Nederlands2020-147: Treating women in clinical forensic mental health care
Abstract
The aim of this project was to develop guidelines for treating women in (gender-mixed) inpatient forensic mental health care. This is done by studying the literature on gender-responsive working in forensic mental health care and by systematically inventorying the knowledge and experiences of practitioners, policy-makers, researchers and female and male patients. An online survey about working with women in gender-mixed forensic settings was completed by 295 respondents. The following themes were considered to be the most relevant for the treatment of women in forensic mental health care: 1) gender sensitive risk assessment and diagnostics; 2) trauma treatment; 3) the role of children. Furthermore, it turned out that most professionalsm (77%), especially those working in an inpatient setting (85%) prefer to provide treatment in gender-mixed hospitals. However, disadvantages were also seen, like the risk of re-traumatization, and it is important to set clear conditions and to guarantee safety as much as possible. It was reported that there is currently too little attention for gender-responsive (trauma) treatment in forensic mental health care. Subsequently, in-depth interviews were held with 22 professionals and 11 patients, of which eight women and three men. The main themes that emerged from the qualitative analysis with atlas.ti were in line with the results from the survey and provided more in-depth insight, especially with respect to gender-mixed treatment and trauma. Female patients emphasized their need for more attention and female specific activities and an early start of trauma treatment. The guideline 'Treating women in clinical forensic mental health care' was written on the basis of the literature, survey and interviews, which was presented in two expert meetings with professionals and one with female patients and subsequently adapted and tested for usability in a pilot study in three hospitals. The first experiences were generally positive, using the guidelines led to more awareness of specific issues in forensic mental health care for women.