Women and girls who are detained under the Mental Health Act are, at that moment, often at their most vulnerable and desperate. Many are detained because they pose a risk to themselves. Being taken into hospital care is therefore a critical point at which, in theory, they can get the help and support they need to get better.
Yet, new figures suggest that detaining them in this way is not keeping them safe and supported. Data obtained by Agenda from the Care Quality Commission (CQC) shows that in 2015 the number of self-inflicted deaths of women detained under the Mental Health Act overtook men’s for the first time. This trend continued into 2016.
Meanwhile, there were more than twice the number of self-inflicted deaths of young women and girls compared with young men and boys. Nine females under 20, including one under 17, died in this way, compared to four males in the same age range, with no boys under 17 dying.
The question is why is this happening? In truth, we cannot be sure of all the answers, but there are a number of factors that could play a part.
Overall, these statistics highlight a growing crisis in care for women and girls. The deaths of those aged 20 and under in particular, could reflect the much publicised growing deterioration in younger women’s mental health. It is also an indictment of our mental health system’s failure to respond adequately to that deterioration.
Pressures on services means women and girls are having to reach absolute crisis before being able to get help. A number of women have told us it was only when they attempted suicide, that they were offered any support. Yet they had been struggling and asking for help in the weeks, months and even years leading up to it.
Then when detained, the conditions under which the Mental Health Act is enforced are not fit for purpose for women and girls.
For example, the majority of women and girls being detained will have experienced abuse. But the evidence suggests they are not asked about this and even if they are, it is not understood or responded to appropriately with care that takes these experiences into account.
This results in women who have been abused by men being under close observation by male nurses, which can add to feelings of anxiety. We know also that women and girls continue to be restrained at alarming rates (some dying after being restrained), which is particularly worrying given the risk of re-traumatisation for women and girls who have histories of abuse.
This lack of gender and trauma-informed support, whereby women’s needs and experiences, particularly histories of violence and abuse, are considered in every element of their care, is a vital missing part of women’s experiences of the Mental Health Act. It can be no coincidence that this is the context in which so many women and girls are dying.
The Mental Health Act is currently under independent review. This presents an opportunity to tackle some of these issues and it must not be missed. We need to see a Mental Health Act that responds better to the realities of women and girls’ lives and takes their needs into account.
This means, among other things, investing in more specialist support, both in the community and in inpatient services, so women and girls can get the help they need when they need it. These services should be gender and trauma-informed, with women and girls asked if they have experienced abuse and having that taken into account as part of their care plans.
It is crucial that detention under the Mental Health Act becomes an opportunity for women and girls to rebuild their lives and have a positive future rather than them feeling like they have no future at all.