PSYCHIATRIC PATIENTS AND THE ATTITUDE OF HEALTH WORKERS IN FEDERAL NEUROPSYCHIATRIC HOSPITAL

1.1 Introduction

The psychiatric patient, in the minds of the Nigerian public, is responsible for their illness, especially when it is an alcohol and/or substance-related problem. This belief denies them the sympathy and understanding traditionally bestowed on the sick in African society (Ewhrudjakpor et al., 2009; Gureje et al., 2005). Moreover, it is the belief of most people in Nigerian society that psychiatric illnesses are afflictions caused by supernatural forces and, as such, require care by traditional and syncratic religious healers, rather than orthodox care (Ewhrudjakpor et al., 2009). Misunderstanding of psychiatric illnesses by the public as outlined above robs the psychiatric patient of, among other things, provision of satisfactory mental and physical healthcare services, even in the tradocultural context (Minas et al., 2009).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of technical terms.

1.2 Background of Study

The universality of harmful beliefs and subsequent negative attitudes towards the mentally ill is not in doubt (Thara and Srinivasan 2000; Murphy 2002; Botha et al. 2006). This study is set out to identify the persistent socio-cultural factors impeding the acceptability of mentally sick persons in Nigeria, particularly among health care providers in Ogun State. The concept of mental health or illness has a problematic definition because it is largely subjective. It can only achieve a near uniformity of meaning in the medical arena although a complete state of mental health or well being is almost impossible to attain. The sufferers of mental illness are part of the society but are viewed differently by the society (C.M.H.A. 1993; Murphy 2002; Paterson 2006). Therefore, societal reaction to the mentally sick varies from society to society, as the culture of a people is also a model for human behaviour.

African societies have a peculiar attitude towards the sick or mentally ill persons and this is evident in the rejection, scornful disposition and a negative perception of the sick individual (Sharma 1998; Mohammed et al. 2004; Mohammed and Mohammed 2008). Mental illness is a disorder of one or more of the functions of the mind such as emotion, perception, memory or thoughts, which causes suffering to the person and embarrassment to the family and society. There are a varied number of mental illnesses but the most common and broader classification is psychoses, neuroses and mental retardation. Mental illness could be spurred by environmental or cultural factors and also, by physiological malfunctioning and heredity, these are referred to as functional and organic psychoses respectively.

Although mental health problems are extremely common in our society, there has historically been a negative attitude towards people with mental disorders. A study found that public attitudes towards people with mental illness in England and Scotland became less positive between 1994 and 2003 (Mehta N,et al, 2009). Stigma is thought to stop those with mental health problems seeking appropriate medical help (Jorm A.F., 2000). Stigmatising attitudes towards mental disorders may be influenced by lack of knowledge of psychiatric illness, (Schomerus et al., 2008) and contact with people with mental disorders may lead to more positive attitudes and enlightened views (Addison et al., 2004). Within a psychiatric care setting, informed consent is the voluntary acceptance of a plan for medical care by a competent patient after full disclosure of the care plan, its risks, benefits, and alternative approaches. This implies that the patient must have full information about any treatment options and must be competent to make the needed decisions.

The mentally sick in Nigeria culture, most traditional communities ought to look after them since they are still a part of the community and there are possible traditional therapeutic regimens to bring them to a relative state of normality (Jegede 1981; Adebowale and Ogunlesi 1999; Gureje et al. 2005). However, in Nigeria the situation is now different as mentally ill individuals are socially stigmatized even after they have been cured of this illness (Jegede 2005; Brinn 2000; Binitie 1970). This is in contrast with the communal and closely-knit kinship system in which each person has a responsibility for the well being of the other which dominated African societies (Ayorinde 1983).

Therefore, in Federal Neuropsychiatric Hospital where the research was carried out, the activities that was conducted is to know the Psychiatric Patients and the Attitude of Health Workers.

1.3 Statement of Problems

Investigation revealed that the Mental illness is a diseased condition, which is deemed undesirable for both the affected individual and the society because it affects adversely the normal functioning of the mental, psychological and emotional make-up of the individual and so it makes the capacity for insight, orientation, judgment, thought, mood and perception blurred (WHO 2001; WPA 2002).

The mentally sick people constitute nuisance since their consciousness is affected, this is why they need treatment and rehabilitation but the Nigerian situation is quite different as government and the family unit have not done much towards their rehabilitation since many mentally sick persons are not taken care of but allowed to become vagrants. Also, health workers who should know better seem not to display positive attitude towards such sick people.

There is also the problem of cultural factors, which label such people as evil possessed and witchcraft ‘infested’. Most Nigerians believe that mental illness is afflictions caused by supernatural forces (Udoh 2002). Therefore they hold unorthodox beliefs that only traditional and syncretic religious healers can offer more effective and sustainable treatment than orthodox health practitioners.

1.4 Aim and Objectives of Study

The aim of the study is to examine the Psychiatric Patients and the Attitude of Health Workers in Federal Neuropsychiatric Hospital. In achieving this aim, the following specific objectives were laid out as follows:

1. To access reasons for the negative attitude of healthcare workers towards psychiatric patients;
2. To determine whether there is adequate healthcare equipment and facility for taking care of the mentally ill;
3. To determine the impacts of fear on attitude of health workers towards psychiatric patients; and
4. To proffer necessary solutions to the identified problems.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Are there adequate healthcare equipment and facility for the taking care of psychiatric patients?
• Is there a link between fear and attitude of health workers towards psychiatric patients?
• What are the reasons for the negative attitude of healthcare workers towards psychiatric patients?
• What are the likely solutions to the identified problems?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant relationship between medical knowledge, cultural beliefs and health workers’ attitudes towards the mentally sick.
• H1: There is a significant relationship between medical knowledge, cultural beliefs and health workers’ attitudes towards the mentally sick.

Hypothesis Two

• H0: There is no significant relationship between fear and attitude health workers’ attitudes towards the mentally sick.
• H1: There is a significant relationship between fear and attitude health workers’ attitudes towards the mentally sick.

1.7 Significance of Study

This study will provide information on the general attitude of Nigerians particularly health workers towards the mentally sick. Also, it will increase the knowledge of people on mental illness in general and correct all misconceptions about the disease and prompt governments and non-governmental agencies efforts in making more readily available resources for treatment facilities and rehabilitation of mentally ill persons.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Psychiatric Patients and the Attitude of Health Workers in Federal Neuropsychiatric Hospital, Aro, Abeokuta. Hence, this study is limited in scope to Abeokuta area of Ogun State as other locations will not be considered.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
4. Lack of Initial Cooperation from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.

1.10 Definition of Terms

Attitude: manner, disposition, feeling, position, etc., with regard to a person or thing; tendency or orientation, especially of the mind.

Health Workers: are people whose job it is to protect and improve the health of their communities.