CHARACTERIZATION OF PATIENTS REFUSING PROFESSIONAL PSYCHIATRIC-TREATMENT IN A PRIMARY-CARE CLINIC

The purpose of this study was to characterize patients' refusal to mee t a psychiatrist in a primary care clinic. Three hundred and seven pat ients were diagnosed as suffering from mental disorders; 57 of them we re referred to the psychiatrist. Forty-seven patients who refused spec ialized psychiatric care formed the study group. The main measures wer e expressions, statements and reactions given by the patient for his/h er refusal to undergo psychiatric care. Among nine types of expression s, statements and reactions, the most prevalent were: ''I am afraid pe ople would think I'm insane'', ''it might interfere with my social rel ationships and threaten my job,'' ''I'm sufficiently strong to be able to deal with the problem myself,'' ''it won't help, it won't solve my problems.'' We believe that a team approach involving the psychiatris t, social worker and the family physician should initiate and develop strategies for dealing with the stigma of psychiatric ''treatment'' as the refusal to undergo such treatment may result in the deterioration of these patients' mental condition.