Violence and Violation: Women and Secure Settings¹

Abstract

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

Negotiating the Dependency/Nurturance Tightrope: Dilemmas of Motherhood and Disability*

“…Some theorists who have considered gender and dependency have characterized women's dependency as problematic, noting that women who rely "excessively" on heterosexual partners are subject to increased risks of economic, social, psychological, physical and sexual abuse (DeKeseredy and Hinch, 1991;Gilson, DePoy and Cramer, 2001;Morton, 2000). Others have argued that when women are dependent on the State and its institutions, they are actually at increased risk of being abused (Aitken and Noble, 2001;Gil, 1984;McCarthy and Thompson, 1996;Schneider, 1996;Taylor, 1987). Still others have argued that dependency on the State results in increased social stigmatization and surveillance for women (Fraser and Gordon, 1994).…”

Lived experience of working with female patients in a high‐secure mental health setting

“…; Women In Secure Hospitals, ). The promotion of gender‐specific security needs, namely the emphasis of a greater need for relational security over physical security (Aitken & Noble ; Department of Health, ), saw the introduction of Women's Enhanced Medium Secure Services. Alongside these, a single National High Secure Healthcare Service for Women (NHSHSW) was established to provide 50 beds for female patients from across the UK detained under the Mental Health Act (1983) who require high‐secure care.…”

VIII. Dangerous Women? A UK Response

“…This concern is over and above existing critiques of women's life experiences being inappropriately psychiatrized (Department of Health, 2002b); the stereotypical pathologizing associations between femininity, emotionality, dangerousness, unpredictability and madness (Ussher, 1991); inattention to women's experiences as survivors of childhood and adulthood abuse and trauma (Root, 1992); and the role of existing prison and hospital 'therapeutic' regimes in re-enacting trauma (Aitken and Noble, 2001).…”