More women than men are dying by suicide in psychiatric hospitals

A high proportion of these women may have experienced traumatic events involving physical assault or some loss of power or control. That hospital staff understand this is a matter of life and death

When the psychiatrist first told me that I had been detained under section two of the Mental Health Act, I struggled to believe that it had happened. Their approach up until then had always been to avoid sectioning me. They were concerned that it could retraumatise me and increase my immediate suicide risk in the psychiatric hospital. Their predictions proved correct.

It’s important to consider the particular risks of sectioning women who may already be traumatised, and what might need to be put in place to support them in hospital. New Care Quality Commission figures show that since 2015, more women than men have ended their lives while detained under the Mental Health Act in psychiatric hospital.

Men can, of course, also experience violent and disempowering assault but women may more frequently be victims of such crimes, including domestic violence.

I was sectioned because I believed that I was receiving messages instructing me to end my life on a particular date. In retrospect, I know that the decision to detain me for my own safety during this period was the correct one, because I was very mentally unwell. Psychiatric staff had to weigh up the risk of my being retraumatised against the risk of me dying by suicide.

However, I feel that much more could have been done to prevent that hospital admission from being as harrowing as it was. A psychiatrist had identified the potential risk of retraumatisation and increased suicide risk. They could have put measures in place to reduce the possibility of that retraumatisation occurring.

The act of sectioning was in itself profoundly traumatic. My liberty had been taken, causing the resurgence of feelings of imprisonment and being trapped that I experienced during the traumatic event that originally triggered my suicidal crisis. My control had been taken from me once again. I was powerless.

Sectioning caused my suicide risk to become so high that I was placed on one-to-one observations 24 hours a day. This means that a member of staff is with you constantly, even when you use the bathroom. There is never a moment when their eyes are not on you. This continued for 10 days.

This one-to-one observation over a prolonged period can be extremely psychologically oppressive and invasive, particularly for people who have experienced past trauma. You can never escape the person watching you.

Over the past year, the charity I run, Suicide Crisis, has undertaken research into deaths by suicide, mostly in Gloucestershire.

In the case of one young woman who died while sectioned in our local psychiatric hospital, it was revealed at her inquest that she had repeatedly absconded from the hospital in the days leading up to her death. On each occasion, she had fled because she had heard the voice of her former attacker in her head.

As well as researching deaths by suicide in our local psychiatric hospital, we also looked at cases where women had attempted suicide while under section, requiring emergency hospital treatment. A high proportion had experienced traumatic events in the past which involved physical assault or some loss of power or control.

We noted that the women had usually not received psychological therapy or trauma-focused therapy at any point prior to their hospital admission. There is an urgent need for access to appropriate therapies, before the person reaches the stage of psychiatric hospital admission.

If traumatised women are sectioned, it is vital that they are cared for by psychiatric hospital staff who understand the potential impact of detention on them. My impression is that they do not always recognise our inner torment. “It must be frustrating for you,” they told me, when I was sectioned. Perhaps they imagined that this was what it felt like. But if they don’t understand the impact, they cannot support the patient effectively.

Access to a hospital psychologist – within the first few hours or days – should be provided for women who are identified as being at risk of retraumatisation. I saw no evidence that this happens currently.

As the feeling of disempowerment can be so distressing, it would also help if staff took steps to give traumatised patients control over some aspects of hospital life. That may include granting them accompanied leave to buy food and enabling them to prepare their own meals. These small things would have helped me enormously, giving back a little of the control to me.

Despite the fact that I run the independent Suicide Crisis Centre which has a very different ethos and approach, I recognise the vital role of psychiatric hospitals. Sectioning can and does save lives. But there is an urgent need for a greater understanding of the impact of sectioning on traumatised women. We need to do more to protect their lives.

Joy runs the Suicide Crisis Centre in Gloucestershire: http://www.suicidecrisis.co.uk

If you have been affected by this article, you can contact the following organisations for support:

mind.org.uk
beateatingdisorders.org.uk
mentalhealth.org.uk
samaritans.org