Date of Award

2007

Degree Type

Thesis

Degree Name

Bachelor of Arts Honours

School

School of Psychology

Faculty

Faculty of Computing, Health and Science

First Advisor

Dr Ken Robinson

Abstract

The experience of living with psychological problems has a profound effect on an individual's life. For those actively seeking help, General Practitioners usually present the first point of contact. General Practitioners thus serve as gatekeepers who either decide to manage the individuals themselves and/or refer them to a mental health professional. The referral decision is part of a complex help-seeking process in which patients have to mediate their own understanding of their problems with that of the practitioner, all within the structural constraints of the current health care system. This literature review discusses constructs of mental illness and the impact of these constructs on symptom management. It is argued that a person's perception of symptoms, problem recognition and help-seeking decisions are strongly influenced by social, political and cultural contexts, in combination with the individuals' interpretation of their experience. Using the concepts of Gadamer's (1975) hermeneutic phenomenology, it is suggested that in order to understand the way individuals choose to manage their psychological problems, both research and practice need to focus more on patients as important sources of meaning. Involving both scientific expertise and patients' interpretation of their lived experience could result in better mental health care. General practitioners usually present the first point of contact for individuals seeking help for psychological problems. General practitioners (GPs) thus serve as gatekeepers who either manage the individuals themselves and/or refer them to a mental health professional. This study investigated the subjective experience of individuals who had been referred by their GPs to psychologists for treatment of psychological problems. The second aim was to demonstrate the use of Gadamerian hermeneutics in qualitative psychological research. Audiotaped transcripts of interviews with five Australian adults were analysed. While all participants agreed that the referral process was well-managed, the referral itself played a minor role in the lived experience. Rather, the participants emphasized the broad context within which the referral took place, and their understanding of the concept of mental illness. Issues related to self-management and coping, self-disclosure and personal identity were examined as well. The themes were linked by the patients' self-realization which was a process through which they acknowledged that their problems were psychological in nature. Implications related to the impact of self-realization on help-seeking and on the therapeutic relationship are discussed.

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