Into the unknown: Transitions in psychiatric services as construed by clients and staff

Abstract

Mental health policies on resettlement of the long-stay residents of psychiatric hospitals are presenting both the clients and staff of such hospitals with major transitions. In this article, we explore their reactions to these transitions from a personal construct theory perspective by considering the possible effects of hospitalization on a client's construct system, the anxiety with which the client may be confronted by the prospect of discharge, and the threat posed to some staff members by the community care policy. Research findings presented include evidence that clients are more likely to feel dischargeable, and to be considered dischargeable by staff, if their constructs applicable to people outside the psychiatric hospital are relatively highly organized. Evidence is also presented that staff who oppose the community care policy differentiate less between dischargeable and nondischargeable clients, and between nondis-chargeable clients and themselves, than do staff who favor the policy. Implications for the methodology of the study of psychiatric inpatients' views are discussed. The extent of commonality in clients', staff members', and others' constructions of resettlement in the community and quality of life is also considered.