Women and mental health services

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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 )
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...

Which can't be correct. There needs to be a clear plan put in place, a proper efficient process, that models the private sector. It needs reform

Also do some research and you'll realise how horrifically most women who have bene through abuse are treated. Often diagnosed as "personality disordered" for a start! A label that meant exclusion from services until 2007. And a case of abusers having the same label as their victims. Not that the abusers usually seek help.... it's the abused who get the labels.

The NHS doesn't really do trauma. Unless it's from a war zone - soldiers actually have different access criteria to services, if not specialist services. So being a traumatised woman is lower priority than traumatised men. And in general they just don't recognise it. Everything's very simplistic, the idea of past harm affecting someone doesn't make sense to them, you can keep telling them and they just doint take it in.

Parity with physical health would be a start.

People just have no idea how crap the system is. They can do it for physical health, but the public dont care enough for mental health. It's one of the hardest things actually - people judge you and think you're not trying hard enough because they assume there's help there that just isn't. I've actually contacted my MP's office and they were concerned about me there and then and suggested I self-refer into the service for the time being! Goodness know what imaginary service they had in mind.

Great thread OP.

Completely agree with other posters re pnd. I would have worn that t shirt. I had a horrendously traumatic birth, pain for 6 months,was isolated, had mastitis three times. Of course I was depressed and traumatised, but that was a completely proportional response. Not an illness.

I think approaches like anti-depressants and cbt are quick and cheap ways of dealing with far more complicated situations like posters have mentioned in terms of abusive relationships, and other very, very difficult life situations. In reality though many good doctors hands are tied by the sheer lack of any other services.

I'm interested too in the idea re suicide rates in women being lower as a result of their ultimately responsible role as care giver.

My husband is currently under section for the second time in two years. Previously the stress of dealing with him and his illness has had bad effects on my mental health. So my notes now say mental illness. They should say carer of husband with bipolar with psychosis diagnosis and mother trying to keep things normalish for two young children.

I'm sadly not convinced his hospital stay is in any way therapeutic either.

I don't think it's reasonable to blame mental health services for the fact that people have abused you. I'm sorry it's happened to you, but blaming healthcare professionals seems pretty bizarre. And I find you very aggressive and confrontational.

Often diagnosed as "personality disordered" for a start!

Are you speaking from experience? Is this thread really about the fact you've been diagnosed with a PD and you're pissed off about that?

I didn't read it as OP blaming mental health services for having suffered abuse, but that mental health services often don't/can't treat root cause of trauma which is now leading to poor mental health. Often sticking plasters of cbt and anti depressants are all that's offered.

When I went to my doctor when I was depressed all she offered me was anti depressants. How is that going to help me solve my problems by turning me into a zombie. My mum was on them for years and it never helped her. The doctor refused to give them to her in the end. There is no funding for therapy for people who need it and the doctor can't wait to throw you out of the room.

I think the best therapists are the ones who go through it themselves. They understand and they get it where as book worms will never understand how you feel.

Talking therapy can be pursued on a private basis by those who want it. And afford it .

And I find you very aggressive and confrontational. Whereas It would carry about as much weight as this argument. isn't confrontational or argumentative at all.

"Are you speaking from experience? Is this thread really about the fact you've been diagnosed with a PD and you're pissed off about that?"

Namey, you're not coming out of this looking very good. That's a pretty unpleasant personal attack on someone who is suffering from mental health issues and not receiving the help they need. Yes, I get that you've been lucky enough to receive the support you need from NHS mental health services. That's great. But it doesn't change the fact that many women are not, and there is a long and well documented history of institutionalised sexism within psychiatric medicine which is probably playing a part in that situation. You coming on here and saying "I'm alright Jack" would be like me going onto a thread about poor maternity provision in overstretched London hospitals and saying "I don't know what you're all making a fuss about - my maternity care in my small, regional, well-funded hospital was excellent." By doing this you are in effect claiming that they haven't experienced what they actually are experiencing, and by way of evidence referring to something completely irrelevant - a one off anecdote that you personally were okay.

would be hideously impractical for whom? Namey Just depends on where you think resources should be spent.

Talking cures work, pills and CBT don't always, according to this great documentary on radio 4 today.
www.bbc.co.uk/programmes/b084x6m6

Imagine a world in which middle class and upper class white men were being forced to stay in abusive relationships because they have no other option, told they were suffering from PND after having to provide 24hr care for a newborn infant after a serious medical episode they had just endured, etc etc.

If they wouldn't put up with it, why should the rest of us? Economic and social equality is being decimated. That is having a deleterious effect on a range of people's mental health.

I am finding this thread very interesting.

I have recently come under the care of CMHTs but after two months and being told my cpn will arrange a visit with me I am still waiting.

My cpn did manage to see my DH though and asked him questions about my ability to clean, care for the children etc... Without seeing me or the children or my house and just took his word for it.

Before I got passed on to CMHT everyone's main concern seemed to be getting me back to work, wife and kids with no real interest in why I have problems or what I feel.

This is an amazing thread. OP, you are struggling - and succeeding in your attempt - to describe a situation where the very service which is set up (supposedly) to help you is more focused on fitting its idealogy into the constraints of their finances and the system within which it was created.

It is hegemony. Systems support systems.

However that doesn't mean that medication can't be be useful sometimes, and certainly I am a big believer in therapy where experiences and situations, and the feelings they triggered within us, are analysed with support and attentiveness. Unfortunately this kind of therapy is expensive and hard to find (some practitioners aren't competent). But it can be life changing.

Drugs and cbt are quick fixes whereas human understanding, kindness and giving someone the space to feel heard - helping them slowly build a sense of security - is real healing. It's sad that this is in such short supply and our society doesn't operate around that premise.

I wish that there was a way where people could come together within a community, tell stories, listen to each other, hang out, eat together...spend time together in a healing way which didn't revolve around drinking or religion.

Just wanted to say, I hear you.

My cpn did manage to see my DH though and asked him questions about my ability to clean, care for the children etc... Without seeing me or the children or my house and just took his word for it.
wtf! It's the The Handmaid's Tale' !
Thanks for posting, this is so important to share. I am learning so much about something I had suspected, and so many of us are forcibly isolated through gender structures in this country, it's brilliant to find out what's really happening. Also, none of this valuable anecdotal data seems to be on any reports into gender and MH

Take care Thadius , no wise words, really but I hear what you say.

Even 40 years ago in Glasgow, new mothers were entitled to council provided house help in the early weeks of this job. Women were at least given a while in hospital to recover.

With my last, I gave birth at 7am. They needed the hospital bed at 8.30am and I was making tea and looking after my 3yr old and new baby at 1pm. While husband slept.

Very few civilised cultures across the globe would treat new mothers like this, like breeding cattle. In China, new mothers, used to, at least, spend a month recovering and being fed and pampered.

And English birth procedures in hospitals are awful and exacerbate trauma and injury. Dutch women are encouraged to give birth naturally and stress free at home, and then have again, civilised financial and practical support for the new mother.

human understanding, kindness and giving someone the space to feel heard AtrociousCircumstance beautifully put.
A fantastic thread, thanks OP.

I don't think these threads help you at all With great compassion Fallonjamie I don't think that is for you to decide. We all have the right to choose our own paths, and this thread is fascinating and clearly a bit threatening to some. Perhaps you should ask yourself why you would need to write such a post? Warm good wishes.

hotmail124 thank you. I am very lucky with the family support I have but i worry about people who have no family and friend support experincing some of the treat I have from mental teams. If I were alone I don't know if I would still be here.

My DH couldn't understand why I was upset with the cpn for just taking his word. I explained it was because without seeing me or the things she was asking about she had no proof the children were safe with me etc.. and I felt like she was happy just to take his word with no evidence because he was a respectable business man in a suit.
What of he were lying?
What if he were abusive?
How could she possibly know the children were well care for?

Hotmail - because I see the very different posts by the OP when she can barely form a sentence and they're often deleted as she is threatening suicide.

And it is clear that she is in crisis and needs help but local MH services know her and say they cannot offer help because they feel she has a BPD and until she is willing to work with that, anything they offer is pointless and won't help.

And when OP is feeling less desperate she posts very intelligent threads on here where people tell her MH services don't give a shit, don't have the expertise, are labelling her wrongly or are discriminating against her or the patriarchy is gearing MH services against women.

I don't think that helps. And I'm not being a bitch. I've spent many hours on numerous threads trying to help OP as have many others. It isn't helping. She is still unwell and desperate and won't get the help she needs till she develops some insight and is willing to work with services.

I dont agree that men are 'allowed' to be angry. Anger in men is often conflated with abuse and threatening almost as default.

I do however completely agree with what the OP and others are arguing.

Having been in military situations of sleep deprivation where low level hallucination, talking to yourself and dreaming whilst awake, as well as using aggression to keep going are joked about and seen as linked to the physical conditions, and similar when sailing, the same effect in a home or hospital situation caused by poor sleep or a desire to stay awake or thoughts racing when you are fucking knackered are seen as not only seen as low ' mental heath ' but also 'memtal illness' when it isn't.

Army training for officers consciously avoids high level teaching when physical exhaustion is highest, because they know you lose visualisation, high level thinking emotions, and multitasking , and simple skills go last.

So women having no emotions left during childbirth or other times of exhaustion is normal and predictible.

I also agree that because emotions are nearer to the surface/more acceptable/ the social currency /the entire operational sphere (i am struggling to explain what i mean..something like emotion is 'real' to a lot of women in a way that isnt always there in men, and that actually 'mental health' is really emotional health and/or understanding and that how you feel underpins all of it. This is how i think medicalisation of emotions does affect women more. once drugs and self-labelling enter the equation, you then get predictible 'mentally ill' behaviour that traps people.

Music Poetry art literature history religeon all explain dark thpughts grim times ghosts from the past helping or hindering and tend to tie those elements within a coherent human personality, so why we are mow calling these things 'disorders' amazes me.

Thadius that is appalling.

I agree with previous poster about ridiculous expectations and demands placed on new mothers. Dd1s birth was the most terrifying and medically traumatic event of my life, but I was just expected to get on with 24 hour care of a colicky newborn. I'll bet a lot of money those countries you've cited have far lower levels of pnd.

In relation to my dh's severe mental illness I've been patronised and looked on as neurotic when expressing concerns about his changing moods to doctors. Only after he almost succeeded in committing suicide have docs started actually listening to me

Fallonjamie thank your for your post. I am going to think about it.
My general reply would be, if it is difficult to trust the MH services, how can any one get help? Do you at least agree that in general MH services are gendered in their response (from the moment of pregnancy I noticed that I lost all my degrees but became referred to in 3rd person as 'mum') and that has a really deleterious effect on how women engage with the support, if any, which is offered?
Samuel Pepys, the diarist had to have a gall stone removed this was pre anaesthesia, anti biotics etc. He embarked on a pre operation friendship with the surgeon which lasted for months and by the time he had the operation, he trusted him so much, that I am sure that helped him survive a pretty dangerous operation.
Without trust, it is so difficult for any positive outcome to arise from any intervention.

Hotmail - I think that MH services are possibly gendered in their response but I think that's often to the detriment of men. And I promise I'm not a 'what about the menz' person.

I think it's much more acceptable for women to be distressed and less so for men - this contributes to the higher suicide rates in males.

And a PP said anger may be more acceptable for men - I don't think it is. In my experience, traumatised women who self-harm or 'act out' are more likely to be diagnosed with depression, PTSD or (if other DSM criteria is present, BPD) but men are much more likely to be assessed as having a substance misuse disorder or an antisocial PD.

The referring to you as Mum thing is probably due to lazy HCPs who can't remember your name but when you're talking about a report about a child, GPs and lots of other HCPs won't/don't have the time to read a 5+ page report so it's safer and makes more sense to refer to you as Mum rather than 'Hotmail' which may lead some readers to not immediately know who that is.

namey Are you speaking from experience? Is this thread really about the fact you've been diagnosed with a PD and you're pissed off about that?

This thread is about what I've experienced, observed, talked to others about, thought about (trying desperately to understand apparently incomprehensible stuff) and researched in terms of looking up relevent research studies and books. At the moment it's a big glob of very triggering stuff in my head I'm trying to unravel and make sense of.

Right now, I suspect triggered by PMT, i'm in a bit of a mess, feeling very panicked and stuff cos I had a lot of weird and traumatic nightmares last night (these come in spates).

I'm sorry if you felt I was being "aggressive and confrontational", I can assure you this is due to a muddled brain and frustration at years of crap all muddled together.

I'm glad you had a good experience - it just shows that they can get it right. Mental health does seem to be a postcode lottery in many ways, but it's the way this translates into a sort of denial that is interesting (And awful). So eg. a psych nurse who has to deal with people in dire circumstances every day, with a caseload of six million, maybe kind of shuts off for their own sanity? So a service user who isn't going to be better after 6 sessions of CBT is seen as a nuisance, or you have generic things eg. I was told I was unsuitable for therapy, but they gloss over the fact that only a limited range of therapies were available (previously was supposed to have a longer-term type but it was cut.)

I also wonder how your journey through sevices went, if you felt able to share it. What I'm particulary thinking about is the order in which things are revealed. So for example, someone who had episodes of severe psychosis might not be believed if signs of abuse became apparent in their relationship(s). Plus the reliance on family/friends/partners to look after the person...

As for the BPD label, yes it was applied to me many years ago. But that itself begs some questions - if you have a young woman (still in teens), who has tried to carry on without asking for help (out of fear, and feeling they are somehow stupid) and has pieced enough together to approach a GP and say "abc happened which starting causing me xyz problems"... why on earth are they being given a pejorative label that means they are not listened to (and formerly excluded from all services), rather than the more obvious therapy to help deal with abc?