Abstract
Aims: To compare the initial attitudes of nurses and other professional groups in a psychiatric hospital towards the legal representation (LR) of involuntary admitted psychiatric patients before District Psychi- atric Boards (DPB), and to assess how these attitudes changed after LR had become an everyday routine practice in the hospital. Background: LR of hospital- ized psychiatric patients before DPB has been intro- duced into mental health system worldwide, include- ing Israel. Attitudes of psychiatric staff towards LR and their changes over time are a very important -though unstudied issue. Methods: Thirty seven psy- chiatric nurses employed in the Tirat Carmel Mental Health Center, Israel and 30 other mental health professionals (comparison group) completed the At- titudes to Legal Representation Questionnaire before LR has been instituted in the Center (November 1, 2006) and one year later. Baseline differences be- tween the groups were tested using one-way ANOVA, and pre-post differences in the attitude scores were tested by paired t-tests. Results: Baseline psychiatric nurses attitudes towards LR were significantly more negative than those of the comparison group (F67,3 = 6.87, p < 0.0001), but they significantly improved over the study period (t37 = 2.56, p = 0.015). Conclu- sion: Yearlong, routine exposure to the LR of invol- untarily admitted psychiatric patients may attenuate negative nurse beliefs and attitudes towards LR of such patients at DPB hearings. The more positive attitudes may enhance the nurses' ability to present information about patients without jeopardizing their human and civil rights, and help patients to attain a greater sense of control over their illness manage- ment and satisfaction with the services received.
Highlights
In Israel psychiatric hospitalizations, both voluntary and compulsory, are regulated by the Mental Patients Treatment Act, 1991 [1]
To compare the initial attitudes of nurses and other professional groups in a psychiatric hospital towards the legal representation (LR) of involuntary admitted psychiatric patients before District Psychiatric Boards (DPB), and to assess how these attitudes changed after LR had become an everyday routine practice in the hospital
Thirty seven psychiatric nurses employed in the Tirat Carmel Mental Health Center, Israel and 30 other mental health professionals completed the Attitudes to Legal Representation Questionnaire before LR has been instituted in the Center (November 1, 2006) and one year later
Summary
In Israel psychiatric hospitalizations, both voluntary and compulsory, are regulated by the Mental Patients Treatment Act, 1991 [1]. Patients hospitalized under District Psychiatrist Order appear before the DPB within 14 days after involuntary hospitalization and every three months thereafter. Creech and Pewett [5] noted a positive association between the attitudes of carers towards patients and effective mental health care delivered. The researchers compared the attitudes of the different mental health professionals (doctors, social workers, rehabilitation staff, nurses, etc.) in psychiatric hospitals and in community mental health centers. The researchers concluded that positive attitudes toward mental illness and treatment especially among nurses would facilitate better rehabilitation outcomes than authoritative or paternalistic attitudes
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