A child with psychiatric illness is absent from his school for the last 30 days, but his parents gave a reason to society and the school principal that our child is suffering from jaundice. This statement was given by parents because?

1. A

   Stigma in society related to psychiatric illness

2. B

   Encourage the child to recover from psychiatric illness

3. C

   Positive reinforcement therapy

4. D

   Negative reinforcement therapy

Appeared in: AIIMS Delhi NO - 2017

Explanation

• The primary reason for the parents' false statement is the pervasive social stigma associated with psychiatric illnesses.
• Stigma is characterized by negative beliefs, stereotypes, and fear, which leads to discrimination and social rejection.
• Families often conceal a mental health diagnosis to protect the individual and themselves from shame, prejudice, and isolation.
• In contrast, a physical illness like jaundice is generally more understood and accepted by society, making it a 'safer' explanation for the child's absence.

Why Other Options Were Wrong

• Option B: Hiding the true nature of the illness and creating an environment of secrecy and shame is counterproductive to a child's recovery. It teaches the child that their condition is something to be hidden, which can negatively impact their self-esteem and willingness to engage in treatment.
• Option C: Positive reinforcement is a specific behavioral therapy technique that involves adding a rewarding stimulus to increase a desired behavior. It has no relevance to the parents' act of communicating a false diagnosis to the school and society.
• Option D: Negative reinforcement is a behavioral therapy technique that involves removing an aversive stimulus to increase a desired behavior. This concept is completely unrelated to the parents' motivation for lying about their child's illness.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Social Stigma of Psychiatric Illness as background academic context rather than a clinical decision trigger.
• Nurses have a critical role in combating mental health stigma by educating patients, families, and the community.
• It is essential for nurses to create a non-judgmental and supportive environment where families feel safe to discuss their fears and challenges related to a psychiatric diagnosis.
• Nurses can advocate for patients by providing accurate information to schools and communities (with family consent) and connecting families with support groups.

How to Approach the Question

• First, analyze the core action in the scenario: Parents are substituting a psychiatric diagnosis with a physical one.
• Ask yourself 'Why would someone feel the need to hide a mental illness but not a physical one?' This points towards a social or cultural reason.
• Evaluate the options. 'Stigma' directly addresses the societal pressure and negative judgment associated with mental health.
• Recognize that 'Positive reinforcement' and 'Negative reinforcement' are specific clinical terms for behavioral therapy and do not fit the context of a social interaction with the school.
• Eliminate the option 'Encourage the child to recover' as lying and creating shame is detrimental, not encouraging, to recovery.
• Conclude that social stigma is the most logical explanation for the parents' behavior.

Concept Tested & Keywords

• Concept Tested: Social Stigma of Psychiatric Illness
• Stem keywords: psychiatric illness, absent from school, parents, jaundice, stigma
• Lead-in keywords: because
• Clinical cues: The key cue is the discrepancy between the actual illness (psychiatric) and the reported illness (jaundice), pointing towards a social, rather than a clinical, motivation.

Question ID

QYwlwNPeowhuE4FCEW31LI

Copy ID

Reference Book

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 164-166