Developing Inpatient Services for Women: Challenges and Implications
| Pages | 32-35 |
| Published date | 01 March 2003 |
| DOI | https://doi.org/10.1108/13619322200300007 |
| Date | 01 March 2003 |
| Author | Kath Vardi |
| Subject Matter | Health & social care |
Developing Inpatient
Services for Women:
Challenges and Implications
Kath Vardi
Independent Mental Health Consultant and
Trainer, based in the North West
Focus on…
n October 2002 the Department of
Health published the strategy for the development of
mental health services for women entitled Women’s
Mental Health: Into the Mainstream. The document sets
out an ambitious agenda for change in mental health
services. Building on the National Service Framework
for Mental Health and the NHS Plan, the strategy
emphasises the importance of listening to women. In
her foreword to the document, Jacqui Smith, the
minister for mental health, writes:
‘We must take heed of what women are saying. They want
to be listened to, their experiences validated, and most of
all to be kept safe while they recover from mental ill
health. They want importance placed on the underlying
causes and context of their distress in addition to their
symptoms, support in their mothering role and their
potential for recovery recognised.’
This commentary will look at the current service
context of adult acute inpatient services for people
who are mentally ill and how this interacts with
attempts to provide appropriate services for women. It
will explore why the development of services for
women has received such little priority by
organisations themselves and will consider the
implications of implementing the recommendations of
the strategy for both organisations and staff.
Along with core documents I will draw upon my
own experience as a practitioner and manager in
outlining what I believe are the central reasons why
organisations have been reluctant to address the issue
of women’s services in any meaningful way. I will
describe how my experiences have shaped my
Iunderstanding of such a thorny issue. During my time
both as a practising nurse and as a clinical and service
manager I have been party to many discussions, both
formal and informal, about the service response to
women. During these discussions I have often felt like
a lone voice in the wilderness, proposing that we
radically review our approach and attitude towards the
provision of women’s mental health services. I have
been ridiculed, sidelined, dismissed and laughed at,
but I have also found an oasis of support and
understanding among other women professionals
forging alliances and networks. Through these I have
continued to develop my understanding of why this is
such a politically difficult subject.
The service context
Adult acute inpatient mental health services continue
to face the challenges of chronic staff shortages,
impoverished skill mix, archaic ward environments
and rising client expectations. In such a pressurised
environment there exists a sense of siege for many
working on the wards; staff are working in teams in
which there are unfilled vacancies resulting from a
recruitment freeze or an inability to fill posts. High
levels of bank and agency staff and overtime mean
that exhaustion and ‘burn out’ rates among staff are
high, and levels of sickness attributable to stress and
related disorders are rising. Adult acute inpatient
mental health services are in crisis and continue to
struggle to integrate into wider mental health services,
existing as islands in what are often fragmented
service systems (Sainsbury Centre for Mental Health
(SCMH), 1998; Standing Nursing and Midwifery
Advisory Committee (SNMAC), 1999).
32 The Mental Health Review Volume 8 Issue 1 March 2003 ©Pavilion Publishing (Brighton) 2003
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