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The concept of stress in the experience of relatives of Crease Clinic patients : a study of the subjective responses of relatives to the hospitalization and the post hospital period of psychiatric patients Reid, Birnie Ella

Abstract

Psychiatrists and social workers are aware of the existence of relatives when a patient is hospitalized in a psychiatric treatment centre. Current research points to the importance, in the patient's environment, of many variables, and among these, the presence of relatives who inter-act with the patient is one which may have a significant bearing upon the outcome of treatment. This thesis examines the stress factors which influence the relatives behavior toward the patient, as they arise from the fact of hospitalization at the Crease Clinic of Psychological Medicine, and from the subsequent period of post hospital adjustment. Literature on the subject of environment in relation to personality has been consulted, and nine families were studied. The main technique employed was the structured research interview with the relatives. Supplementary information was obtained from a review of the Crease Clinic files on the patients, and from discussion with the caseworkers and the casework supervisor. The information obtained from the interviews concerned the relatives' responses to the fact of hospitalization, to their understanding of mental illness, and to the practical problems and emotional stresses of the rehabilitation period. The sample group was divided into two groups, wives and mothers, to examine the effect of family structure in the patient's post hospital experience. The sample also contained a number of cases receiving social casework services, but no conclusions could be reached in regard to this variable owing to the difficulty in placing specific research focus on this factor while examining the stress areas. The study reveals that the relatives of mentally ill patients experience stress in two phases, that of hospitalization and that of the post hospitalization period. In the first, stresses centre around fear of mental illness, the kind of hospital required, and the relative's isolation from the treatment program. In the latter phase, stresses originate in two sources, practical problems such as employment or housing, and the role relationships with the patient. The most forceful stresses are connected with interrelationships, and there are differences between the group of wives and the group of mothers in this regard. The results indicate a need for more family oriented casework both in hospital and community. Present trends to treat the patient in the community find support in the study.

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