"Does being in here mean there is something wrong with me"?

Much of what has been written about how psychiatric hospitals change a patient's self-image has been written from the perspective of the hospital and related social forces. Little has been done to explain the patient's perspective and role in this process. This study examines the process from that essential perspective, using both qualitative and quantitative methods. The results suggest that both frequency and duration of exposure to psychiatric hospitals, as well as a past history of hallucinations, are important variables in determining engulfment in the patient role. The process of engulfment appears to be a developmental sequence with important transitional events (e.g., hallucinations, Supplemental Security Income, repeated hospitalizations) demarcating and pushing forward the process, and shifting beliefs and definitions associated with each developmental stage. What seems to underlie this process is patients' need to maintain a positive view of themselves as competent.