Attitudes toward mental illness and role conceptions of psychiatric patients and staff

The patients and staff of a psychiatric hospital were asked about their attitudes toward mental illness and how they conceive the roles of various patient and staff groups in the therapeutic community. The focus was on the bipolar dimension of "Custodial" vs. "Accountability" orientation. A Custodial orientation discourages autonomy, promotes submission, and emphasizes the satisfaction of the physical needs of the patients. On the other hand, an orientation of Accountability emphasizes the "healthy" aspects of the patients and encourages autonomy and the sharing of power. These orientations were tapped by the use of a close-structured questionnaire. The results revealed that attitudes toward mental illness and role conceptions were highly related. Patients and nursing staff showed a greater custodial orientation than did other members of the staff.