The attitudes of an unselected sample of general nursing students to a series of matched medical and psychiatric case-examples were assessed before and after they received 9 weeks training in either a general hospital psychiatric unit or a geriatric unit. The major component in cluster analyses of construct ratings of case- descriptions by both groups before and after training was a factor of fear, or distrust, on which students differentiated clearly between medical and psychiatric cases, tending to expect the psychiatric patients to be more frightening, less likely to cooperate, more likely to be violent and dangerous and to need strict control. Psychiatric training, therefore, did not eliminate students’ distrust of psychiatric patients. This highlights the importance, during training, of attending to issues of trust and responsibility, and the problems of fear and prejudice caused by psychiatric labels. The attitudes of permanent psychiatric staff are highly relevant in considering how students will be affected by psychiatric work experience.

Some benefits of contact with psychiatric patients were found, and the implications of these are discussed. These benefits support the value of the training experience, overall, and it is suggested that students should work with psychiatric patients earlier in their course (in the first year). The scope of psychiatric training should be broadened and improved to make this a more attractive, worthwhile option.