Tell the Tale: A Qualitative Study on Ethical and Legal Challenges Faced by Nurses Rendering Schizophrenic Care at Neuro-Psychiatric Hospitals in South-West Nigeria
Year: 2026
Type: article
Abstract: Caring for individuals with schizophrenia in neuro-psychiatric hospital settings is often accompanied by unique ethical dilemmas, particularly in facilities with limited mental health resources, and in a population with strong socio-cultural factors influencing care. Mental health and psychiatric nurses often navigate conflicts between patient autonomy, beneficence, non-maleficence, and justice. This study aimed to explore and describe the ethical and legal challenges encountered by nurses in the care of patients with schizophrenia at neuro-psychiatric hospitals in South-West Nigeria. A qualitative research design was employed in this study. 12 nurses from Federal Neuro-Psychiatric Hospital, Yaba, Lagos State, Nigeria; and Aro Neuro-Psychiatric Hospital, Abeokuta, Ogun State, Nigeria were selected purposely for in-depth interviews. Data was collected over 1-3 months, and every interview was audio-recorded, transcribed verbatim, and analyzed thematically. 5 main themes were studied viz i. ethical dilemmas in patient care, ii. coping strategies of nurses, iii. conflicts between professional values and institutional policies, iv. barriers to ethical decision-making, and v. support systems for mental health and psychiatric nurses. The key ethical challenges included treatment refusal, informed consent difficulties, confidentiality breaches, and the use of involuntary admission and restraints. Legal challenges were largely attributed to unclear legal frameworks, inadequate staff training, and insufficient institutional support. Nurses reported experiences of moral distress, emotional exhaustion, and burnout, although coping strategies such as peer support, thorough documentation, and professional consultation were commonly utilized. Nurses face recurrent ethical and legal challenges in mental health care due to systemic and institutional limitations despite their strong commitment, positive attitudes, and ongoing professional development. There is an urgent need for context-sensitive ethical guidelines, mental health law reform, and structured ethical support for nurses.
Authors: M.O. Olasupo, A.O. Ikwuka, F.C. Udeh
Language: English
Topic: Ethics in medical practice
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7203712901
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