Patient participation in mental healthcare: when is it difficult? A qualitative study of users and providers in a mental health hospital in Norway.
BACKGROUND
In western countries, patient participation is requested in policies on mental health services. Participation is built on ideas of democracy and individual responsibility. Mental illness has, however, been characterized by its irrational features.


OBJECTIVE
To investigate mental health service users' and providers' views on patient participation during episodes of mental illness.


METHODS
Qualitative interview study with 20 users and 25 staff from a mental health hospital in central Norway.


RESULTS
Both users and professionals saw poor illness phases as an obstacle to patient participation. Lack of insight, lack of verbal ability and difficulty cooperating made participation difficult. During such phases, patient participation was redefined. There was a shift in responsibility where professionals took charge through strategies of providing information, motivating patients and reducing choices. Respect and dignity were maintained and not redefined.


CONCLUSIONS
In poor phases of mental illness, patient participation was redefined and weighed against what was perceived to be the patient's best interest.
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. marit.solbjor@ntnu.no
Marit
M
Solbjør
Marit By
MB
Rise
Heidi
H
Westerlund
Aslak
A
Steinsbekk
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003156:Community Mental Health Services / Q000592:standards*; D055812:Community-Based Participatory Research; D056348:Emotional Intelligence; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D008603:Mental Health / Q000592:standards*; D008875:Middle Aged; D009664:Norway; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011369:Professional-Patient Relations; D011567:Psychiatric Department, Hospital / Q000592:standards; D036301:Qualitative Research