Ann Gallagher1, Anne Arber, Rob Chaplin, Alan Quirk. 1. International Centre for Nursing Ethics, Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey (project conducted when employed by Faculty of Health and Social Care Sciences, Kingston University and St George's University of London), Guilford, Surrey, UK. a.gallagher@surrey.ac.uk
Abstract
BACKGROUND: The breaking and receipt of bad news is little referred to in the mental health literature, particularly from a service user perspective. AIMS: This project aimed to gain understanding of service users' experiences of receiving good and bad news from mental health professionals. METHOD: Ten semi-structured interviews were conducted in which mental health service users recounted key moments when good or bad news was delivered to them and described the impact of that news on their psychological well being. Transcripts were analysed thematically. RESULTS: The receiving of a diagnosis could be perceived as bad news or a cause of confusion where a diagnosis is changed. The importance of trust in professionals, the use of adequate time and information was considered important in buffering the impact of potentially bad news. The technique of comparing a mental disorder to a physical disorder is not always helpful. CONCLUSIONS: The delivery of bad news in mental health is more complex than a "good or bad news" paradigm and it should be done in the context of a good therapeutic alliance. An individualized approach to delivering news about diagnosis is advocated.
BACKGROUND: The breaking and receipt of bad news is little referred to in the mental health literature, particularly from a service user perspective. AIMS: This project aimed to gain understanding of service users' experiences of receiving good and bad news from mental health professionals. METHOD: Ten semi-structured interviews were conducted in which mental health service users recounted key moments when good or bad news was delivered to them and described the impact of that news on their psychological well being. Transcripts were analysed thematically. RESULTS: The receiving of a diagnosis could be perceived as bad news or a cause of confusion where a diagnosis is changed. The importance of trust in professionals, the use of adequate time and information was considered important in buffering the impact of potentially bad news. The technique of comparing a mental disorder to a physical disorder is not always helpful. CONCLUSIONS: The delivery of bad news in mental health is more complex than a "good or bad news" paradigm and it should be done in the context of a good therapeutic alliance. An individualized approach to delivering news about diagnosis is advocated.