Unveiling patienthood in psychiatric care: an ethnographic study in Nigeria

Abstract

This article explores the creation, significance, and implications of patienthood within biomedical psychiatric hospital care practices, a topic that has often received insufficient attention from researchers. Using an ethnographic approach and discursive narrative framework, I argue that patienthood in this mental hospital is a social status deliberately constructed to facilitate decision-making regarding treatment and to guide social interactions within the hospital context. While patienthood is created within the hospital, its effects extend beyond its walls. I demonstrate that patienthood is a multifaceted concept emerging from 'assemblage practices' within the hospital, involving numerous human and nonhuman entities contributing to its creation and perpetuation. The processes underpinning patienthood are dispersed and collectively shaped by multiple 'agents', often diminishing the patient's active agency. This paper contributes to empirical knowledge and enhances our theoretical understanding of doctor-patient relationships and the evolving concept of 'patienthood' over the past six decades. It bridges the divide between older and contemporary literature and perspectives on doctor-patient relationships and patient agency, particularly concerning the Parsonian 'sick-role' and 'assemblages' theory. Furthermore, the article addresses the implications of its findings for mental health care, paving the way for a more comprehensive understanding of the complexities involved in caring for individuals with mental health issues.