Over the last 10 years, there has been an unprecedented rise in reported mental health problems among women and girls.
For the first time in 2015, the number of self-inflicted deaths of women overtook that for men – as shown in figures from the Care Quality Commission. This was repeated in 2016. At the same time, mental health services, both in the community and in hospitals, are under increasing strain and are struggling to meet need. As a result, many women are unable to access support until they reach crisis, and are not receiving the right support when they do.
Women in Crisis
A report entitled “Women in Crisis” was published last month by Agenda, the Alliance for Women and Girls at Risk. The report examines how women and girls are being particularly disadvantaged by detention under the MHA. It calls on policy makers (as part of the current independent review of the MHA) to consider how the legislation can be improved so that it is implemented without detriment to women and girls.
Shortcomings and recommendations
The report states that there is a lack of trauma-informed care supporting women. Five of the key shortcomings and recommendations in the report are summarised below:-
- A lack of routine enquiry into patients’ experience of violence and abuse.
Recommendation - There should be specialist gender-specific, trauma-informed in-patient and community mental health services. Trained professionals should ask questions about abuse and violence and therapeutic follow up support should be offered.
- Inappropriate staffing and wards. This incorporates concerns about male staff delivering care (including restraint and 1:1 observation), as well as breaches of single sex accommodation rules and alarmingly high rates of sexual assaults on mental health wards.
Recommendation - women and girls should be able to choose the gender of professionals involved in their care. In addition there should be an end to any breaches of single sex wards and comprehensive steps should be taken to prevent and respond to sexual harassment or violence.
- Widespread use of restraint, which can potentially be re-traumatising.
Recommendation - There should be an end to the use of face-down restraint and other forms of physical restraint should be used only as a last resort.
- A lack of hospital beds, leading to women being held far away from their homes and families. Also, children and other caring responsibilities are being overlooked, meaning their role as mothers is not considered in their treatment.
Recommendation – The roles of girls and women as carers should be considered during all parts of their treatment.
- Risk that abusive partners/relatives are classified as the “nearest relative” which could put the victim at risk of further abuse.
Recommendation - the “nearest relative” should be replaced by the “appointed person” model enabling women and girls to specify who should have a say in their care.
Understanding the issues
The report highlights that there are significant gaps in understanding the issues surrounding the mental health of young women and girls. Robust data collection and research is needed on the experiences of women and girls of the Mental Health Act, including:-
- Publishing existing annual statistics by age, gender and ethnicity;
- Establishing why girls are more likely than boys to be detained under short term orders;
- Research into what happens to children when their primary carers are detained under the MHA; and
- Research into those females in contact with the criminal justice system.
The report calls for action to address these issues. This includes more investment in community and in-patient services, a review of the Mental Health Act such that it responds better to the realities of the lives of women and girls and a culture change in services so they take into account the specific needs and experiences of women and girls.
The most encouraging development is the changing attitude of the public towards mental illness. However there is a growing crisis in the mental health of women and girls which needs to be given a greater focus by the Government.
Bevan Brittan has a dedicated Mental Health team who can advise you on all legal aspects of Children or Adult Mental Health Services. Please contact Claire Bentley if you wish to discuss the content of this article any further.