Women's experience of forensic mental health services: implications for practice
| Published date | 09 December 2011 |
| DOI | https://doi.org/10.1108/17556221111194527 |
| Date | 09 December 2011 |
| Pages | 186-194 |
| Author | Kerry Cooke,Di Bailey |
| Subject Matter | Health & social care |
Women’s experience of forensic mental
health services: implications for practice
Kerry Cooke and Di Bailey
Abstract
Purpose – The aim of this pilot study is to explore women’s experiences of forensic mental health care
with a view to designing a larger scale research project.
Design/methodology/approach – In-depth interviews were undertaken with seven self-selected
women who had experience of using secure services currently or in the past.
Findings – The findings revealed three key themes: women’s experiences of settings and treatments;
relationships with staff; and how placements impacted upon important social contacts with family and
friends. Despite their relatively disadvantaged position, the women were able to articulate what worked
and offered clear solutions for implementing best practice.
Originality/value – The women’s experiences testified to the importance of meaningful relationships
with professionals, and with families and friends, as protective factors to help manage risk. This
‘‘relational security’’ is particularly for women in secure services and can be promoted in a range of
ways, hinging upon consistency of care, well managed transitions, and appropriate therapeutic
treatment.
Keywords Women, Forensic medicine, Secure settings, Mental health services
Paper type Research paper
Introduction
Forensic mental health services play an important role in caring for women whose mental
health issues pose a significant risk to themselves or others, with evidence to suggest this is
more likely to be the latter (Women in Secure Hospitals (WISH), 1999). Being female is a risk
factor for certain types of mental distress with women more likely to be diagnosed with mood
and personality disorders than men (Nicholls et al., 2011. Women are more likely to have
experienced domestic violence, childhood sexual abuse and sexual violence than their male
counterparts. Such events commonly precipitate risky behaviours such as self-injury as
an outward sign of inner mental distress (Itzin, 2000; Miller et al., 1995; Yates et al., 2008;
Singleton et al., 1998).
Forensic mental health services also offer women who have committed offences a diversion
route from custody. With the number of forensic service users increasing women who have
been transferred from court or prison now comprise one in eight of the secure psychiatric
population (Ministry of Justice, 2007). Extensive research indicates that women are often
inappropriately placed (Hassell and Bartlett, 2001) and are more likely to be transferred to
high secure settings from another psychiatric hospital due to a lack of local services to meet
their needs (Lindsay et al., 2001). Overall, there is a ratio of five women to every one man
in medium and high secure hospitals, yet women have less serious offences and more
minor previous convictions (Jamieson et al., 2000). Almost 90 per cent are found not to
require the high level of security provided, but are there rather for intensive psychiatric care
(Lindsay et al., 2001).
PAGE 186
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
VOL.6 NO. 4 2011, pp. 186-194, QEmerald Group PublishingLimited, ISSN 1755-6228 DOI 10.1108/17556221111194527
Kerry Cooke is a Mental
Health Social Worker at
Homeless Services,
St Nicholas Hospital,
Newcastle upon Tyne, UK.
Di Bailey is a Professor of
Mental Health at School of
Social Sciences,
Nottingham Trent
University, Nottingham, UK.
To continue reading
Request your trial