The patient's diagnosis: Explanatory models of mental illness

The purpose of the study was to develop a grounded theory about individuals ' perception of the situation of being a psychiatric patient. Thirty-five i npatients (19 males, 16 females), ages 18 to 68, in two psychiatric units o f an urban, public facility were interviewed on a biweekly basis from admis sion to discharge. Data were analyzed using the constant comparative method , and the data indicated that participants used the basic social process of managing self-worth to deal with the stigmatizing social predicament of be ing a mental patient. Events occurring before admission that shaped their r esponses were substance abuse, medication noncompliance, and the lack of so cial capital, which led to norm violations and subsequent hospitalization. Six attribution categories emerged: problem, disease, crisis, punishment, o rdination, and violation. Findings support the need for professionals to im prove their practice by acknowledging the effects of patients' subjective a ssessments on their response to hospitalization and by placing move emphasi s on assisting patients to deal with the stigmatizing effects of a psychiat ric diagnosis.