Indicators of empowerment and disempowerment in the subjective evaluation of the psychiatric treatment process by persons with severe and persistent mental illness: a qualitative and quantitative analysis

Empowerment and disempowerment is studied in terms of the way persons with long and persistent schizophrenia evaluate their psychiatric outpatient treatment. One hundred persons with the diagnosis of schizophrenia (ICD-10 F 20.0) were interviewed about their perceptions and evaluation of the treatment process by means of problem-focused interviews. Transcribed interviews were subjected to qualitative content analysis. Relationships among the categories of the qualitative content analysis were analyzed by means of a homogeneity analysis. The latent dimension extracted by the homogeneity analysis could be interpreted as a quantitative measure of an empowered or a disempowered perception of the treatment process. As a result of the qualitative content analysis it was found that a majority of participants tend to describe their treatment as reduced to drug treatment and that they tend to notice only positive medication effects rather than mixed medication effects or positive effects of conversation and that they feel helpless or indifferent rather than actively involved in the treatment process. The impact of socio-demographic, clinical, and treatment characteristics on the participants' location on a latent dimension called "empowerment" was examined by means of multiple regression analysis. General life satisfaction, negative symptoms and getting depot medication were positively associated with a more disempowered perception of the treatment process whereas positive symptoms, getting antidepressant medication and being treated in an outpatient clinic instead of a private practice were associated with a more empowered perception.