Speaking for themselves: women's experiences of treatment, care and rehabilitation in forensic psychiatric services, 1990 to 1996

Abstract

The triple burden of menial illness, offending and femininity pose complex problems for women clients of forensic psychiatric services. To the public at large, these vulnerable and disadvantaged women are enigmatic and best forgotten. The forensic sphere of mental health service provision is highly specialised, operating at the interface of psychiatry and the law. As consumers, women are a minority group in numerical terms. They receive care within authoritative and restrictive inpatient environments. These institutions of incarceration are masculine in orientation and philosophy. Policy and facilities which address the special needs of women are lacking. This research asserts that New Zealand women have a specific and unique experience of treatment, care and rehabilitation. Generic studies of forensic psychiatric service consumers that fail to take account of gendered experience, cannot truly represent them. The voices of women consumers are under-represented in existing research and literature, internationally. The central argument of this research is that the voices of women with experience of treatment, care and rehabilitation in forensic psychiatric services, have a valid contribution to make to effective service provision. This study aimed to explore and understand women consumers experience and perceptions of forensic psychiatric services. It aimed to identify critical aspects or phases of their encounters. Also, it sought to reveal issues for women which have implications for practice and policy in service provision. Phenomenological perspectives informed the research approach which sought to uncover the meaning of participant's experiences. The theoretical framework embodied feminist, postmodern principles and guided a qualitative, interpretive research methodology. Semi-structured, face to face interviews were conducted with three women, gathering in-depth data about their experiences in forensic psychiatric services. Case file documentation and previous literature were reviewed. The relevant literature relates to the British experience of women in forensic psychiatric settings and gender issues for women as consumers of general and forensic mental health services. Emergent themes of the literature support the central argument and rationale of this research. An inductive, constant comparative approach to data analysis and interpretation was utilised to identify patterns and core revelations of the research. The findings of this study provide a voice for women consumer's views on the most important issues in their experience of Wellington regional forensic psychiatric services. It is argued in this research that women's experience is gendered, different from men's, and deserves to be explored in it's own right. Observations pertinent to policy and practice in forensic psychiatric services are made. Suggestions for future research and implications for social work practice are proposed.