DMH 265 WISH Women in Secure Hospitals
WISH
( Women in Secure Hospitals)
18 Borough High Street
London SE1 9QG
Charity No. 3161774
Contact Person at WISH
Laila Namdarkhan
29th October 2004
Submission of written evidence
to the Scrutiny Committee on 'Draft Mental Health Bill'
Who are WISH
WISH is a unique National charity, working
with and on behalf of women during, after and at risk of containment
in high security hospitals, medium and low secure units and prison
psychiatric units. WISH also supports women when leaving the system
and during the complex process of re-building a new life in the
community.
WISH successfully engages with women
in these dire circumstances to enable women's silent voices and
invisible experiences of being detained, heard and responded
to by Government, service providers and commissioners in both
the public and private sectors of provision. WISH have been campaigning
successfully over the past 13years for the recognition that women's
needs when receiving and being detained for care and treatment
for their mental distress , demands , out of necessity ,to be
rooted in a gender sensitive philosophy and service approach
with women themselves being at the very heart of the process.
Over the past 13yrs WISH has developed
and published cutting edge research, policy and women centred
philosophies of care that have informed and influenced new ways
of approaching the delivery of care to women. Demonstrated by
the fact that nationally a wide variety of services who provide
care and treatment to women in this category have used WISH's
work to improve their services and achieve best practice and
offer a better deal to women. Finally and more importantly the
core work of WISH is our ability to maintain and sustain meaningful
relationships with women in all the settings where WISH operates
based on a relational security model developed by WISH. WISH
achieves this through regular contact with women in the system
through professional support, visits, women centred advocacy,
briefings, newsletters (that women themselves contribute and
edit) and sponsored 'Feel Good Day' events. Currently there are
over 100 women who are members of WISH. Two recent consultations
with women in the system (June/July August 04) demonstrate that
women benefit from, continue to want and value WISH's involvement
during and after their journey through the current Mental Health
system. As such WISH feel that we can claim to represent a large
proportion of this small but significant group of women.
Giving Evidence
WISH do not propose to comment upon
the draft bill paragraph by paragraph as we do not have the legal
capabilities to do so but rather place before the committee WISH's
views regarding areas of the bill that raise concerns and areas
where we are seeking assurances that women's rights are not further
eroded by proposed changes emanating from the current draft and
suggested inclusions to the bill and the code of practise.
- WISH are concerned that the new
compulsory treatment provision will adversely effect women, currently
women are detained for longer periods in Mental Health secure
services than is necessary and any changes to the current act
that increases this risk will be detrimental to women in this
category.
- Current evidence suggests that women
are more likely to receive a diagnosis of boarder line personality
disorder/ personality disorder than men and as such would under
the new "treatability" test proposed in the draft be
at greater risk of being detained than under the current act.
WISH are seeking assurances that this will not be the case. WISH
endorse MINDs concerns here from women perspective and have real
anxieties that women who experience extreme self harm will now
be at risk from being detained and would by definition be more
afraid of seeking help in the knowledge that this could lead to
them being involuntarily detained as would other instances where
women might seek help for mental distress.
- WISH are concerned that there appears
to be under the new draft bill proposal a lack of legislative
'right' for people to access good quality mental health and social
care services with assured standards of care. This lack will and
does have an adverse effect upon women's ability to receive care
and treatment based upon appropriate gender sensitive assessment.
To often in WISH's experience women have been spiralled up the
secure forensic health provision due to lack of early intervention
and recognition that women's life experiences can and do impact
upon their mental well being. ( see "Into the Mainstream"
Strategy for Women's Mental Health DOH 2002, and the Implementation
Document 2003 that accompanies the strategy) for evidence and
confirmation that women's mental health needs and that includes
new Mental Health legislation, should as all current evidence
indicates, be delivered within a gender informed framework.
Women as observed time and again by WISH to not be receiving
appropriate assessment, care and treatment in a mental health
system that fails to have any understanding of the gender specific
needs as presented by women.
- WISH are concerned that the new
bill appears to make it more complex for people leaving the secure
system to receive the right support and treatment during these
difficult transitions. 6 weeks of free care is not enough and
in the case of women would put them at great risk of re-call thus
enforcing their sense of personal failure. It is imperative that
the bill is clear and unambiguous about how after care in managed.
This is imperative for women to feel safe, secure and supported
for as long as it takes.
- WISH are pleased to note that Advocacy
is to be recognised as essential prerequisite for strengthening
the defence of patients Human Rights while being detained. WISH
are concerned that at the preliminary stages before and order
is made no provision has been made to include the right to an
advocate, WISH urge reconsideration of this on the grounds that
a women is most vulnerable at this time and most isolated and
needs independent support and advice should she want it. WISH
would urge that specialist advocacy for women be promoted as recommended
by "Into the Mainstream" Women's Mental Health Strategy
DOH 2002.
- WISH are concerned that under the
new bill women's advanced directives
(that are still not fully part of the
current mental health forensic service opportunities for women
patients) though upheld under Mental Capacity Bill may well be
denied under these new proposals, WISH seek assurances that this
will not be the case.
Finally in our submission WISH urge
that both in the Revised Bill and the Code of Practice mention
is made of the need to administer both the acts and the code in
the knowledge of gender awareness within mental health services
and how currently that awareness is now becoming part of service
delivery and therefore should be an intrinsic part of both the
new bill and the code. This is an opportunity to place on record
how the ways in which women and men experience Mental Health distress
is different in Britain to-day, all the evidence available now
points to this and as such should be reflected in Modern laws
and codes that should be at the forefront of leading good practice
and upholding the civil and human rights of both women and men
rather than replicating a gender neutral law and code that makes
invisible the significant and important distinctions that are
experienced by women and men.
WISH Laila Namdarkhan
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