Accessible summary
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The experiences of women patients with sexual abuse histories in inpatient mental health services are a cause for concern. Many of these women patients receive a diagnosis of borderline personality disorder, and are vulnerable to sexual assault.
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Attempts to reduce sexual assault have included the introduction of policies, improved monitoring of data, as well as improvement in ward layout and increased numbers of staff.
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A number of workshops were devised for a variety of mental health staff to address the sexual safety of women patients, where several issues emerged which are discussed in this paper.
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This paper suggests that psychoanalytic insights offer an understanding of ways in which women patients with sexual abuse histories may relate to the staff caring for them. This can be combined with supportive supervision to enable staff to safely speak about their experiences of caring.
Abstract
Strategies to reduce sexual assault on women patients in mental health inpatient acute wards have included effective policies, a consistent approach to recording and monitoring data relating to incidences of sexual assault, increased staff levels and improvements in the ward layout. A series of workshops were devised to enable mental health staff to work with greater awareness and sensitivity to keep women patients safer on inpatient wards. What emerged in particular during the training was the ways in which staff felt at loss as to how to build therapeutic relationships with women patients, particularly those with histories of sexual abuse. These patients may repeat early ways of relating which may at times be a challenge for the staff caring for them. This paper suggests that psychoanalytic insights offer an understanding of these ways of relating. This can be combined with frequent and supportive supervision to enable staff to safely articulate their often troubling responses to caring for women patients, this creating a caring and supportive environment for staff.