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The interpretation of stress in relation to families of hospitalised mental patients : an exploratory analysis of a sample of mentallly ill patients and their closest relatives, Crease Clinic, Vancouver, 1962-1963. Sharpe, Francis Noel Brian

Abstract

The complexities of man's current social universe permit little opportunity for him to function in a social environment that is undergoing constant change, without experiencing stress. Those who are unable to adapt or adjust to the stresses of modern living fall prey to the ravages of mental illness. Changing professional perspectives and the research of social scientists are re-awakening professional eyes to the significance of the patient in relation to his social environment. The experience of mental illness and all its ramifications are also the experience of those who shared in a reciprocal role relationship to the patient. Isolation - the remedy of old - today is a lost cause. For social work, current theories of social dynamics promise to add a new dimension, by which to understand the social structure of the mentally ill person and those who interact with him. The new theory requires inspection and testing. This thesis is an attempt to examine some of the clinical applications of a theory that might well have great consequences for social casework. Social role theory is reviewed as background, and the concepts of role and stress are explored in relation to the family, when one of its members becomes mentally ill and requires hospitalisation. To examine clinically the effects of hospitalization on family and patient, using role concepts, a small group of families was selected and studied. Structured interviews were used to elicit both descriptive details and feelings about the family, as well as the meaning and effect of hospitalisation. The sample group was drawn from both female and male sections of the Crease clinic of Psychological Medicine; and, where possible, both the patient and a reciprocal (close relative) were interviewed. The questions were directed particularly to roles and relationships before and after admission. The study reveals that patients and their reciprocals experienced stress in two phases: (a) when the patient is mentally ill, but living at home and (b) when the patient has been hospitalised. In the former, stress centres around changes in perception and performance in an effort to continue functioning, in spite of the maladaptive roles of the mentally ill family member. In the latter, stress centres around the absence of the family member, whose absence displaces role and relationships upon which the social structure of the family network is highly dependent. The study also reveals that hospitalisation is relieving for both patient and reciprocals, and in some cases leads to the resumption of certain roles discarded during the presence of the mentally ill member at home.

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