Service Responses to Women with Mental Health Needs

Abstract

There are individual mental health professionals who respond to women with mental health needs with warmth and intelligence; staff whose practice is antioppressive and fully cognisant of the impacts of poverty, domestic violence and racism upon their patients’ lives; and there are doctors, nurses and therapists who work in solidarity with the women in their care and who fully appreciate their practical and emotional struggles. However, only a handful of mental health services could be described in such terms. Most services fail to provide the support and safety women with mental health needs require and many routinely demean women, dismiss their distress and replicate the dynamics of abuse and exclusion that have characterised their previous lives. This article suggests we have reached a turning point in Britain in relation to mental health service provision for women. Not only is there considerable evidence of an association between women’s social experience and their mental health, but this association is also acknowledged by the majority of mental health workers. Many staff also recognise that the professional training they received provided them with a wholly inadequate preparation for engaging helpfully with their patients. As individuals some have abandoned the medical paradigm altogether and no longer ask ‘What is wrong with this woman?’ but rather ‘What has happened to this woman?’ In this paper we draw upon evidence from a range of sources to explore these issues, including some of the work we have ourselves carried out in the last two years. Particularly relevant in this context is information gathered as part of a national programme to develop and pilot training for staff in secure services who work with women with mental health needs (Scott & ParryCrooke, 2001). As part of the training needs assessment phase of this programme, data was collected by questionnaire from 63 multi-disciplinary staff and through interviews with 60 staff in six secure services. We also draw upon findings from a recent survey (Williams et al, 2001a) of attitudes to mental health services for women, which was carried out to inform the Mental Health Strategy for Women currently being developed by the Department of Health.