Lancashire Care NHS
Trust delivers a stark example of Victim Blaming and delivers changes that
maximise the distress of vulnerable women in its care.
In October 2014, The Orchard Psychiatric unit in Lancaster
was closed to women. This change was
made without consultation with service users or the wider community and the
result is that any woman in Lancaster and its surrounding towns and villages
will no longer be able to access local inpatient psychiatric care.
The closest psychiatric hospital with female beds is in
Blackpool, a 50 minute drive from Lancaster.
Women will also be sent to Blackburn, Burnley, Chorley and as far as
Manchester and beyond. The shortage of psychiatric
beds in the Lancashire Care NHS Trust has always meant that patients could be
sent to hospitals out of their area, but moved back into the area once a bed
became available. Now there are no
female inpatient beds in Lancaster, seriously ill women from that area will be
separated from their families, friends and support networks at a time when they
are most in need of that support.
While information about why the closure was made is sparse,
due to the lack of a consultation process, there have been two reasons given by
the trust for this decision. Firstly, it
is to help protect vulnerable women and secondly, because there is a greater
demand for male beds. The first of these
reasons falls under Victim Blaming and the second is gender discrimination as
the trust prioritises the needs of men over women.
Need for Beds?
Before this move, the Lancashire Care NHS Trust already held
more male than female beds across the trust.
Information about numbers can be found on their website - http://www.lancashirecare.nhs.uk/Services/Adult-Mental-Health/Inpatient-Care.php.
The Orchard had 10 Male and 8 Female beds. Occupation rates in the Female area ran at
100%, with beds being filled the same day, and in some cases just hours after a
patient was discharged. There were
frequent occasions where a female bed would be used temporarily for another
woman, while the patient it belonged to was on home leave or at the general
hospital in order to cope with demand.
There is a definite need for female beds in the area, so why
is the demand for male beds more important than local psychiatric care for
women?
If lack of male beds is an issue then that should be
addressed by the trust by looking to increase the number of male beds without
denying access to a whole group of people under their care. Women should not be denied local access to
inpatient psychiatric care due to a lack of male beds. The needs of women with mental illness are
not less important than the needs of men.
The need of women to be close to their families, children and support
networks is not less important than male beds.
Victim Blaming and
Maximising distress
The suggestion that the move to make The Orchard a single
sex ward is to protect vulnerable women seems to be a clear case of Victim
Blaming as instead of addressing the problem of male aggression, it is blaming women
for their vulnerability. It says to
women "You may be vulnerable, so to protect you, we are going to deny you
access to local inpatient care."
Before the closure there were 10 male beds and 8 female beds
in the unit. The male and female areas
were separate and could only be entered via key-card access, so the men and
women could only access their own bed areas.
Individual rooms in the unit were also locked via key-card, providing
extra security. A single sex lounge was
available in both the male and female areas of the ward. In addition to these areas, there were
communal areas, including a dining room, games room, lounge and inner
courtyard. In the other hospitals of the
trust, Chorley operates a similar system with single sex and communal areas and
Ormskirk has a fully mixed ward. This
would suggest that there are reasons other than vulnerability for denying women
access to The Orchard.
Rather than protecting vulnerable women, removing local
inpatient care will increase their vulnerability and significantly increase
their distress. Sending women 30-70
miles away from their home for treatment means that they won't have access to
their families, friends or support networks.
Research on isolating women from their support networks is well
documented as having negative effects.
Women are also still overwhelmingly the primary care givers to children
and carers for older adults. Treating
women 30+ miles from their home means less opportunities for contact with their
children and people they care for, causing distress on both sides.
If there has been a problem with male to female aggression
in the communal areas, then the trust should address how that is managed. There are single sex units available for men
who are seriously ill, and therefore at risk of harming others and otherwise
aggressive males. A better solution
would be for staff to ensure that known aggressors or those shown to be
aggressive are moved to male wards, able to deal with those problems, rather
than place the blame on women's vulnerability and deny them access to the local
services that they need.
Removing access to local care is likely to discourage women
from seeking help and accepting voluntary admission, and will discourage their
families from seeking help for their relatives, knowing they will be sent miles
away from home. This can lead to
increased detentions under the Mental Health act, with women not willing to
accept voluntary admission, or by deteriorating to the point where a section is
inevitable.
This closure leaves the women of Lancaster and the
surrounding areas with stark choices. Should
they accept treatment for their mental illness isolated away from home, or stay
with the support of their families and friends, knowing that they may be detained
against their will anyway?
Either way, the decision of the trust to close the female
beds at The Orchard is likely to have significant negative consequences for the
women and their families.
