Practising in a person-centred care way involves understanding the problems a person is facing. Learning about a person’s strengths, hopes and dreams guides how to best support their recovery. Being gender sensitive and considering the uniqueness of each person, their connections to their family and whānau and their communities is essential.

When the person identifies as being female we know they are more vulnerable to experiencing mental health problems. In particular women experience higher rates of depression, social phobia, dysthymia, generalised anxiety, seasonal affective disorder, panic, psychosis, bulimia and bipolar disorders than men. The use of substances by women is also on the increase, particularly alcohol use. In New Zealand more men access mental health and addiction services than women.  

Female offender rates are also on the rise, and many female prisoners have mental health and addiction problems. However a lot of women haven’t accessed mental health and addiction services prior to being imprisoned.  Some women will receive support in prison, which may include transfer to secure forensic mental health units.

Globally far too many women experience trauma – physical, sexual and emotional. Women in prison or in mental health and addiction services are highly likely to have had traumatic experiences which impact on their wellbeing and how they relate to people. Many will also be mothers who may experience feelings of loss and separation from their children and families while in secure care.

At any given time there are around 30 women living in secure forensic mental health mixed gender units in New Zealand, and many more admitted into locked adult acute mental health mixed gender units. For women who have experienced trauma, living in mixed gender units may impact on their wellbeing and recovery. In response some services have developed female only units and many have female only areas within the units.

Women in secure mental health care say they want the people supporting their recovery to see past labels – having a mental health and/or a substance use issue, being an offender, being a woman and being seen as someone who is difficult, demanding or attention seeking. They also want people to understand the likely impact of living in mixed gender units on their wellbeing and recovery. They want people to “see the real me, listen to me and make me feel safe”.

New Zealand’s mental health and addiction service development plan Rising to the Challenge calls for improved services for women who experience mental health and addiction issues and who are involved with the justice system (Ministry of Health, 2012).

The national women in secure care group was established over a decade ago, with representatives from each of the five regional forensic mental health services in New Zealand. This group has long recognised the need to develop the capability of the workforce to best support the recovery of women in secure care.

See through our eyes

Waitematā District Health Board invited Te Pou o te Whakaaro Nui to partner with them to develop an education resource which resulted in the creation of ‘See through our eyes – A resource to support women in secure mental health care with their recovery’. This was launched at a leadership event in Auckland in May.

Dr Jackie Short, psychiatrist, inaugural member of the national women in secure care group and current member of the Family Violence Death Review Committee, described the new resource as “powerful, dynamic and unique to New Zealand and having the capacity to help change attitudes to women both inside and outside of the workplace and maybe contribute in its own way to reducing our scandalous rate of family violence in New Zealand and its intergenerational transmission.” Service user advisors also shared their honest views about the resource and belief that this resource will be very helpful in conveying and creating awareness about experiences of women in secure mental health care.

See through our eyes is designed to develop the knowledge, values and attitudes to best support women in secure mental health care.

The four part resource package is available only to managers and leaders of services providing secure mental health services for women.

Knowledge, values and attitudes guide

This outlines the knowledge, values and attitudes needed by mental health and addiction practitioners to enable them to best support women in secure mental health care with their recovery. The contents of the guide are aligned with Let’s get real. It was developed during a workshop with members of the women in secure care group. The guide is viewed as starting point, it is expected to evolve over time.

Video series

The unique feature of this resource is the use of videos in facilitated education sessions to raise awareness about the experiences of women in secure care. There are three videos: Admission, Living here and Moving on.

Training guide

This guide provides information about how educators, leaders and managers can use the video series to increase staff awareness about:

  • how a woman may experience being in secure mental health care
  • promote discussion on identified issues
  • identify what is needed to best support women with their recovery.

Evaluation guidance is also given for the resource package.

Matrix

The matrix is an electronic tool designed to enable educators, leaders and managers to identify and map the current internal and external training, education and resources relating to women in secure mental health care. This helps to find and address any gaps in education and training.

For further information about the resource please contact Suzette Poole, clinical lead.