Hostname: page-component-7c8c6479df-hgkh8 Total loading time: 0 Render date: 2024-03-28T11:31:23.962Z Has data issue: false hasContentIssue false

The Difficult Patient

Published online by Cambridge University Press:  29 January 2018

M. Y. Ekdawi*
Affiliation:
Netherne Hospital, Coulsdon, Surrey

Extract

It is usual to encounter, in any large mental hospital, a group of patients who are considered by the staff to be difficult. This opinion is slowly formed, but, once established and repeatedly expressed in nursing reports and medical records, it rarely alters and may have a powerful influence on the patient's career in hospital. A difficult patient may find himself deprived of privileges and moved to a “lower level” ward (9, 10, 11) and his demotion in this way can affect his relatives' attitudes towards him (17). On the other hand, patients informally classified by the staff as “good patients” may be granted certain advantages and, as Cohen put it, “if they behave okay, they move to a better billet” (5).

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1967 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Banton, M. (1965). Roles, London: Tavistock Publications.Google Scholar
2. Belknap, I. (1956). Human Problems of a State Mental Hospital. New York.Google Scholar
3. Brown, G. W., Carstairs, G. M., and Topping, G. (1958). “Post-hospital adjustment of chronic mental patients.” Lancet, ii, 685689.Google Scholar
4. Caudil, W. (1958). The Psychiatric Hospital as a Small Society. Cambridge, Mass.Google Scholar
5. Cohen, G. L. (1965). “The sick mind.” New Statesman, LXX, 1793, 119.Google Scholar
6. Cumming, J., and Cumming, E. (1956). “Affective symbolism, social norms and mental illness.” Psychiatry, 19, 7785.Google Scholar
7. Folkard, M. S. (1960). “Aggressive behaviour in relation to open wards in a mental hospital.” Ment. Hyg. (N.Y.), 44, 2, 155161.Google Scholar
8. Frank, H. D. (1964). Patient Distribution in a Mental Hospital . Ph.D. Thesis, University of London.Google Scholar
9. Goffman, E. (1961). Asylums. New York.Google Scholar
10. Jones, K., and Sidebotham, R. (1962). Mental Hospitals at Work. London.Google Scholar
11. Kraus, P. S. (1957). “Ward assignment and patient movement in a large mental hospital.” In: The Patient and the Mental Hospital. Glencoe, Ill.Google Scholar
12. Main, T. F. (1957). “The ailment.” Brit. J. med. Psychol., 30, 129145.Google Scholar
13. Merton, R. K. (1957). Social Theory and Social Structure. Glenco, Ill.Google Scholar
14. Meyer, B. T., and Lucero, R. J. (1953). “A validation study of the L. M. Fergus Falls Behaviour Rating Scale.” J. clin. Psychol., 9, 192195.Google Scholar
15. Parsons, T. (1957). “The mental hospital as a type of organization.” In: The Patient and the Mental Hospital. Glencoe, Ill.Google Scholar
16. Robertson, J. P. S. (1962). “Perceptual-motor disorders in chronic schizophrenia.” Brit. J. soc. clin. Psychol., 1, 16.Google Scholar
17. Schwartz, C. G. (1957). “Perspectives on deviance—wives' definitions of their husbands' mental illness.” Psychiatry, 20, 275291.Google Scholar
18. Stanton, A., and Schwartz, M. (1954). The Mental Hospital. New York.Google Scholar
19. Venables, P. H. (1957). “A short scale for rating activity-withdrawal in schizophrenics.” J. ment. Sci., 103, 197199.Google Scholar
20. Wing, J. K. (1962). “Institutionalism in mental hospitals.” Brit. J. soc. clin. Psychol., 1, 3851.Google Scholar
21. Wittenborn, J. R. (1955). Psychiatric Rating Scales. New York.Google Scholar
22. Wootton, B. (1956). Sickness or Sin. London.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.