Hospital no sanctuary for women at risk

Jojo Moyes

Vulnerable women patients often share psychiatric wards with men who may have histories of violence or sex abuse, according to a study.

The Annual Report of the Mental Health Act Commission, which was laid before Parliament yesterday, said safety for women was "a major issue", especially where staffing levels were low and violence considerable, such as in London.

It said it would be paying "particular attention" to women's issues after finding cases where female victims of sex abuse had to share ward facilities with male sex offenders. Similarly, on some wards, "women who have been abused are having to share with men with a history of violence", the report says.

The commission found that locking doors, self-contained washing and toilet facilities or a suitable place for visiting children were "too often lacking", while many units contained few or no female staff.

"Only a minority of units ... reported having policies dealing specifically with women's safety, although, when questioned, 58 per cent of nurses thought there were issues of sexual harassment of women patients by male patients on the ward," the report says. It quotes one nurse, who saw "no problem" but recalled two sexual assaults the previous year. In a west London unit, meanwhile, "women residents ... were uncomfortable at being subjected to explicit conversations between fellow male patients, and furthermore, at not being able to lock their doors".

The report is based on 1,200 visits made by the commission to hospitals and mental nursing homes, made between July 1995 and March 1997, as well as interviews with patients. It found what it described as "a wide variation in standards".

Figures show that only a third (35 per cent) of women have access to women-only sleeping areas (ie with own bath/toilet facilities), while 27 per cent have to pass through male areas to reach separate bathroom facilities. A third have access only to mixed sex toilets, bath or shower facilities, while 3 per cent have to use sleeping areas also used by men.

Women make up the majority of patients of most mental health units. The report notes that many have experienced sexual or physical abuse in childhood, with the figure reaching 80 per cent among women patients in high-security hospitals.

Viscountess Runciman, chairman of the commission, concluded: "It is an unacceptable irony that many women patients, detained in the interests of their health or safety, find themselves in hospital conditions that not only feel threatening but in fact offer inadequate safety and privacy."

The report is keen to stress, however, that the service is having to cope with immense pressures. Mental Health Act admissions to NHS trust hospitals increased by 53 per cent between 1990 and 1995, although there are signs that this may be levelling off. Bed occupancy in some London units was as high as 150 per cent, so that patients were being sent home "on leave".