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Original poster

Women and mental health services

90 replies

BBCNewsRave · 03/01/2017 20:14

Been thinking about a lot of things recently. Hope I can put this coherently...

Basically I'm concerned about the effect of mental health services on women, regarding therapeutic approaches and general approaches of professionals, including misogyny and attitudes to abuse and expected gender roles. (Am in the UK so specifically thinking about NHS services).

For example, everything seems very focussed on positive thinking, thinking about what you can change in your life rather than what you can't. This is I suspect very influenced by severe funding shortages meaning a service that tries to get people vaguely functioning in their expected roles ASAP rather than bringing about lasting insight or change. But sometimes, people need to get angry. On a personal note, despite feeling terrified and helpless at some of my life experiences, simply understanding the context is a help.

I suppose I sort of feel that services gaslight women. (Potentially men too, but I think there's particular issues for women.) A service that aims to get a woman out the door as soon as possible isn't going to be very good at spotting the signs of abuse, for example - or at least, of realising abuse is happening rather than the woman just being mentally ill. And in fact services try to push as much care as possible onto family/friends of the unwell person, so a woman could be doubly trapped.

Also men working within mental health services can come with shedloads of misogynistic attitutes (as can women actually). I won't repeat some of the advice I've been given here but it's hair raising.

Plus the whole idea of trauma as a mental illness, naming the problem as being within the person rather than the experiences they've suffered. Are women viewed as unstable because on average we kind of are, as so many have been traumatised (by men) over the years?

I don't know... I mean, psychiatry is set up to preserve the status quo, I guess. So it shouldn't come as a surprise... (And saying something like "psychiatry is set up to preserve the status quo" sounds like tinfoil hat territory... amazing how th system does that to you Wink)
I suppose I'm still reeling at the shock of a system one expects to be there to help, not being. In fact potentially being harmful. And a sort of realisiation I'm not that crazy, but the world sure is

I hope this post makes some kind of sense... er... Smile

OP posts:
Kanewreck · 06/01/2017 12:33

My experience is that upon seeing your GP he will quickly put you on ADs and sleeping tablets. You fiddle about with those for a while before you get to primary and secondary therapy. Strangely enough, you get more talking therapy at primary level.
Secondary seems more psychiatrist led with the offer of courses. There isn't any free form talking therapy.
It seems that they make no effort to try and make an early diagnosis or atleast assess you, so they can steer you in the right direction regarding therapy. They seem to blindly treat you without knowing what they are treating.

nameychanges · 06/01/2017 12:09

I do not recognise this experience. Mental health services saved my life, and when I was vulnerable and in an abusive relationship, they told me to stay away from him.

MH services are often shit, but in my experience they are as shit for men as for women, due to lack of funding.

I don't believe psychiatry is a big conspiracy to keep women in their roles. It is a legitimate medical specialty that changes peoples' lives.

You could just as easily claim that cancer treatment is designed to aggressively remove the cancer so women can return to their roles. It would carry about as much weight as this argument.

Batteriesallgone · 06/01/2017 12:01

I've always had extensive mental health diagnosis (plural, but don't know what the word is). I now suspect I have autism. Apparently it is common for this to happen.

I do wonder if the much touted success rates of CBT are because it's effective at helping someone with undiagnosed autism function in the mainstream. Another tinfoil hat theory there.

ISaySteadyOn · 06/01/2017 11:40

I'm marking my place too. Thank you for starting this thread OP.

OneFlewOverTheDodosNest · 06/01/2017 10:09

I think a lot of mental health provision is focused on giving people the tools to function in a society approved way, rather than actually helping people.

I read a fascinating interview with a doctor in Afghanistan who said that nobody gets diagnosed with PTSD there because it's just the normal way of living, but as a society they can't afford for two thirds of people to fall apart so they focus on getting people back to functioning. I guess it's a way of limiting collateral damage when you can't change the world.

The difference is we don't live in a war zone, we just don't want to put the effort into e.g. examining what's wrong with the current system and fixing it when women complain of depression because it's just quicker and cheaper to medicate them.

ihatethecold · 06/01/2017 10:01

Marking my place so I can come back and join in.
Fantastic thread and currently close to my heart.

woman12345 · 06/01/2017 08:46

'they closed the amazing women only ward near me' Tragic, this. On closing good quality female wards; part of this insidious system is to shut down female environments, online and especially state provided. And at what cost to women's health, it's a travesty.

And what is being done to young women's mh in schools, Camhs etc is like bringing up a generation who only know suffering. If fact their suffering has become an identity for many teenage girls and young women, they've been infantilised and oppressed into a victim mode. Very strange, it was not always like this!

woman12345 · 06/01/2017 08:31

"on getting you appearing well... again, it's back to your role, don't ask questions"
Absolutely! Agree with you there. I'm not sure when the tipping point in the last 30 years was when women became socially required to talk like insecure little girls and dress and make up like pastiches of femaleness
( in the 1970s and 1980s girls could be fat, make up less, human, without fear of opprobrium), but it hasn't helped that the 'rule' is to dress up and act up a certain way. Absolutely.

Enjoy your studies, good to hear! Hope it's going OK; let me know when you publish this great research into mh, I'd love to read it.

Only mainstream writer I know of who's writing or has written honestly about some of this business is Rachel Cusk. "A Life's Work" "Marriage an aftermath". She was roundly vilified. Wonderful writer.

Original poster
BBCNewsRave · 05/01/2017 21:38

Re. violence, from the link:
It is generally found that female in-patients are aggressive at similar rates and severity levels as male in-patients, although they may be less likely to cause injury to others. Krakowski & Czobor found that women had a much higher level of verbal assaults and early physical assaults. Difficulties with ward routine and social interactions were found to be more highly associated with aggression in these women. A more recent survey of incidents on medium and low secure units found that women were more likely to be involved in other-directed and self-harm incidents, but that men were involved in the most severe incidents.

OP posts:
TitaniasCloset · 05/01/2017 21:38

They closed the amazing women only ward near me, despite campaigns and articles in the press. Money as usual was the reason. The unit had won awards and all sorts.

Original poster
BBCNewsRave · 05/01/2017 21:28

Woman I'm actually studying now. :) Yeh it's good, but it's so hard to do when you feel physically ill due to the emotional pain and anxiety, and struggle to concentrate etc. That's something that's really hard - the things one is expected to do to get better often boil down to "do more stuff". People - including mental health professionals - confuse cause and effect. Yes, I was happier when I had a job, but not because I had a job! The whole effort seems focussed on getting you appearing well... again, it's back to your role, don't ask questions.

Just had a quick google looking for info. on female:male ratios in secure units (which is apparently where most of the mental health funding goes) and got distracted by a thing about violence... did you know the NHS zero-tolerance policy includes shouting as violence? Which made me wonder if patient violence might be being misrepresented in these stats... what's someone being ill or very distressed, and what's actualy violence? What's the female:male ratio of physical violence? Not sure how relevant that is, mind.

Ooh, just found this: Women in acute psychiatric units, their characteristics and needs: a review.

Studies have shown that single-gender wards are not necessarily safer or more gender-sensitive. The provision of a gender-sensitive approach requires staff attitudes to change and treatment programmes to be tailored to the needs of the women they are treating. However, research into what this should look like has been scarce, and there remains no clear, single approach to issues of gender, despite the government guidance. This is especially the case in secure and acute settings where the difficulties faced by female patients may be more subtle, and the hierarchical environment may feed into their feelings of powerlessness, exacerbating their illness. There is evidence that the needs of women in these services may have been particularly overlooked. This is worrying, given that women with a serious mental illness are considered to be more vulnerable to abuse and exploitation.

OP posts:
TitaniasCloset · 05/01/2017 21:21

Yes there is evidence that women's caring responsibilities prevent them committing suicide. Because there are some "holding" factors that prevent a successful suicide attempt and caring responsibilities are one of them. Also religion. Don't know where to find the evidence though.

It seems like we have all had some similar experiences though we are all very different women, thats why you are onto something here OP.

Original poster
BBCNewsRave · 05/01/2017 21:07

That's interesting, Woman, thanks.

There’s a simple recognition that family is going to happen. You can’t just drop the baby in the fields.
And when we are expected to be robot-like economic units rather than humans, it's women who have to do all the family stuff, the care, AND somehow fulfil their expected role in paid employment.

So much essential work is done by women... I do wonder if the lower suicide rate in women might actually be due to the sense of responsibility we have for others, expected to look out for their emotional welfare if nothing else. I stress that this is just my ponderings, I'm not making such a strong claim without evidence.

It's all so complicated... more women present with "mental health problems" yet proprtionally more men get taken seriously/get the higher levels of care... yet they are more likely to be diagnosed with more extreme "othering" labels, be viowed as violent monsters etc... yet they are also much more likely to be violent... arghh!!

I will chip in with one anecdote: Male ex (contolling, mansplainy, eventually violent) saw GP regarding depression. GP couldn't do enough - very sympathetic, offered a two month sick note off work, antidepressants, referral to therapy (that ex refused to follow up). Same GP completely dismissive of me, would only speak civilly to my (male) friend. Said failing my benefits assessment obviosuly meant I was putting it on and should just go get a job (won by a landslide on appeal, I had a CPN at the time, wtf was he thinking?). Not interested in trying to help me get therapy.

OP posts:
TheChampagneGalop · 05/01/2017 21:01

God this is my experience, OP.

I was just wondering if I should try to seek more help or say fuck it to therapy, finally.

No one I have talked to has really understood trauma. It's meds, or you're being too complex to treat, or "too well" (can do your everydays tasks) to treat.

As someone wrote earlier we are injured, not metally ill.

woman12345 · 05/01/2017 20:44

BBCNewsRave
I don't know if it's your thing, but this was recommended on another thread, it's free on line courses, and they're lovely, I did two short ones, and one has inspired me to follow up another idea.

Learning always seems like an empowering way out of stasis to me, just for its own sake.
www.futurelearn.com/courses

woman12345 · 05/01/2017 20:38

Great thread and post OP.

The personal is political, as I think you've explained beautifully.BBCNewsRave In countries where woman, wife and mother work is accommodated, funded and acknowledged, there seems to be fewer 'mental health' issues for women.

You are so right about the gas lighting. I think, sadly, that much of psychological services have been hi jacked to serve gendered ( and racial see mental health stats for non white British people) agendas. It's also been used to justify work place abuse, in which workers are bullied, signed off with 'stress' and fired. Using mental health diagnoses as social weapons is an old trick, but it's always worked particularly well on women.

There are, I am sure some fantastic counsellors and psychiatrists, but I agree that in the case of women surviving abusive partners, giving birth(agree with you on all your post M0stlyHet) and mothering single handedly or just surviving, the diabolical pairing of big pharma and professionals with a misogynistic agenda is crap, and arguing against it proves female paranoia etc.

Not such a problem in Scandinavia:

www.economywatch.com/economy-business-and-finance-news/gender-equality-key-to-wealth-and-happiness-in-nordic-countries.27-03.html

^In Norway, parental leave is state-paid with full wage compensation up to a high ceiling. In recent years, the quota for fathers has been expanded to 12 weeks of a total of 47. Norwegian fathers are also entitled to two weeks of paternity leave.

“Studies show the benefits for both men and women of these enlightened social policies,” said Ingebritsen. “You get greater sharing of tasks in the home and men see more of their children.

”There’s a simple recognition that family is going to happen. You can’t just drop the baby in the fields. But to have such welfare policies, citizens have to be willing to pay more into the system and that means trusting the Government. If we trusted the Government more in the U.S., we might be willing to pay more to get better roads, schools and childcare.

In stark contrast, the World Happiness Report 2013, written by leading academics, finds that levels of self-reported happiness are higher in Denmark than anywhere else, with fellow Scandinavian countries Norway and Sweden also in the top five. The UK is 22nd^.

TitaniasCloset · 05/01/2017 19:05

Oh gosh. Sad

Maybe we should set up our own somehow.

Original poster
BBCNewsRave · 05/01/2017 17:49

I had a little look around here but they've all been taken over by trans ideology...

OP posts:
TitaniasCloset · 05/01/2017 17:07

I'm thinking if finding myself a feminist group to join. My fb friend goes to one in brixton which isn't too far from me. I need to find myself a group of like minded women.

Chipsahoy · 05/01/2017 16:35

I went private in the end, to deal with the trauma from male violence. Originally I was given anti depressants and offered cbt. All my nice enough male drs, but with no real understanding that I wasn't mentally unwell, I was and am injured.
I "have PTSD". I reject this entirely. Not because I don't display the symptoms, but because I don't have a disorder, I am not ill.

I am working with a wonderful male therapist who has allowed me to tell him everything that happened to me, rage, be upset, her, feel shame etc etc. And he is working with me now to integrate the "PTSD symptoms" into my life. That might sound odd, and I don't want to explain it, cos I'd be here all week, but he recognises, validates, realises the severe impact of male violence, he doesn't tell me I'm ill or disordered.

Anyway, my point is, I agree with you entirely. Previously to my current therapist, I'd had a push from every direction, to accept that I had a problem and it was my fault. I needed treatment for my problem apparently.
I didn't need treatment, I needed support to work through hideous abuse. I needed allowances, love and care. Not pills and labels and a stigma.

Original poster
BBCNewsRave · 05/01/2017 14:05

Yes it's very frustrating when the therapist doesn't seem to understand because they see everything in a very simplistic way. Worse when they're men and you get a loads of mansplainy shit on top of it.

On another thread today I see someone has been given antidepressants due to being in a relationship with an utter bellend Hmm. I wish the NHS would stop colluding with abusers.

[God I'd love to meet some intelligent, empathetic women. My life has been dominated by idiot men and their handmaidens. I'm not very educated though and unemployed through ill health so I don't seem to fit in anywhere. Any ideas..?]

OP posts:
TitaniasCloset · 04/01/2017 22:48

That's why I loved my psychologist, she is a very smart woman. I love being around brainy educated women so we had a good transference.

Prawnofthepatriarchy · 04/01/2017 15:59

CBT is popular because it's the only talking therapy that has been proved to be effective. Other forms, psycho analysis, for example, wouldn't get a licence if they were medication. Unfortunately CBT is not suitable for complex problems. However it's cheap and it helps most people.

I've had two courses of CBT. The first was ok, not dreadful, but at the end she said "I shouldn't say this but if I had your life I'd be depressed". This was when one of my DS had been seriously ill for years, in and out of hospital. The second was so poor I abandoned it after the second session.

I keep meaning to look up the qualifications required to be an NHS CBT therapist. From my experience I'd guess it is a short course. Both my CBT therapists were not terribly bright, tbh.

user1483524971 · 04/01/2017 13:56

Marking place

CBT therapist has twice written to tell the GP my problems are too long-standing/complex for her to be able to help

GPs seem irritated that I won't just take a prescription for anti-somethings and leave their office within a 10 minute window.

Now being passed to a psychologist.

Anger/rage is a big part of it, it just pops up out of nowhere and is terrifyingly strong

scallopsrgreat · 04/01/2017 10:25

My grandmother underwent Electric Shock Therapy (the term therapy used very loosely there!) in the 50s/60s for depression.

Her problem: an abusive husband who offered her zero support; being made to give up a job she loved because she got married; three children that her husband didn't want and blamed her for conceiving. He was a real piece of work. But he was an excellent grandfather apparently. So all is forgiven Hmm.

All this was, of course, ignored.

She survived and was wonderful. She had a completely different life once her husband died. She outlived him by 30 years and until the last few years, made the most of it.

And strangely enough didn't need ADs/therapy or anything else.