Understanding Therapeutic Breakdown:A Measure for Malignant Alienation
Research type
Research Study
Full title
Understanding Therapeutic Breakdown:A Measure for Malignant Alienation
IRAS ID
360282
Contact name
Henna Chumber
Contact email
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
This research aims to develop a questionnaire to better understand and measure a concept called malignant alienation. This term describes a breakdown in trust, connection, and communication between mental health service users (patients) and the professionals who support them. When people receiving care feel misunderstood, judged, or hopeless, it can lead to feelings of isolation and withdrawal from services. In some cases, it may even contribute to poorer mental health outcomes, including self-harm or suicide.
Although this issue has been described in mental health literature, there is currently no standard way to identify or measure malignant alienation. This study will create a new tool, a carefully designed questionnaire, that can help identify when this is happening. It will be informed by existing research, feedback from clinicians, and most importantly, the voices of service users with lived experience.
The study will involve asking current and former patients in mental health hospitals to complete the draft questionnaire. Their responses will help refine the questions to ensure the tool is clear, relevant, and useful. Demographic information, diagnoses, and other contextual data will also be analysed to explore patterns in who may be most affected.
The findings could help improve communication between patients and professionals, encourage earlier support when relationships break down, and inform service improvements. It may also help researchers and clinicians identify people who feel disconnected from care, allowing for timely interventions.
This study is being carried out as part of a PhD programme at the University of Birmingham. It will take place over the next two years in mental health hospital settings across the UK. Participants will take part by completing a short questionnaire, which will take approximately 15 minutes.
REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
26/WM/0040
Date of REC Opinion
30 Apr 2026
REC opinion
Further Information Favourable Opinion