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Brief Reports   |    
Communicating a Schizophrenia Diagnosis to Patients and Families: A Qualitative Study of Mental Health Clinicians
Sue Outram, Ph.D.; Gillian Harris, M.A.; Brian Kelly, F.R.A.N.Z.C.P., Ph.D.; Martin Cohen, M.B. B.S., F.R.A.N.Z.C.P.; Harsimrat Sandhu, M.B. B.S., F.R.A.N.Z.C.P.; Marina Vamos, M.B. B.S., F.R.A.N.Z.C.P.; Tomer T. Levin, M.B. B.S., F.A.P.M.; Yulia Landa, Psy.D., M.S.; Carma L. Bylund-Lincoln, Ph.D.; Carmel Loughland, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300202
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Dr Outram is with the School of Medicine and Public Health and with the Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia (e-mail: sue.outram@newcastle.edu.au). Ms. Harris, Prof. Kelly, and Dr. Loughland are with the Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, New South Wales. Dr. Cohen, Dr. Sandhu, and Dr. Vamos are with the Department of Psychiatry, Hunter New England Health, Newcastle, New South Wales. Dr. Levin and Dr. Bylund-Lincoln are with the Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York City. Dr. Landa is with the Department of Psychiatry and the Department of Public Health, Division of Prevention, Weill Medical College of Cornell University, New York City.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  The aim of this research was to explore mental health clinicians’ experiences and perceptions of discussing a diagnosis of schizophrenia with their patients. The results of this research will inform a communication skills training program for psychiatry trainees.

Methods  Semistructured interviews were conducted with 16 mental health clinicians from public mental health services in New South Wales, Australia. Interviews were recorded and transcribed for qualitative analysis.

Results  Although most clinicians supported the need to give patients a named diagnosis of schizophrenia, most gave multiple reasons for not doing so in practice. The reasons given centered on concerns for the patient; they included fear of making an incorrect diagnosis, fear of the patient’s distress, and harm from stigma.

Conclusions  Mental health clinicians need to reflect on their own feelings, examine personal identification with their patients, and recognize the subtle interplay of hope and pessimism in their communication of a schizophrenia diagnosis.

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