Characterization of patients refusing professional psychiatric treatment in a primary care clinic.

The purpose of this study was to characterize patients' refusal to meet a psychiatrist in a primary care clinic. Three hundred and seven patients were diagnosed as suffering from mental disorders: 57 of them were referred to the psychiatrist. Forty-seven patients who refused specialized psychiatric care formed the study group. The main measures were expressions, statements and reactions given by the patient for his/her refusal to undergo psychiatric care. Among nine types of expressions, statements and reactions, the most prevalent were: "I am afraid people would think I'm insane", "it might interfere with my social relationships and threaten my job," "I'm sufficiently strong to be able to deal with the problem myself," "it won't help, it won't solve my problems." We believe that a team approach involving the psychiatrist, social worker and the family physician should initiate and develop strategies for dealing with the stigma of psychiatric "treatment" as the refusal to undergo such treatment may result in the deterioration of these patients' mental condition.