The impact of behavior settings on attitudes toward mental illness

With the increase in community mental health programs, there has been an Increasing shift in treatment setting from hospital to the community. In conjunction with this change in treatment locations, or environments, a great deal of interest has developed regarding attitudes about mental patients and mental Illness held by the general public. Much of the increase in Interest concerning the general public's attitudes toward mental illness stems from the recognition that the success in establishing community based treatment facilities is in large part dependent upon the attitudes of the general community toward mental patients and mental illness, and a further recognition of the possibility of influencing those attitudes through a change in treatment setting. The present study attempted to investigate the relationship between an individual's attitudes toward mental patients and mental illness and the treatment setting where he encountered a group of psychiatric patients. More specifically, the intent was to analyze college students' attitudes toward mental illness and mental patients as they are influenced by a brief encounter with chronic schizophrenic outpatients in two different behavior settings: 1) a Day Treatment Center located on Veterans Administration hospital grounds, and 2) a private home setting within the community. The primary question was, 'Does the setting (hospital behavior setting or community behavior setting) where S encounters the psychiatric patient exert an influence on the direction and intensity of change in his attitudes toward psychiatric patients and mental illness?� There were 72 Ss who were randomly assigned to four experimental groups and two control groups In a modified Solomon 4-Group design. Two of the experimental groups encountered psychiatric patients for two hours in the hospital setting. The other two experimental groups encountered the same patients for the same length of time In the community setting. The control groups had no structured experience with patients, but engaged In the same activity as the experimental groups on the University of Houston campus. All of the groups of Ss received posttesting with the Opinions about Mental Illness scale (OMI), which assesses attitudes of Authoritarianism, Benevolence, Mental Hygiene Ideology, Social Restrictiveness, and Interpersonal Etiology, and with a social distance scale which assesses the tendency to avoid contact with ex-mental patients. Half of the groups received pretesting In addition to posttesting with the above scales, and the other half received no pretesting. It was hypothesized that In relation to Ss in both the hospital setting and the control group conditions, Ss In the community setting would show significantly more favorable posttest attitudes. Analysis of variance indicated an overall significance for settings on the OMI factors of Benevolence and Social Restrictiveness. T-tests showed that Ss who encountered patients in the community setting earned, posttest means which were significantly higher for Benevolence (p<.025) and significantly lower for Social Restrictiveness (p< .01) than the mean scores of Ss in the control group, rhe mean scores of Ss who encountered the same patients in the hospital setting did not differ significantly from the means of Ss in the control group on any of the attitudes assessed. The results showed that brief contact with psychiatric patients in a community setting significantly Influences attitudes in a direction consistent with less restriction of patients1 activities, a smaller tendency to perceive psychiatric patients as a threat to the community, and a greater tendency to perceive patients in a benevolent manner. In contrast to the community setting, brief contact with psychiatric patients in a hospital setting had no significant impact on attitudes toward psychiatric patients and mental Illness. The results were seen as consistent with Kelson's (1964) adaptation-level theory, Barker's (1968) theory of behavior settings, and Wicker's (1970) notion of behavior-environment congruence.