Identification of Violence in Psychiatric Case Presentations

Previous research on medical discourse suggests that physicians minimize patients' social problems through conversational and linguistic interactions. There has been little assessment, however, of the neglect of violence by psychiatric staff. In an attempt to address this important area, the case presentations of 77 recently violent psychiatric patients were examined. A contextual analysis of the violence mentioned during the case presentations revealed four categories of identification violence as part of the primary problem, as a psychiatric disorder, as an unrelated incident, or not mentioned at all In nearly two-thirds of the case presentations, the violence was not identified as part of the primary problem The findings and case examples substantiate the assertion that social problems are neglected, minimized, or medicalized in medical discourse They also suggest that clinical protocol should be established to ensure more extensive consideration of the "dangerousness" implied by reported violence The sociological study of medical discourse—that is, the discussion among physicians, clinicians, and patients—has become a rich and fruitful field in recent years (Kuipers, 1989; Mechanic, 1989). The broad perspective of this research has exposed the interactive processes by which medical conditions are defined and addressed. This research suggests how macrolevel