"The Person Gets Lost in the Whole Process": Access to Physical Healthcare for Patients Hospitalized in a Psychiatric Hospital

Res Theory Nurs Pract. 2023 May 1;37(2):214-230. doi: 10.1891/RTNP-2022-0089. Epub 2023 May 31.

Abstract

Background and Purpose: Persons living with mental illnesses have unmet physical healthcare needs, leading to premature death. When they attempt to access physical health services, they are faced with numerous barriers that lead to delays in care. Although mental health nurses are identified as being essential actors in helping persons with mental illnesses navigate the complexities of the healthcare system, they also engage in conduct that further stigmatizes them. To complicate matters more, mental health nurses themselves face stigmatization when they help their patients living with mental illnesses access physical healthcare services. The aim of the study was to explore mental health nurses' experiences of associative stigma when accessing physical health services for their patients. Methods: To achieve this aim, we used an interpretive phenomenology methodology and a theoretical framework rooted in Erving Goffman's notion of associative stigma. Specifically, we conducted six interviews with mental health nurses working at an urban multisite psychiatric hospital to elicit accounts of their experiences of associative stigma when seeking physical healthcare for their patients and the meanings they make of these. Results: The results presented in this article illustrate some of the mechanisms by which stigmatization toward persons living with mental illnesses and mental health nurses cause delays in physical healthcare accessibility. Implications for Practice: In our discussion, we highlight the implications of these results for the practice of nurses and propose two structural solutions to improve access to physical healthcare and reduce stigmatizing experiences.

Keywords: accessibility; mental health; nursing; physical health; stigma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery of Health Care
  • Hospitals, Psychiatric
  • Humans
  • Mental Disorders*
  • Psychiatric Nursing*
  • Stereotyping