Being an inpatient in a hospital can be a lonely and frightening time. You are so ill that you can’t stay at home and you are separated from those who love and care for you – visiting hours are nice, but most of the time it’s just you and the blue curtains surrounding your bed.
When you’re an inpatient on a psychiatric ward, things can be more frightening and isolating still. The way you see the world might be especially confusing, you might be absolutely lacking in hope for the future, or you might be suspicious of everybody around you. These are some of the myriad of reasons that people are admitted to a psychiatric ward, and they make inpatient stays especially intense.
Something that can get people through the darkest times is the other people who are also patients on the ward. Professional support from the doctors and nurses on the ward can be useful or utterly useless, but peer support is frequently informally cited as the most positive aspect of inpatient psychiatric stays. These are people who understand what you’re going through. They’re also not allowed out for a cigarette because they’re on a section and there are no staff available to take them out. They, too, are bewildered by everyday things and having deep thoughts about the state of the world. They are there, they keep you going, and they are invaluable during a lonely stay in hospital. They tolerate the odd things you say because they, too, are thinking and feeling odd things.
What happens, though, if one of your fellow patients turns against you? What if the people who sleep in the next room become dangerous?
A new report from the Care Quality Commission (CQC) has found that, in three months last year, 1,129 sexual incidents were reported on psychiatric wards. 29 of these were alleged to be rapes and 457 were sexual harassment. They were predominantly carried out by male patients but some were reported to be by female patients or by staff members. In 2/3 of the incidents, the victims were patients.
And the problem with being a psychiatric patient, especially a woman, and especially if you have any other marginalised identities, is that people do not believe you. You are seen as a liability – your illness or distress makes you an “unreliable witness”, your psychosis means you might have “imagined it”, your borderline personality disorder means you might be exaggerating for attention.
This is a particular risk if your perpetrator was a member of staff. Psychiatric patients, inpatients even moreso, are gaslighted and even openly accused of lying. Who would believe the woman who’s on medication and was inconsolable, compared to the nice, rational male nurse who everybody likes and admires? Who could formulate a more coherent argument in that situation? Who would have the backing of the other members of staff or management? Who would look more believable in a confrontation?
The problem is that disabled women, including those experiencing mental distress, are not believed as much as non-disabled women are. And it’s not like non-disabled women enjoy the confidence of everybody around them! If somebody is learning disabled, it might be argued that she does not understand what really happened. If somebody is physically disabled, it might be argued that she was just receiving care and there was no assault. And if somebody is mentally unwell, it can be – and often is – argued that it simply did not happen.
The majority of women in psychiatric hospitals are already survivors of sexual abuse, frequently in childhood. They know what they are talking about and they do not make accusations lightly. When I was in hospital, the man who wandered into women’s bedrooms at night was argued by staff to be harmless, with the women’s concerns dismissed with “Well he’s not well, he doesn’t understand what he’s doing”. Other women I know faced far more blatant abuse than that, with physical sexual assaults almost commonplace. These are women who have been made vulnerable, which is not a nice word to apply to anybody but a disablist society, a biased health system and the bloody patriarchy make it an important word for us to hold onto, for now. Many of us are more vulnerable than we would like to be, and those in psychiatric wards are in that group.
At the time when women feel at their worst, others can target them and abuse them further. And as most of them have past experience of abuse, this triggers old memories as well as creates new ones.
It obviously goes without saying that this is not conducive to good mental health and to recovery. But the more unwell somebody becomes, as abuse and assaults take place, the more they are likely to be committed to the ward for longer and longer periods of time. There is a vicious cycle that needs to be addressed and adding another section to somebody’s records, or not allowing them to transfer somewhere less triggering for them, should be carefully looked at as potentially a way to re-traumatise and control victims, not help their recovery.
Photo: Richard Potts