Tuesday, May 13, 2008

Women in mental wards face grave risk of abuse

From The Age (an Australian Newspaper), as seen on the Psych Observer Website

NEARLY two-thirds of female patients surveyed in psychiatric wards in Victoria have been sexually abused or harassed by male patients, new figures show.

A report by the Victorian Women and Mental Health Network has also revealed that 70% of mental health staff surveyed by the group knew the abuse and harassment was occurring in public hospital wards. A further 30% of the 42 staff surveyed said the abuse, usually perpetrated by sexually disinhibited male patients, happened frequently.

Network convener Heather Clarke said the report, Nowhere to be safe: Women's experiences of mixed-sex psychiatric wards, showed that 61% of the 75 female patients surveyed about their experiences in psychiatric wards had been abused or harassed in some way and did not feel safe.

"These women are being admitted to hospital to get well and then they are being subjected to harassment and abuse that has an adverse effect on their health," she said.

"The situation is most concerning in areas of wards where staff are not always present, or in cases where patients are heavily medicated, making them more vulnerable to abuse."

Ms Clarke said any form of abuse in psychiatric facilities had great potential to retraumatise women. "Evidence suggests that up to 70% of women admitted to psychiatric inpatients units have experienced past sexual abuse," she said. "These women are at risk of having that trauma retriggered in a place where they should be safe."

During inpatient meetings last year, some women said they had been sexually assaulted or had seen women engaging in sexual activity with men when they did not seem well enough to consent. One woman fled from a high-dependency unit after a male patient sexually assaulted her in her bedroom. When she returned to the unit days later, the offender was still there.

Monash University psychiatrist Jayashri Kulkarni said most of Victoria's public inpatient units became mixed wards in the 1960s, creating the potential for men to assault women.

"It's a system that is a recipe for problems," she said. "There are lots of minor incidents occurring all the time that can have quite an impact on vulnerable female inpatients. Unfortunately, there are major incidents occurring as well. The framework of the inpatient settings has allowed this to happen."

Professor Kulkarni said that while some units tried to separate men and women when they could, ward design often hindered their efforts.

"A lot of wards have very rabbit-warren-like structures so there are lots of pockets staff can't see. Some of the designs are better with smaller bedrooms now, but you can often still have common bathrooms, which means both sexes traipsing around from bathroom to bedroom and so on … It's a situation where women can be assaulted too."

She said she knew of two cases now before the courts involving a public and a private hospital.

Ms Clarke and Professor Kulkarni said Australia needed to follow British policy to segregate new wards for patient safety.

"What's happening at the moment is a dereliction of that duty (of care), which could lead to litigation if nothing is done about it," Professor Kulkarni said.

A spokesman for the Department of Human Services said the Government was looking at ways to increase women's safety in new hospitals, which "may involve creating spaces that are for women only".

The department gave some centres a $20,000 grant to promote gender sensitive practices last year, which included the development of separate outdoor garden areas, he said.

But Ms Clarke said it was not enough. "At the end of the day, this is about people's safety. If the UK can introduce segregation, we should at least be able to start talking about it here," she said. "The safety of vulnerable people in hospital should be paramount."

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