The Social Relations of General Health Professionals in the Provision of Care to People with Serious Mental Illness in General Hospital Wards

Abstract

Background: Despite general hospital wards focusing on physical health care, mental illness remains a highly prevalent disorder within these settings, both newly emergent mental illness and people with existing mental illness who suffer with relapse. Understanding the challenges that are faced by generalist health professionalsin the provision of care to people with serious mental illness in generalist settings, may lead to better service provision for this group of patients. Objectives: This study aims to explain basic social processes faced by generalist healthcare professionals involved in the provision of health care for people with mental illness in general hospital settings. Methods: Constructivist grounded theory was chosen as the study method. The setting focused on general hospital inpatient settings such as medical and surgical wards. Data was collected from two tertiary referral metropolitan hospitals in Sydney, Australia. Four primary sources of data informed the study: three participant observations, two focus groups, 21 individual interviews, and 12 policy and protocol documents. Social workers, medical staff and nurses participated in the study after ethics approval. Results: Generalist health professionals provide care to people in a social space that evokes emotions in themselves as health professionals. The generalist health professional's ability to ‘know answers’ or express their understating of mental illness is mitigated by their levels of satisfaction and confidence in the care they provide. The generalist health professional attempts to provide care with consumers is done within a ‘balancing act’, where their attempts and desires to interact are offset by organizational factors, the consumers isolated space and how mental illness can impede access to care in generalist settings. Conclusion: Approaches to education of generalist health professionals, development of hospital policy and protocol, suggestions on generalist ward design and the making of mental health care more explicit by identifying the language and behaviour required to provide the care to people with mental illness will be discussed.