Men’s Experience of Hospitalization in a Closed Psychiatric Ward, and Their Perception of Its Effects on Their Masculine Identity

Psychiatric hospitalization has undergone significant transformations over the years. Originally conceived as an institution primarily aimed at isolating individuals from society, it was later repurposed to stabilize people experiencing mental health crises and to transition them to continued treatment in the community. Despite this objective, research has shown that a psychiatric hospitalization may involve coercive measures, stressful interactions with treatment staff, and violent behavior by other patients. Such experiences can have a lasting negative impact on one’s mental state and may even lead to the development of trauma.

Goffman (1961), when referring to the psychiatric institution, defined it as a “total institution” that reshapes the identity of the person who enters it. Part of an individual’s identity is their gender identity. Since the dominant model of masculinity in Israel is hegemonic masculinity- which emphasizes control, strength, and independence psychiatric hospitalization and the subsequent stigma can lead to a crisis in masculinity. This raises the question of what happens to masculine identity following a stay in a psychiatric institution.

As far as we know, no prior studies have specifically examined the consequences of psychiatric hospitalization on masculine identity. Therefore, the present study aimed to explore men’s experiences of hospitalization in a locked ward of a psychiatric hospital, and how they perceive the impact of this hospitalization on their masculine identity. Drawing on a qualitative phenomenological approach, semi-structured interviews were conducted with nine men who had been hospitalized in a closed ward at a psychiatric hospital. These interviews underwent thematic analysis to uncover the essence of the phenomenon under investigation.

The thematic analysis revealed four main themes: 1.Coercion, Loss of Control, and Dignity Violations in Psychiatric Hospitalization: This theme describes the use of coercive measures, incidents of violence, loss of bodily autonomy, feelings of helplessness, and diminished self-worth among patients within the ward. 2. Between the Outside and the Inside: This theme addresses the tension between the patient’s inner world during hospitalization, often experienced as a prison-like environment, and the external reality of the life and society left behind.3. Life After Hospitalization: This theme focuses on the enduring effects of hospitalization on participants’ lives, including changes in personal and social self-perception, as well as their processes of recovery and return to everyday routines. 4. Masculinity: This theme examines the participants’ perceptions of masculinity in light of the experiences described in the preceding themes, and considers how societal stigmas and gender expectations influence the way the study’s participants view their masculine identity during and after hospitalization.

The findings indicate that the experience in a closed psychiatric ward harms both personal and masculine identity. Hospitalization may involve feelings of humiliation and helplessness that conflict with hegemonic masculine values. The gap between societal expectations of a “strong man” and the reality of vulnerability and dependence on the treatment staff results in shame and a diminished self-image. Stigmas toward those who have undergone psychiatric hospitalization add another layer of harm, complicating reintegration into one’s former life in areas such as employment, relationships, and social functioning. Nonetheless, the study also shows that many men take active steps toward recovery, regaining a sense of control over their daily routines, improving their body image, establishing supportive intimate relationships, and seeking out rehabilitation services that emphasize equitable power dynamics.