Health professionals’ experiences of providing care for women survivors of sexual violence in psychiatric inpatient units.

Abstract

Background: Survivors of sexual violence, who are predominantly women, commonly access mental health services. Psychiatric inpatient units in Australia are predominately mixed gender and may further retraumatise these women. Sexual violence is under-recognised by mental health professionals and there is a lack of adequate policy or direction for mental health service services. To date, only a small amount of research has focused on health professionals’ experiences of providing trauma-informed care to women in psychiatric settings, with most studies focused on specific practices or interventions. Qualitative data is particularly lacking on this topic. This is a critical gap in the knowledge given that health professionals are key to detecting and addressing victimisation. The aim of this study was to gain an in-depth understanding of healthcare professionals’ experiences and perceptions in providing care to women who are survivors of sexual violence in psychiatric inpatient units. Methods: This qualitative study utilised semi-structured interviews with 40 health professionals recruited from four psychiatric inpatient units within a large Australian public mental health organisation. Data were examined using thematic analysis. Results: Three main typologies were developed to describe participants’ experiences of the care provided to women; 1) Dismissing and denying; 2) Acknowledging but unprepared; 3) Empathising but despairing. Discussion: Gender, professional training, adherence to the biomedical model, and level of experience influenced health professionals’ experiences. Conclusions: Health professionals in this study held varying attitudes towards female consumers and responses to sexual violence. Our findings suggest the need to address individual staff perceptions and promote trauma-informed and gender-sensitive care across all disciplines, genders and levels of experience.

The Impacts of Working With Victims of Sexual Violence: A Rapid Evidence Assessment

“…They often faced ethical and professional dilemmas about their role and the usefulness or necessity of their role (Backe, 2018; Javaid, 2017). Faced with these issues, staff felt stressed and unable to cope with the demands of the job, their sense of self-worth, confidence, and self-efficacy as professionals were diminished, felt disempowered and meaningless in their job, as well as experiencing constant doubt and ruminations over decisions taken due to no longer perceiving themselves as skilled to a high standard (Albaek et al, 2020; Brend et al, 2020; Gatuguta et al, 2019; O’Dwyer et al, 2019). This effect was exacerbated when they lacked clear guidance, guidelines, or resources (Backe, 2018; Kreinath, 2019), when there was an overreliance on procedures, and when they did not feel that the organizations they worked for would support their decisions (Albaek et al, 2020).…”

“…The volume of work and having to empathetically engage with client’s stories and feelings left professionals experiencing emotional and psychological distress. Most commonly, they felt fearful, depressed, anxious, sad, angry, upset, horrified, fatigued or drained, and frustrated (Dutton et al, 2017; Hunt, 2018; O’Dwyer et al, 2019). Sometimes they wanted to get away from clients and looked ahead with dread, finding it hard to motivate themselves to come to work (Brend et al, 2020; Parkes et al, 2019a).…”

“…Generally, studies focused on the support available, including supervision and guidance, workload and caseload characteristics, including perceived control over them, and the type of clients professionals worked with. While what was meant by “support” was not clearly defined in all studies, it was evident that perceiving the organization, the work environment, including colleagues, and the management as organizationally and operationally supportive impacted on professionals’ well-being and the quality of the services they provided to their clients (Choi, 2017; O’Dwyer et al, 2019; Turgoose et al, 2017).…”

“The real pandemic’s been there forever”: qualitative perspectives of domestic and family violence workforce in Australia during COVID-19

“…This study used a relatively large sample size compared to similar studies where samples varied from 16 to 40 [ 26 , 43 – 46 ]. This enabled us to collect rich information about the diverse experiences of DFV workforce across Australia.…”

Transforming health settings to address gender‐based violence in Australia

“…System‐level barriers, such as the presence of the partner in consultations or a lack of training or referral services, can impede practitioners even further 23 . There were no specific reviews on sexual violence, but in the Australian mental health inpatient setting, some practitioners dismissed that sexual violence was an issue, some acknowledged it but felt unprepared, and others understood sexual violence but despaired of being able to respond in a gender‐sensitive way 24 …”