Ethical Practices in Schizophrenic Care: Experiences of Nurses at Neuro-Psychiatric Hospitals in South-West Nigeria

Abstract

Mental illnesses such as schizophrenia are chronic and debilitating conditions that pose significant ethical and legal challenges in mental health care. Nurses, as frontline mental health professionals, frequently encounter ethical dilemmas and legal constraints while caring for patients with psychiatric disorders. This study explored nurses’ ethical practices in the mental health care of schizophrenic patients in two neuro-psychiatric hospitals in South-West Nigeria. A cross-sectional study design was employed. Quantitative data were collected from 222 psychiatric nurses at the Federal Neuro-Psychiatric Hospital, Yaba, Lagos State; and Aro Neuro- Psychiatric Hospital, Abeokuta, Ogun State using structured questionnaires and analyzed using the Chi-square and the one-sample proportion tests. Most study participants (77.5%) reported a consistent adherence to ethical guidelines, 48.6% indicated being very familiar with ethical guidelines, and 98.6% agreed that they had received ethics training. The statistical analysis shows that nurses’ gender and years of experience are not statistically associated with the ethical dilemmas they face, and that nurses do encounter significant ethical challenges in caring for schizophrenic patients. Despite nurses’ commitment to their duty and resilience, systemic issues hinder their ability to ensure ethical compliance. Nevertheless, inclusive and enforced ethics training programs, encouraging patient-centered care with patient and family inclusion, support networks, fostering interdisciplinary collaboration, and policy-level measures are methods reported to support nurses to react effectively and ethically in difficult ethical dilemmas.