'In the mind of another' shame and acute psychiatric inpatient care: an exploratory study. A report on phase one: service users

In the UK and internationally, there are concerns for the quality of health care available to people with mental health problems. A number of surveys and reports suggest that hospital admission for acute psychiatric care can be stigmatizing and non-therapeutic. This paper describes the setting up and progress to date, of an ongoing qualitative research study carried out in Wales. The study explores service users' subjective experience of shame before, during and after psychiatric hospital admission. The research study's aims are to learn about situations that might influence quality of care because of shame experienced by individuals and groups of people. The study also seeks to explore specifically ways that relationships with healthcare professionals are influenced because of shame related experiences. This paper reports on phase one of the study, service users views and reviews acknowledged benefits and difficulties experienced to date. Both phases of the study encompassed mixed membership focus groups conducted by both researchers. Although the data analysis is still in progress, provisional findings of this research study suggest that an awareness of the complexities in relation to ways shame is aroused in individuals and groups of people because of mental health problems could contribute to improving the quality of care provided to service users, before, during and after hospital treatment and care. Although not initially part of the study's intentions, the views of all focus group participants so far indicate that collaborative research is found to be empowering. Information gained to date indicates that we will gain a better understanding of situations that provoke feelings of shame in established service users and those experiencing emotional distress for the first time.