Greenley, James R.
October 1972
Social Problems;Fall72, Vol. 20 Issue 2, p252
Academic Journal
Two views of the inpatient psychiatrist's role are examined using data from a study of discharges from a mental hospital. One view of the psychiatrist sees him in the traditional professional role using his skills to advise and direct patients. Another view of the psychiatrist pictures him rationalizing and legitimizing in medical- psychiatric terms actions taken toward patients, such as discharges, which occur neither for professionally acknowledged medical nor psychiatric reasons. The desires regarding discharge timing held by the patient and a member of his family are found strongly and positively related to the actual timing of release. These desires account for almost all of the relationship between the psychiatrist's medical-psychiatric evaluation of the patient and the timing of discharge, suggesting, along with other supporting data, that the psychiatrist's professional judgments are at best indirect determinants of the discharge decision. Observations of psychiatrist-patient relationships over time also suggest that psychiatrists sometimes alter their evaluations of a patients psychiatric condition in response to pressures from the family and patient, allowing professional prescription of discharge or retention as the family or patient demands. Implications of these Endings are briefly explored.


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