Breaking barriers: Lessons from Ophelia House six months on

Last year, Phoenix Futures opened an important new residential service, Ophelia House. Six months into the journey, the charity shares its insights, learning, and some of the challenges it faced along the way.

Photo by Benjamin Manley on Unsplash

The core principle of Ophelia House is that it is designed by women, for women. For too long, many women have had to fit into treatment systems that don’t work for them. We knew that for Ophelia House to be an effective treatment option, it must meet their specific gender needs of women.

Trauma is often a factor in substance use for both men and women; however, women frequently experience additional gender-based traumas that impact their substance use and have devastating short and long-term effects. The women we support at Ophelia House come from diverse backgrounds and have individual life experiences. However, we are seeing common intersecting experiences, including co-occurring mental health support needs, domestic violence and experiences of coercive and controlling behaviour. Many women have experienced the heartbreak of losing children to the care system or are involved with child services on referral, whilst others grapple with complex inter-related family dynamics.

Of the women that we have supported at Ophelia House, 77% have survived
domestic abuse.

Sam was referred to us by a community drug treatment team that she had been supported by to safely flee an abusive relationship. On leaving the relationship, she was carefully supported directly into a secure detox placement. The team at Ophelia House worked closely with the community service and detox provider to plan a rapid assessment and admission to Ophelia House with a particular focus on comprehensive safety planning, always ensuring her security and strict confidentiality.

Sam joined the community at Ophelia House in December after completing her detox. Our multi-disciplinary staff team supported her to ensure she was at the centre of her treatment and goal setting. Supporting women at risk of domestic violence to access rehabilitation involves a comprehensive approach that prioritises their safety, empowerment, and holistic recovery.

Through a collaborative trauma-responsive approach provided within a flexible environment, she successfully completed her treatment programme in March and was supported to safely relocate back to a new, secure community environment.

‘I feel a female-only rehab provides me the time to focus on myself and have no distractions. It gives me time for myself. My illness was very much interconnected with unhelpful relationships, so having the space away from that to focus just on me is helping so much already.’

Ophelia House is an effective evidence-based treatment option designed and developed in-line with best practice approaches to trauma-informed care. We have worked with partners across the substance use sector and have seen over 50 referrals from all regions of the country, evidencing a wide need for women’s only treatment. Yet, the inequity of access to residential treatment still means that many women are being excluded from this effective treatment option.

We have continually developed our approach to referrals since opening Ophelia House to address specific barriers that women face when entering residential treatment, including visitation arrangements of children, time-sensitive admission pathways for women fleeing domestic violence and those in custody settings and multi agencies liaison for women with complex mental or physical health support needs.

Much more work is still required to open pathways and make it easier for more women to access Ophelia House. Too many barriers make the funding process unnecessarily complex and unclear; too many women are still being asked to demonstrate their commitment by working through a series of discriminatory and unfair asks.

Stigma disproportionately affects women, especially mothers who use substances. Many women that we support report experiencing a combination of highly stigmatising experiences, frequently when accessing health and social care support. Mothers seeking support fear the removal of their children, and women, more broadly, are judged and shamed for their circumstances more heavily than men.

Deaths of women who use drugs and alcohol are rising, whilst stigma creates huge barriers to women seeking support. We must work to break down the stigma and discrimination that women face and normalise access to appropriate treatment options. Ophelia House should not be seen as the exception. We have to make it the norm.

‘Ophelia House has saved my life. When I arrived, I didn’t think I wanted to live. Crippled with toxic shame, I hated my very being–  yet here I am today loving life more than I ever have and learning to like the woman I am becoming. Treatment has not only kept me clean and sober, it’s changed one thing and that’s everything.’
J – Ophelia House, Community Member

Ophelia House offers a coordinated approach to drug and alcohol treatment with intensive support across a range of different needs; providing a safe and therapeutic environment, with trauma-responsive delivery, on-site counselling, and mental health support. As well as specialist interventions for women who have experienced domestic violence, there is also housing, health, and family support on offer.

As we take our learning forward from our first six months in operation and use it to inform the delivery of our other specialist services, we will continue to share best practice across the sector and continue to work together with commissioners and key stakeholders to consider how to overcome the significant barriers to accessing residential treatment that women with multiple support needs face. This way, they can experience the benefits of an environment designed by women for women.

We have put together a summary of some of the best practices in supporting women at risk of domestic violence into rehab.

Supporting women at risk of domestic violence to access rehabilitation involves a comprehensive approach that prioritises their safety, empowerment, and holistic recovery.

Safety planning: Before anything else, ensure the woman’s and any dependents’ safety. Develop a safety plan that includes strategies for accessing detox and rehab confidentially.

Trauma-informed care: Recognise that women who have experienced domestic violence may have complex trauma. Provide trauma-informed care that prioritises their emotional well-being and acknowledges the impact of trauma on their lives.

Empowerment: Empower women to make their own choices and decisions. Offer support without judgment and respect their autonomy. Encourage them to identify their needs and goals for rehabilitation.

Accessibility: Ensure that rehabilitation services are easily accessible to women at risk of domestic violence. This may involve providing transportation or accessible accommodation.

Culturally competent care: Recognise and respect the cultural backgrounds of women seeking rehabilitation. Offer services sensitive to their cultural beliefs, values, and traditions.

Integrated services: Provide integrated services that address the complex needs of women affected by domestic violence. This may include counselling, substance use treatment, mental health support, advocacy, housing assistance, and vocational training.

Collaboration and coordination: Foster collaboration between rehabilitation providers, domestic violence shelters, healthcare professionals, and community organisations. Coordinate efforts to ensure a seamless transition between services.

Education and awareness: Raise awareness about domestic violence and its impact on women’s health and well-being. Provide education and training for healthcare providers, social workers, law enforcement officers, and community members to recognise signs of abuse and respond effectively.

Long-term support: Offer long-term support to women after they complete rehabilitation. Help them access ongoing resources and support networks to maintain their recovery and rebuild their lives.

Advocacy and policy change: Advocate for policy changes and funding to support comprehensive services for women at risk of domestic violence. Work to address systemic barriers that perpetuate gender-based violence and inequality.

To find out more about Ophelia House, to make a referral, or to speak to us about working together to support women into treatment, please contact alice.smallwood@phoenixfutures.org.uk

This blog was originally published by Phoenix Futures. You can read the original post here.


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