RRN Manager Alexis Quinn speaks out on sexual safety within mental Health units in england

TRIGGER WARNING: sexual violence, restrictive practices

Today (29th Jan 2024), Sky News released a series of podcasts featuring author and autism campaigner Alexis Quinn, highlighting devastating levels of sexual violence within English Mental Health Units.

Just over thirty NHS Trusts responded to a Freedom of Information (FOI) request as part of a joint investigation by Sky News and the Independent, which revealed more than 20,000 sexual safety incidents occurred across these trusts since a 2019 Care Quality Commission investigation. With more than twenty trusts failing to respond, the true figure of incidents is likely to be significantly higher.

Sky and the Independent’s FOI request found that there were over 800 allegations of rape and serious sexual assaults on women, and that less that 5% of sexual incidents were reported to police.

In the accounts shared, the physical hospital environments involved did not promote privacy or sexual safety, with mixed wards, exposed toilets and rooms, and filmed surveillance being used, all compromising elements of the women’s safety. Staff were unable to prevent and respond to sexual safety incidents and disclosure was not taken seriously.

Harrowingly, the experiences shared make clear that fear of reprisal and of not being taken seriously resulted in incidents not being reported to staff.

Alexis’ own experience of being physically restrained, held in solitary confinement and forcibly medicated after reporting sexual assault illustrates publicly funded mental health providers’ failure to protect those in their care and to respond robustly, appropriately or compassionately when sexual violence occurred.

Upon submitting a complaint, Alexis received a response from the trust whose care she was under, stating: “it is regrettable that these events occurred, and it is apparent they were very distressing [for Alexis]. It is unfortunate that incidents like these occur due to the acute nature of the patients admitted.”

Responding to sexual violence with dispassionate apathy and acceptance, suggesting that in such an environment there is little to be done, is wholly unacceptable. The experiences shared by individuals, including Alexis, demonstrate high levels of cultural and psychological restraint – dismissal, fear of reprisal – used to disregard horrific sexual violence.

In Alexis’ role as Restraint Reduction Network Manager, she works with the charity raising awareness of the importance of addressing workplace cultures, attitudes and practices to reduce the use of restrictive practices.  The experiences shared in the podcasts demonstrate a link between restrictive practices – including blanket restrictions, psychological restraint and cultural restraint – and increased sexual safety incidents.

Alexis Quinn, RRN Manager, said:

“Sexual violence is a harmful and traumatic life event, irrespective of gender. It must be recognised that the inherently restrictive nature of detention, however rights-respecting, life sustaining and affirming, can increase feelings of helplessness and powerlessness. Restrictive practices such as blanket surveillance can in themselves constitute sexual violence and the physical ward environment increases the likelihood of sexual violence occurring. When in hospital, people have less agency and control over their surroundings and are more vulnerable to violence.”

People in inpatient units have a right to sexual safety. This means feeling safe from any unwanted sexual comments, observation or behaviour. Most NHS Trusts that responded to the Sky News FOI failed to provide evidence that they conformed to Government-backed safeguarding protections, including people being cared for within single-sex spaces.

Ward culture and quality of relationships are key factors impacting on rates of sexual safety incidents. Wards with high levels of cultural restraint (inequalities towards those with protected characteristics including people with disabilities, women, LGBTQ+ communities and mental health difficulties) use of blanket restrictions, including surveillance methods and psychological restraint, correlate with increased sexual safety incidents.

It is likely that there will be a higher risk of sexual violence within wards where toxic cultures and high levels of restrictive practices prevail; however, this needn’t be the case. People in mental health units need support, compassion, and crucially, safety.

Senior leaders must take responsibility for ward culture and implement values and approaches such as the Six Core Strategies to reducing restrictive practices and preventing toxic cultures. In reducing the instances of restrictive practices, the conditions that enable higher incidents of sexual safety will be reduced.

Further, where incidents do occur, in order for people to feel safe, disclosure must be taken seriously and addressed promptly. It is essential that incidents are recorded, that police are informed, and that post-incident support is provided with empathy, compassion and without judgement.

If you need help

Anyone who has been impacted by any of the issues covered in this statement can contact the below organisations for support and/or advice:

Rape Crisis England and Wales – free support and advice for people who have experienced sexual violence in England or Wales.

Rape Crisis Scotland – free support and advice for people who have experienced sexual violence in Scotland.

Samaritans – free helpline for anyone struggling to cope or having a difficult time.

About the Restraint Reduction Network

The Restraint Reduction Network (RRN) is a registered charity with an ambitious vision to eliminate the unnecessary use of restrictive practices in health and social care and education.

We seek to create a culture of respect for human rights across services, wanting services to be safe, dignified and respect people’s autonomy and wellbeing.

As a network of over 2500 committed organisations and individuals, the RRN is working towards this mission by sharing learning, developing quality standards and practical tools to support restraint reduction, and by working across sectors to promote culture change.

Contact

For more information, please contact Clare Stephen, RRN Director of Communications, on 0121 415 6960, ext 1026 or email [email protected]