Trigger Warning for discussions of violence against women with disabilities, and discussions of sexual violence particularly within the context of psychiatric units.
Last week, news broke in the Australian state of Victoria that women who are patients in psychiatric wards are being routinely sexually harassed and assaulted by men who are patients in those same wards. The Australian Broadcasting Corporation (ABC) reports:
The Victorian Women and Mental Health Network is calling for more wards to be segregated after reports of patient harassment and sexual assaults.
Victorian wards were de-segregated in the 1960s because of a perception that sharing spaces with women would help male patients.
The network’s chairwoman, Heather Clarke, says the assaults hinder the victim’s ability to cope with and recover from mental illness.
“Threats and intimidation, unwelcome sexual advances, sometimes males entering bedrooms and at times even sexual assault,” she said.
“This is very concerning when it’s recognised that a majority of women, 70 per cent of these women, already have past histories of physical or sexual abuse so these volatile environments are re-traumatising.”
Ms Clarke says while some facilities have female-only spaces, a lack of resources means it is not always enforced.
“Some wards have created women’s corridors, but there a number of issues with those corridors,” she said.
“There may not be enough beds in them for all women to be admitted and when they need extra beds for men they sometimes admit men to those those corridors.”
Well, it would have been nice if, when desegregating wards because of a perceived benefit to male patients, someone had bothered to ask what the impact might be on the women. That said, very few people with even a passing familiarity with these issues will be surprised by such revelations and accusations, and readers of this blog might recall that I’ve written about this very subject before. Unfortunately, a passing familiarity is much more than most people seem to have.
Julie Dempsey, a woman who has been a patient at various psychiatric units in Victoria spoke to the Age about her experience of being assaulted in a ward and witnessing other sexual assaults. Her comments offer invaluable insight:
”You’re told to go to hospital so you will be safe, but people are often put into vulnerable positions,” she says.
”I no longer feel comfortable even visiting someone in hospital, let alone voluntarily putting myself in as an inpatient to a psychiatric facility.
”Something needs to be done to make them safer.”
Like the rest of this story, what Dempsey has to say is not surprising, but it is devastating. It’s no secret that sexual violence almost always has a negative impact on the victim’s mental health, not infrequently going so far as to cause or otherwise trigger a mental illness (such as post-traumatic stress disorder or depression, to name only a couple of examples), or exacerbate one that’s already present. And, as the ABC articles note, 70% of women who are patients in Victoria psychiatric units already have a history of physical or sexual abuse, due both to the link between victimization and mental illness and women with disabilities’ particular likelihood of being chosen as victims by perpetrators of violence. That sexual violence is not good for women already struggling with mental illness is one hell of an understatement.
But clearly, this violence is not only having a direct negative impact on mental health, it’s also preventing women with mental illness(es) from seeking out treatment and services that they may otherwise feel would be beneficial to them. Inpatient psychiatric treatment is definitely not for everyone. But it certainly should be an option for those to whom it does look appealing. And if a woman feels that such treatment may be appropriate and helpful for her, but she is too afraid for her personal safety to seek it out, that is an enormous violation. I highly doubt that Dempsey is the only woman whose prior experiences with violence inside psychiatric facilities has caused this option to be taken entirely off the table for her.
Further, the fact is that not all patients in psychiatric units have freely chosen to be there. This is an issue that needs addressing outside the scope of this post and my knowledge base. But being forcibly placed in treatment against your will is usually traumatic and can be damaging enough to one’s sense of safety. Forcibly confining people in treatment against their will while placing them in an environment that subjects them to the constant threat of sexual violence is unconscionable on a whole new level.
I can’t claim to have the answers. While sex-segregated wards will strike many as an obvious and easy solution, they’re not without their problems, particularly as it concerns trans* patients. Wherever sex segregation is enforced, trans men and women are much too frequently placed by cis people in the units inappropriate for their genders, not only denying their identities but also placing them at risk of violence. Further, non-binary identifying trans patients are put between a rock and a hard place, and forcibly identified with a gender that does not belong with them as well as placed in an environment that may not be safe. While sex segregation almost certainly would reduce the rates of sexual violence by cis men against cis women, there’s a large possibility that it would come at the price of increased rates of violence (sexual and otherwise) against trans* people of all genders (or non-genders), when they likely face some of the highest rates of violence already. And that is a trade off that should be considered unsettling at the absolute least.
The fact of the matter is that gender integrated wards are also hardly the only cause of the problem here. Indifference and rape culture are also major issues:
Network chairwoman Heather Clarke said several sexual assaults had been reported to the network recently, including the rape of an 18-year-old woman by a male patient in an acute adult psychiatric unit.
”She had previously told staff that he was harassing her but they had dismissed her concerns,” Ms Clarke said.
Segregating by gender won’t ultimately have the full desired impact if abusers are still not being dealt with once they have been identified. Rather, the abusers will just get craftier or pick new victims. Further, in addition to failing to address violence at its roots, this strategy alone lets abuse enablers off the hook. Everyone deserves safety, no matter what their mental health or disability status. But there is an extra responsibility to keep safe those who have been placed in restrictive and vulnerable environments. That staff in many (quite possibly most) units are not up to the task, and indeed are sometimes abusers themselves, is a part of the problem and needs to be addressed if freedom from violence is actually to be accomplished.