The gender-sensitive care project: Exploring sexual violence in psychiatric inpatient units
AuthorO'Dwyer, Carol Marie
Document TypePhD thesis
Access StatusOpen Access
© 2020 Carol Marie O'Dwyer
Sexual violence is a major global public health issue. There are strong associations between sexual violence victimisation and mental illness, with one in three women presenting at mental health services have experienced domestic violence, including sexual violence. Women often report feeling disempowered and re-victimised while in psychiatric inpatient units, especially in mixed-gender wards. The biomedical model has been the dominant model of care in psychiatric inpatient units. Recent years have seen a global movement towards gender-sensitive and trauma-informed models of care for those with mental illness. To date, there is limited extant research focused on understanding health professionals' experiences and practices of these care models. This research aimed to understand how trauma-informed care or gender-sensitive care is experienced and enacted by health professionals’ for women victim-survivors of sexual violence across acute psychiatric inpatient units. To address this aim, the research was divided into two phases and four research questions. The first phase answered research questions one and two through a scoping review of the literature. The first research question explored health professionals' experiences of providing trauma-informed care in acute psychiatric inpatient settings. The second research question explored health professionals' awareness of the gendered impacts of trauma and how this impacts the care provided. The second phase included a qualitative case study, including stakeholder interviews, observations, and document analysis. The second phase answered research questions three and four. The third research question explored health professionals' perceptions of providing care for women who are victim-survivors of sexual violence in psychiatric inpatient units. The fourth research question explored health professionals' experiences in providing care for women who are victim-survivors of sexual violence in psychiatric inpatient units. The researcher also conducted a policy review of current mental health and violence against women policy and procedures to understand the context of health professionals' experiences and practices. The findings of these studies are presented in three peer-reviewed published articles. The findings suggest that trauma-informed and gender-sensitive care are inconsistently understood and enacted in practice. A more comprehensive care model, which is gender-trauma and-violence informed, is suggested to address the identified barriers in acute psychiatric inpatient units. This research contributes to improving care provision for women who are victim-survivors of sexual violence during their admissions to psychiatric inpatient units.
KeywordsMental Health; Trauma-informed care; Sexual Violence; Acute Psychiatric inpatient setting; Health Services Research; Gender Studies; Gender-sensitive care; Health professionals; Qualitative research; Case study design; Normalisation Process Theory; Australia; Gender-based violence
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