Issue 1

Development of a Separable Women's Service

Many readers are aware of the recent proposal to establish a separable service for female patients on an area of Wyndham Ward. Since October of this year, a working group consisting of representatives from various professional disciplines within the Clinic, User Friendly Group members as well as current service users have been meeting on a fortnightly basis to discuss its development. This article is intended to outline the focus and progress of the working group to date.

Women in secure environments are in the minority (16-20%), and it is not uncommon to find only one or two women placed on wards within a regional secure unit at local level at any one time. The Department of Health and Home Office (Reed report, 1992) formally acknowledged women in forensic provision as being a vulnerable group, with neglected needs in terms of their care and treatment. It is widely acknowledged that secure mental health services, due to the greater numbers of male users, tend to be male-orientated and not well suited to the needs of women patients.

The working group at the Caswell Clinic recognise that women should receive appropriate treatment in a safe and supportive environment that is sensitive to gender issues. These issues include an understanding of their needs both as women and as individuals. Importantly, it is also felt that, in developing specific services for women, the implications for male patients will be generally positive due to the increased focus on service delivery and quality.

The NHS Executive document "Safety, Privacy and Dignity in Mental Health Units" (1999) highlighted the need for staff to receive training in gender specific issues.

The working group here at the Caswell Clinic identified one such education and training programme, developed at the University of Liverpool, called the Gender Awareness Training Initiative. Fifteen staff members and one user representative will undertake this training in January 2002, the long-term aim being that all Caswell staff involved in direct patient care will receive gender-awareness training.

Another key objective of the Working Group has been to undertake a review of the existing policies and standards in relation to women's services at the Caswell Clinic. These include environmental considerations, as well as issues relating to women's health and social care needs. It is recognised that these should be gender-sensitive and auditable (we can measure how well we are doing) in order to improve and monitor the quality of service provision.

The Working Group is in agreement that a separable service is required, which could respond to patients' needs for gender mixing but could also provide safe single sex accommodation as required. Much consideration has been given by the Working Group as to how to manage this change toward separable facilities. Feedback received from current service users has indicated that not all women want, or indeed need, to be accommodated within a "women's unit". It has been suggested that women may wish to be accommodated separately from men during the early part of their admission, or when acutely ill, but may wish to be accommodated in a mixed environment for the rehabilitation part of their stay.

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