Forensic nurses' perceptions of labels of mental illness and personality disorder: clinical versus management issues

Abstract

Anecdotally, forensic psychiatric nurses generally have a more negative perception of people diagnosed with a personality disorder and this negativity is focused more towards managing the behaviours rather than on treatment efficacy and clinical outcomes. This study reports on research carried out across the High, Medium and Low secure psychiatric services in the UK. One thousand two hundred questionnaires were distributed with a response rate of 34.6%. The results indicated a statistically significant difference across High (z = 9.69; P < or = 0.01), Medium (z = 11.06; P < or = 0.01) and Low (z= 9.57; P= 0.01) security with a focus on the management of people with a personality disorder using the Wilcoxon paired samples test. There was also a statistically significant difference in relation to a more clinical/treatment focus for those with a diagnosis of mental illness in Medium (z = 9.69; P < or = 0.01) and Low (z = 9.57; P < or = 0.01) security but not in the High security services. Finally, the results showed significant differences between High, Medium and Low security on each of the four scales of Personality Disorder Clinical-Personality Disorder Management and Mental Illness Clinical-Mental Illness Management. This raises issues of stigma, prejudice and discrimination and suggests a refocus on skills development, acquisition and application for those with a label of personality disorder.

Mental Illness Training for Licensed Staff in Long-Term Care

“…Changes were measured with video situational testing (VST) and constructs associated with behavior change from social cognitive theory (Bandura, 1969, 1977) and the expanded theory of reasoned action (Fishbein, 2000), including attitudes, self-efficacy, and behavioral intentions. Additional items measured potential changes in empathy and stigmatization because research reports indicate that health care professionals may benefit from training designed to alter stereotypes and negative attitudes towards mental illness (Arvaniti et al, 2009; Glaister & Blair, 2008; Heliker & Nguyen, 2010; Mason et al, 2010; Schafer et al, 2011). We postulated that positive training effects would improve user knowledge, attitudes, intentions, and self-efficacy, with empathy increasing, and stigmatization decreasing.…”

“…Research suggests that nursing students and health care professionals may hold stigmatizing beliefs about individuals with mental illness (Arvaniti et al, 2009; Bayar, Poyraz, Aksoy-Poyraz, & Arikan, 2009; Glaister & Blair, 2008; Heliker & Nguyen, 2010; Mason, Hall, Caulfied, & Melling, 2010; Schafer, Wood, & Williams, 2011), perhaps at the same level found in the general population (Schulze, 2007), which is contrary to the mores of a caring profession. Thus, nursing staff may be ill prepared when encountering challenging resident behaviors, or when supervising direct care workers who must react to problematic behaviors caused by mental illness.…”

Psychological therapy in prisons: Professionals’ perceptions

“…Mason, Hall, Caulfield, and Mellings (2010) found that using the label "personality disorder" compared to "mental illness" determined the responsiveness that forensic nurses had towards their patients. Treating a patient with a label of "personality disorder" meant that nurses were more concerned with security management than treatment, which has implications for stigma and discrimination (Mason et al, 2010).…”

Perceptions of learning disability nurses and support staff towards people with a diagnosis of schizophrenia

“…The study findings suggest that reframing an understanding of schizophrenia, its course and the consequences for those with schizophrenia and their relatives would promote a more optimistic attitude and more confidence in people's capacity for recovery (Mason et al . ). There is evidence that reframing schizophrenia for staff can instil a strengths‐based recovery‐focussed approach where hope is conveyed to the patient and results in greater patient satisfaction, social inclusion and the achievement of life goals (Lester et al .…”