Meeting the Needs of Women in Mental Health Rehabilitation Services
Taylor, Tatiana L., Dorer, Gemma, Bradfield, Sarah, Killaspy, Helen, British Journal of Occupational Therapy
Concerns about inadequacies in mental health care for women led to the development of a strategy document for the organisation and provision of mental health services for women (Department of Health 2002). This included having access to women-only services, groups and social activities; being able to choose to have a female keyworker; and, for inpatients, having single-sex lounges, sleeping, toilet and bathing facilities. To address these recommendations, Camden and Islington NHS Foundation Trust (CIFT), formerly Camden and Islington Mental Health and Social Care Trust, developed a women's strategy (Camden and Islington Mental Health and Social Care Trust 2002) and implementation group.
As part of the CIFT initiative, the women's social network (WSN) was established by the occupational therapy service to provide meaningful occupation by way of regular social networking opportunities for female users of CIFT's rehabilitation and residential services. A lack of meaningful occupation--occupational deprivation--can lead to diminished functioning (Creek 2008). Individuals with mental health problems are at greater risk of occupational deprivation than the general population owing to the symptoms, functional impairment and stigma resulting from their mental illness and to the reduced opportunities and access to meaningful occupation (Mayers 2000). However, strong social networks and support are known to promote recovery (Salokangas 1997, Becker et al 1998, Corrigan and Phelan 2004). Women, in particular, may benefit from positive social networks (Benum et al 1987, Becker et al 1998, Olstad et al 2001). Engaging female service users in meaningful occupations is therefore a primary focus for occupational therapists working in mental health settings.
The WSN is facilitated by a multidisciplinary group of seven female staff members. At the heart of the WSN is the women's cafe group, a fortnightly informal social activity in a mainstream setting (a local cafe) which is facilitated by two female staff.
In 2007, WSN occupational therapists undertook an evaluation of female service users' needs and experiences within all rehabilitation and residential services.
The aims of the service evaluation were:
1. To assess the gender-specific needs of female users of rehabilitation and residential services, from staff and service user perspectives
2. To evaluate whether the objectives of CIFT's women's strategy were being met within rehabilitation and residential services
3. To review the use of the WSN and identify areas for development.
The inner-London boroughs of Camden and Islington have a combined population of 373,817 (National Statistics 2001). High levels of deprivation give this area one of the highest estimated levels of psychiatric morbidity in the United Kingdom (Glover 1998). The CIFT's rehabilitation and residential services comprise 13 projects (see Table 1). Killaspy et al (2008) provided further descriptions of these services and their clients.
Data collection and recruitment
The evaluation was carried out between May 2007 and April 2008. The participants were the staff teams and female service users of all 13 projects. Two questionnaires were developed by WSN core staff:
* A self-report, semi-structured questionnaire that collected information from service users about their needs as women and experiences of the gender sensitivity of the service, including their use of the WSN
* A semi-structured questionnaire that collected data from staff teams about their views of the specific needs of their female clients and the gender sensitivity of their service.
The purpose of the evaluation was explained to unit managers at meetings and through email and telephone correspondence. The staff teams were asked to complete a single questionnaire about their service during a team meeting and to return their questionnaire by email or post. …