By applying Q methodology, the authors attempted to identify community leaders' attitude toward mental illness for the purpose of understanding available informations in the. planning of mental health delivery system. Fifty community leaders such as herb doctor, school nurse, shaman, village leader, high school teacher, pharmacist, pastor and general physician were the subjects of this survey. They were instructed to arrange the 50 statements in preference rank order. The statements were derived from the many previous opinion and attitude surveys toward mental illness in Korea. Cause of mental illness, attitude toward psychotic person, treatment device and world view were the main contents of the statements. The results were statistically treated by Q factor analysis and 3 factors could be extracted. To identify the character of each factor, factor scores were calculated. The characteristic features of each factor regard the cause of mental illness as psychological-environmental stress and deny the supernatural origin. Accordingly psychotherapy and faith healing were strongly accepted and primitive devices of treatment were rejected. Rational understanding, tolerance and acceptance were their characteristic attitude.
Thus factor A could be named an "Psychological humanism". Three herb doctors, three pharmacists, three village leaders, two pastors, one school nurse and one high school teacher belong to this factor A.
Factor b: The subjects in this factor understand mental illness with primitive concepts.
They think that mental illness is incurable and psychotic persons are the object of fear, so they should be isolated into mental hospital or institution. Meanwhile they have pessimistic and hostile world view. This factor could be named as "Hostile rejection".
Three shamans belong to this factor.
Factor C: The subjects of this factor regard mental illness as psychological and environmental nature. They have optimistic view in treatment of mental illness. Their attitude is characterized by full acceptance and familiarity but by inappropriate understanding and traditional concepts of illness. Primitive devices of treatment such as shamanistic ritual and herbal medicine are highly recommended as effective methods in the treatment of mental illness. This factor could be named as "Traditional humanism".
Two pharmacists, one village leader and one shaman belong to this factor.
Meanwhile, only 20 of 50 subjects (40%) belong to one characteristic factor and 30 persons (60%) belong to two or three factors simultaneously or do not belong to any factor. This finding suggests that considerable population of community leaders are confused and complicated in their attitude toward mental illness.
With the above findings, community leaders' attitude toward mental illness can not be understood as an unique or general pattern. Possible various attitudes should be identified and recognized for better understanding of community-hospital interaction.
Three characteristic attitudes derived from this study could be interpreted in terms of acculturation.
The attitude of traditional humanism (Factor C) can be understood as common
traditional attitude toward mental illness in Korea. This attitude has been changed into the attitude of hostile rejection (Factor B) by influence of modernization and the attitude of hostile rejection has again been changed into the attitude of psychological humanism(Factor A) by public education for desirable knowledge and attitude. Different attitudes derived from each acculturational step could be regarded to mingle with each other in the same period.
On the other, herb doctor, pharmacist and village leader manifest the attitude of psychological humanism predominantly, school nurse, pastor and high school teacher have both attitudes of psychological humanism and hostile rejection. Shaman reveals the attitude of hostile rejection and general physician's attitude seems to be extremly confused and complicated because they belong to all the three factors.
In conclusion, educational program for desirable understanding human behavior is strongly. recommended to the community leaders and even in the ecurriculum of the regular educational systm.
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