Meeting the needs of women in secure mental health: a conceptual framework for nurses

Abstract

Within the wards of Britain’s high and medium secure mental health services, the needs of the female population differ significantly from those of their male counterparts. Although much smaller in number, the vast majority of female patients formally detained in secure services are young, Caucasian women, who are less likely to be prone to criminality and have a propensity to suffer from psychological distress. Many have experienced extensive trauma and exhibit both internally and externally driven violence. Drawn from the women’s own narratives and analysed using a descriptive phenomenological approach, the findings provide the basic structure for a new ‘humanistic conceptual framework for care’ which could be used by mental health practitioners to both inform and structure the daily provision of care and to better understand the physical and mental health needs of this unique patient group within secure mental health services.

Just Like a Woman: Gender Role Stereotypes in Forensic Psychiatry

“…Similarly, if mental illness were a risk factor for violence by women, then one might expect psychosis and other Axis 1 diagnoses to be frequently made in inpatient forensic services, but this is not the case. In inpatient forensic services for women, EUPD is the commonest diagnosis ( 69 ), but psychosis is by far the commonest diagnosis in male forensic inpatients ( 70 ). This difference in diagnosis may indicate that women’s violence is attributed more commonly to their personality disorder than mental illness, and is differently formulated compared to male patients.…”

“…Parkes and Freshwater ( 69 ) rightly point out the dangers of caring for women in forensic settings, from becoming embroiled in gang mentalities ( 117 ), being on the receiving end of demeaning attitudes of staff ( 118 ) and the risk of becoming re-traumatised in secure care ( 119 ). However, these are equally as likely consequences for men in similar circumstances.…”

Women in Forensic Mental Health Services: Lived Experiences and Meanings Attributed to Activities in Rehabilitation Programs. Study Protocol

“…Despite the small number of women in relation to the number of men living in these settings, they have a higher chance of being admitted to secure units, where they stay for longer periods (Lart et al, 1999; McKeown et al, 2003; Sarkar & Lstro, 2011; Thomas et al, 2005). This increases their vulnerability of suffering occupational deprivation in these settings (Collier & Friedman, 2016; Parkes & Freshwater, 2015; Ribeiro et al, 2015). In spite of this, as stated earlier, scientific literature lacks research findings from a gender-sensitive approach.…”

Ser mujer en prisión: Privación ocupacional en la vida diaria de mujeres internas en un centro penitenciario en España

“…Las mujeres en prisión presentan unas necesidades personales y ocupacionales diferentes a las de los hombres (Baker & McKay, 2001), sin embargo como se pone de manifiesto en diferentes trabajos el contexto tanto arquitectónico como en el desarrollo de programas de intervención de los centros penitenciarios suele estar diseñado principalmente para ellos (Samaranch, 2003). Por un lado, entre las mujeres existe una mayor probabilidad de tener una enfermedad mental de sufrir trastornos psicológicos, muchas han experimentado un trauma extenso y exhiben violencia tanto interna como externa (Parkes & Freshwater, 2015), una alta tasa de analfabetismo (48,7%), un elevado consumo de drogas y alcohol, una escasa experiencia en el mercado laboral, así como una significativa carencia de habilidades sociales y laborales ya que dentro de prisión suelen realizar trabajos principalmente relacionados con las tareas domésticas (Almeda Samaranch, 2006;Cervelló Donderis, 2006). Otra diferencia de relevancia respecto a los hombres internos es el rol que ejercen como madres.…”