The Importance of Gender-Specific Mental Health Services

Sophie Corlett, Director of External Relations at Mind

Recently I heard from the team that run Drayton Park Women’s Crisis House in North London about the service they run for women who have an urgent mental health need.

Like many crisis houses it provides a safe space to recover, avoiding a longer and more disruptive stay in hospital. Unlike many others – in fact unlike most other crisis house in the country – it is a women-only service. And because of that, it is able to offer something really quite different and transformative for the 12 women there at any time.

Although mental health problems affect one in four of us, and roughly the same numbers of men as women, there are differences in how problems develop and manifest themselves, as well as the success of different treatments. The route to poor mental health, as well the consequences set in train by a mental health crisis, can be very different for women. For that reason it’s vital that female-only crisis services, such as the one in Drayton Park, are available.

Women are more likely to experience sexual violence both as children and as adults and this can have a significant impact on their mental health at the time and later on in life. It is worth remembering that post-traumatic stress disorder (PTSD) is more likely to be experienced by women than by men and can be triggered by violence or abuse, although symptoms might not present themselves for many years after the traumatic event.

Services need to be attuned to women in crisis who have been victims of violence and abuse. This means having a conversation about women’s experience of domestic violence or childhood abuse is a routine when they are admitted – something which doesn’t routinely happen in many inpatient settings. Once this has been established, staff and service users can together work out what package of care is appropriate.

But it is more than this. It seems obvious that services should feel safe and avoid traumatising people, certainly not retriggering previous trauma. And yet, over and over, we hear from women for whom this has been their experience. How does this happen? This may happen in many different ways:

• feeling powerless on a ward where communication between staff and patients is poor or controlling and the atmosphere is one of coercion
• feeling intimidated in a mixed inpatient environment or being subject to harassment or abuse
• being under observation on a ward or ‘guarded’ pending assessment in A&E by someone with whom you don’t feel safe
• being held down and forcibly injected or witnessing other patients being subject to physical restraint.

Another significant difference for women relates to their experience of motherhood. Women with children may worry that their mental health makes them a ‘bad mother’ and can become fearful that their children will be taken away if they have contact with mental health services – a fear not altogether unfounded in some cases. As a result, many women are very slow to seek help until they are truly at crisis point and may appear to be ‘uncompliant’ when they are in touch with services. If they have no family support networks, they may particularly want to avoid inpatient or residential settings because it may lead to their children going into care.

What makes Drayton Park so special for the few women who get to go is that it’s ‘trauma-informed’ from the start – assuming that the women there need to have an extra layer of control over their environment to feel safe. It understands the experience that many have had of physical assault, and through massage and other physical interventions helps to introduce women to a more positive relationship with the physical. And, where appropriate, it allows women to take their children with them.

It’s no surprise that the women who have used their services speak so positively about them. The surprise is that such services aren’t available everywhere.

For this reason it’s great to be supporting Agenda’s Women in Mind campaign – we need to make sure such support is there for all women.