Abstract
D.Phil. (Social Work)
The research question answered in this thesis is: What is the place (role, attitude,
aim) of medical social work as a component in the treatment of mental
illness in a general hospital?
Since the medical staff at a general hospital are primarily concerned with the
treatment of physical illness, it is expected that the place and role of the medical
social worker, as well as the mentally ill patient, create problems with
role-functioning in this primary medical setting. In a general hospital, where
life and death are vital issues, the doctor plays a major role in the treatment
process and social workers and other persons, in ancilliary professions are expected
to render a subordinate and secondary service.
The patient's problems with role-functioning occur prior to admittance, during
hospitalization and after discharge. In the process of becoming a patient the
difference between the medical and psychiatric sick role is accentuated. Problems
after discharge include unemployment and the fulfilment of roles such as
marriage partner, roommate, neighbour, colleague and employer as determined by
the social distance scale.
Legislation, especially the Health Act (Act 63 of 1977) and the Mental Health Act
(Act 18 of 1973) has made provision for psychiatric services to be incorporated
in the general health services of the RSA and for the mentally ill to be treated
in general hospitals. Despite the community-oriented approach, stigma is still
attached to mental illness and the general public remains relatively ignorant
regarding mental illness.
One way of researching the influence of stigmatic labels in determining reactions
to persons who are mentally ill is to investigate the attitudes of various sections
of the community, including professionals in the health field. Attitudes
towards mentally and public perception of the signs and symptoms of mental illness
have for several years been the subject of considerable concern and research.
The empirical data used in this study was obtained from collating the views of
staff members attached to four training hospitals in South Africa. The investigation
covered their knowledge of and attitude towards mental illness and the
mentally ill patient. It al so determined whether respondents showed prejudice
towards the treatment of the mentally ill patients in general hospitals.
An analysis of the empirical data according to occupation indicates that professionals
qualified in the human sciences comprise the smallest component of the
personnel structure in hospitals. Compared to other personnel this group shows a
more favourable attitude towards treatment of mentally ill patients in general
hospitals and the acceptance and employment of mentally ill persons in the community.
Although medical social work quantitatively form the smaller component in the
treatment of mental illness in a general hospital it has a significant contribution
to make with regard to the following aspects of social work service delivery:
humanising the hospital system and the home environment of the mentally ill
person; prouott ng mental health education; activating support systems;
utilising social networks; enhancing effective role functioning; restoring
social functioning as a facet of social health; preventing mental illness;
promoting mental health and changing attitudes towards mental illness