheffT.Social support for stereotypes of mental disorder. Mental Hygiene1963, 47: 461–469.
24.
LehmanM.Psychiatry in the public eye. Psychiatric Opinion1978; 26–31.
25.
LyonsM, ZivianiJ.Stereotypes stigma and mental illness: learning from fieldwork experiences. The American Journal of Occupational Therapy1995; 49:1002–1008
26.
McLeanA.Contradictions in the social production of clinical knowledge: the case of schizophrenia. Social Science and Medicine1990; 9: 969–985.
27.
SchwartzR, SchwartzI.Reducing the stigma of mental illness. Diseases of the Nervous System1977; 38: 101–103.
28.
RomanP, FloydH.Social acceptance of psychiatric illness and psychiatric treatment. Social Psychiatry1981; 16: 21–29.
29.
LinkB, CullenF.Contact with the mentally ill and perceptions of how dangerous they are. Journal of Health and Social Behaviour1986; 7: 289–303.
30.
PennD, GuynanT, DailyT.Dispelling the stigma of schizophrenia: what sort of information is best?Schizophrenia Bulletin1994; 20: 567–578.
31.
HuxleyP.Location and stigma: a survey of community attitudes to mental illness part 2: community mental health facilities - anonymity or invisibility. Journal of Mental Health1993; 2: 157–164.
32.
AlbrechtG, WalkerV, LevyJ.Social distance from the stigmatized. Social Science and Medicine1982; 16: 1319–1327.
33.
WahlO, HarmanC.Family views on stigma. Schizophrenia Bulletin1989; 15.
34.
FabregaH.Psychiatric stigma in the classical and medieval period: a review of the literature. Comprehensive Psychiatry1990; 31: 289–306.
35.
WalterG.The attitude of health professionals towards carers and individuals with mental illness. Australasian Psychiatry1998; 6: 70–72.
36.
GoveW, FainT.The stigma of mental hospitalization. Archives of General Psychiatry1973; 28: 494–500.
