G i l l A i t k e n a n d K a t e N o b l e o n b e h a l f o f W o m e n W o r k i n g w i t h W o m e n ( N W R e g i o n a l f o r u m f o r w o m e n i n a n d o u t o f m e n t a l h e a l t h a n d f o r e n s i c c a r e )
AbstractThis article focuses on service provision for women who are involuntarily referred under the UK Mental Health Act (1983) into medium and high security care in England and Wales. We explore how physical and procedural security in such settings is prioritized over relational care (see also Fallon Report, Department of Health, 1999a and NHS Executive, 2000 -Tilt Report). We are not arguing against the importance of protecting the public from the acts of dangerous members of our society. However, we are arguing that many of the women in our secure services are inappropriately placed and receive inappropriate forms of treatment and care. Rather than physical security, it is high relational care, which the women require. Further, we argue that current service provision often re-produces forms of violence and violation which have marked many of women's lives prior to their entry into the secure system. Keywords women and violation; secure psychiatric care; relational security; physical security; mental health; forensic psychology At present, in England and Wales, there are about 1,500 people in special hospitals and about 1,500 in regional secure units. Women constitute about 15 per cent of these populations. This generally means that there can be between 51-78 women located in a special hospital which also holds 351-81 men, and up to ve women in a medium secure unit which can hold 60+ men, (WISH, 1997; NHS Executive, 2000 -Tilt Report). Following the Department of Health's organized Listening Panel consultation exercises in 1999, there was anticipation that a national strategy for the provision of women's secure services would be announced at a