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Relative visiting for mentally-ill patients: its possibilities and values as a treatment resource Petersen, Ronald Godfrey


Until recently, there has been only limited interest in the role of the family in the treatment and rehabilitation of the mentally ill. Although it is generally conceded that the interest and support of the family, except in some unusual cases, is of considerable help in the patient's treatment, little attention has been devoted to the subject of visits to mental hospital patients by relatives and friends. As a consequence, little is known about the specific effects of such visits and the types of patients who receive visitors. The present study examines mental-hospital visiting in terms of the therapeutic value of visits for patients, with attention directed to how visits by relatives assist social workers in providing treatment services to patients, and what determines how frequently a patient is visited. The material required for this investigation was obtained by a questionnaire distributed to Social Workers in the psychiatric facilities at Essondale and Weyburn Saskatchewan. This information was supplemented by conducting personal interviews with a small sample of patients and another of visiting relatives in the Provincial Mental Hospital, Essondale. Reference has also been made to a previous study of mental hospital visiting conducted at Weyburn, Saskatchewan. Terms such as "disculturation" and "desocialization" have been used to describe the submissiveness, loss of interest and deterioration of personal habits which may result from prolonged institutional residence. The introductory chapter reviews these effects, points up the need for maintaining the patient's contact with the family to help counteract these unintended consequences, examines the social worker's investment in maintaining the support of the family, and demonstrates how the hospital has changed its attitude from one of limited acceptance of visiting relatives to a much greater realization of their potentialities. The core material compiled from the questionnaire interviews, and reference to other surveys is analyzed under three headings: (a) visits of questionable value, (b) positive contributions, and (c) social worker's utilization of visits (Chapter II). The determinants of visiting are assessed by reference to (a) the causes of infrequent visiting, (b) the characteristics of frequently and infrequently visited patients, and (c) other comparable surveys of visited and unvisited patients (Chapter III). The conclusions are that visits can make a positive contribution to the patient's treatment. However, there are some situations in which their value is questionable; for example, visits may not be indicated when the patient is acutely ill, not accustomed to living in hospital, the relatives are unable to accept mental illness, or there is a tenuous relationship between patient and relatives. More often, visits contribute to the patient's treatment by reassuring him that he has not been forgotten by loved ones; helping him to overcome feelings of being an anonymous member of a large community of patients; reassuring him about home and family matters. Visits indirectly benefit patients through the efforts of social workers to employ their contacts with relatives to obtain social information, determine family resources, plan for discharge, prepare for follow-up, communicate information, alleviate stresses in the family situation, discuss treatment, and help the relatives to accept the patient. The study also demonstrates that visiting frequency is dependent upon a variety of factors, such as, the distance relatives must travel, the misconceptions, fear or shame about mental illness, unwillingness to accept the patient's return home, feelings of anxiety and guilt connected with the patient and his illness, loss of interest in the patients, pain or embarrassment connected with visits, the hospital's visiting facilities and regulations, and the attention given to visitors by staff. Infrequently visited patients spend more time in hospital, have fewer previous admissions, are older, and have relatives further removed from hospital. In conclusion, a number of recommendations are made for improving a hospital's visiting program.

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