Women who challenge - Nacro

CHAPTER 2Table 4 Patients admitted to NHS facilities (including high security hospitals) under MHA 1983 bylegal category and sex (1990/91 to 2000/01)Legal categor y 1990/91 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01Part II (civil) patients 15,678 22,570 21,045 22,659 23,980 23,807 23,951Male 7,072 11,482 10,842 11,577 12,226 12,245 12,482Female 8,606 11,088 10,203 11,082 11,754 11,562 11,469Part III court and prison disposals 1,791 1,836 1,751 1,762 1,655 1,468 1,306Male 1,526 1,617 1,516 1,519 1,453 1,291 1,092Female 265 219 235 243 202 177 214Restricted patients 522 839 791 853 846 753 656Male* 457 761 711 755 758 673 57729.9% 47.1% 46.9% 49.7% 52.2% 52.1% 52.8%Female* 65 78 80 98 88 80 7924.5% 35.6% 34% 40.3% 43.6% 45.2% 37%Source: Department of Health (2001) In-patients formally detained in hospitals under the MHA 1983 and other legislation, England: 1990–91 to 2000–01Department of Health Statistical Bulletin 2001/28*percentages are of Part III male and female patientsS e c u re Hospitals (WISH) 2 6 . This includes detailsof those detained in high security hospitalswithout restriction orders or, under Part II of theM H A as civil patients, in addition to therestricted patients re f e rred to above. Even so,the population is still small. The re s e a rch wasbased on the data re c o rded in the SpecialHospitals Case Register for 1996 and shows atotal population at that time of 1,407 men and263 women. This compares with the 1996population of 1,077 male and 144 femalerestricted patients held in high securityh o s p i t a l s 2 7 , less than half of the total populationof 2,549 restricted patients detained in that year.The WISH research 28 provides detailed profiles ofhigh security patients in terms of their lifeexperiences, offending behaviour and mentalhealth needs, and identifies a number of keydifferences between male and female patients.R e s e a rch in relation to female patients detainedin Broadmoor in 1994 by Bland et al 2 9 a l s oreveals key diff e rences between male and femalepatients. The following diff e rences wereidentified in both studies. Women patients inhigh security hospitals are more likely than men:• to be admitted at a younger age• to be detained under a civil section of the MHA• to have a history of previous psychiatrictreatment• to be detained in high security for a longerperiod.Although women are more likely than men to bedetained under a civil section of the MHA anddespite the findings of Bland et al (1999) that23% of the female patients at Broadmoor hadnot been convicted of any offence, the authorsalso found that almost all of those who had notbeen convicted had been alleged to beunmanageable in their previous environmentbecause of assaultive, threatening or disturbedbehaviour. In other words, in almost all cases,they were accused of behaviour which couldhave been framed as criminal and could haveled to criminal proceedings. This raisesquestions of due process which are consideredin Chapter 3 when looking at women in thesecure system.At the beginning of this report, we pointed outthat female offenders generally share a numberof characteristics with female mentallydisturbed offenders. This view is supported bythe findings of Bland et al (1999) that women inspecial hospitals have similar backgrounds towomen in prison, especially in terms of socialdeprivation, childhood adversity, histories ofphysical and/or sexual abuse, and high levels ofself-harm and disturbed behaviour. These issuesare explored further in Chapter 3.26 Stafford P (1999) Defining Gender Issues … Redefining Women’sServices WISH27 Home Office (2001c) op cit28 Stafford P (1999) op cit29 Bland J, Mezey G and Dolan B (1999) ‘Special women, special needs: adescriptive study of female Special Hospital patients’ Journal ofForensic Psychiatry 10 (1): 34-45page 14