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

CHAPTER ONE

INTRODUCTION

1.1       Background of the 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.

Allport (1961) posited that an attitude is “mental and neural state of readiness organized through experience, exerting a dynamic influence upon the individual response to all objects or to situations with which it is related”. Similarly (Ewhrudjakpor 1995; Mohammed and Mohammed 2008) defines an attitude as a “learned orientation or disposition, toward an object or situation which provides a tendency to respond favourably or unfavourably to the object or situation”. However strong these attitude definitions are, it was (Zimbardo and Ebbesen 1969) that put it in proper structure when they defined it as “a predisposition, toward any person, ideas or objects, it contains cognitive, affective and behavioural components”.

Thus, individuals disposition becomes an attitude if it contains in some parts, aspects of  knowing and acting. Zimbardo and Ebbesen (1969) further assert that, affective component of our attitude consists of a person’s evaluation of liking or emotional response to some objects or person. The cognitive component refers to the way the object or person is perceived. It is in fact the mental picture formed in the individual’s brain. This includes the person’s thoughts, beliefs and knowledge about the object. The behaviour component involves the person’s overt acts directed towards another person or group of persons or objects.

Nigerians make attributions in respect of their attitudes towards sufferers of mental illness. They in most cases do this naively (Ugwuegbu 1994). Attribution theory as postulated by (Heider 1958) states the rules people use to infer the causes of observed behaviour. He divides this process into two: dispositional and situational attribution processes. The dispositional attribution is the process where a person’s actions is attributed to internal dispositions (attitudes, traits, motives). While situational attribution is attributing a person’s actions to factors in the environment such as witchcraft, poverty, beliefs, and so forth.

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 AF,2000 ). Stigmatising attitudes towards mental disorders may be influenced by lack of knowledge of psychiatric illness, (Schomerus G, Angelmeyer MC, 2008)  and contact with people with mental disorders may lead to more positive attitudes and enlightened views. (Addison SJ, Thorpe SJ, 2004).