In Plain Sight: Open Doors, Mixed-sex Wards and Sexual Abuse in English Psychiatric Hospitals, 1950s—Early 1990s

Abstract

SummaryThis article investigates the consequences of unlocking psychiatric wards and allowing male and female patients and staff to mix freely in the post-war period. I argue that the sexes were allowed to socialise with each other primarily for the benefit of male patients, and that some superintendents were ‘blind’ to the dangers of sexual abuse to which female patients were exposed, especially given the growing number of male ‘sexual psychopaths’ who were being admitted to open wards. While male nurses did complain about mixed wards in the mid 1960s, it was not until the rise of feminism and patient activism that the extent of sexual abuse and violence in hospitals began to be revealed a decade later. By the 1980s, despite calls to return to segregated living, psychiatric hospitals were no longer able to fund single-sex wards, exposing many women to sexual danger and deterring them from seeking help as in-patients.

Sexual abuse by superintending staff in the nineteenth-century lunatic asylum: medical practice, complaint and risk

“…This had the potential to yield unfortunate implications for female patients residing in institutions, who had little scope for choice and negotiation when confronted with sexual exploitation (e.g. Hide, 2018 ).…”

4 ‘The general atmosphere of this admission unit is reassuring and optimistic’

“…Although not explicitly stated in any of the documentation identified so far, it is likely that an open-door policy was adopted in the unit. Not only had this become widespread practice in Britain in the 1950s (Hide, 2018), but moreover the floor plan of the unit and photographs also support such a conjecture: the entrance hall to the inpatient part of the building has no nurse station or reception controlling access (see Figure 4.2). In the external spaces, although the two yards outside the wards are fenced, those fences are transparent and suggest no intention to enforce confinement (Architect and Building News, 1956: 13).…”

Gender and intersecting vulnerabilities on the mental health unit: Rethinking the dilemma

“…The "phasing in" of gender-integrated units coincided with a move toward deinstitutionalisation, initiated by a decision to halt the planning and construction of further institutional accommodation (2). The shift to mixed-gender units emanated from a more transitory model of mental health inpatient care internationally, with greater focus on community supports and the mirroring of "real world" conditions (3)(4)(5). However, normalization of gender mixing could arguably mirror and augment problems experienced by women in the world outside the unit, which include a disproportionate experience of male-instigated violence (6).…”

“…A considerable body of research exists on the gendered aspects of life in adult acute mental health facilities (3,4,(7)(8)(9)(10)(11)(12)(13). This literature is supplemented by research in specialized forensic (14)(15)(16)(17)(18), general hospital (19)(20)(21)(22), and outpatient mental health (23)(24)(25)(26) settings.…”