Last year we opened an important new residential service, Ophelia House. Six months into the journey we’re keen to share our insights, learning, and some of the challenges we’ve faced along the way. We also want to use this space to encourage sector-wide collective action to keep on working together to overcome the significant barriers that women still face in accessing effective gender specific-treatment.
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. Trauma is often a factor in substance use for both men and women, but women frequently experience additional gender-based traumas that have devastating short and long-term effects. The women that we support at Ophelia House come from diverse backgrounds with individual life experiences – however, we’re 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, while others grapple with complex inter-related family dynamics.
Of the women that we’ve supported, 77 per cent 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, and 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 particular focus on comprehensive safety planning, always ensuring her security, and strict confidentiality.
On completion of her detox, Sam joined the Ophelia House community where she was supported by our multi-disciplinary staff team. 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 and was supported to safely relocate back to a new secure community environment.
Ophelia House is an evidence-based treatment option designed and developed in line with best practice approaches to trauma informed care. We’ve 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 inequity of access to residential treatment still means that many women are being excluded from this effective treatment option.
We’ve continually developed our approach to referrals to address specific barriers that women face when entering residential treatment, including visitation arrangements for 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.
There’s still much more work 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, while too many women are still being asked to demonstrate their commitment by working through a series of discriminatory and unfair tasks.
Stigma disproportionately affects women, especially mothers who use substances. Many women that we support report highly stigmatising experiences, frequently when accessing health and social care support. Deaths of women who use drugs and alcohol are rising while 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 offers a coordinated approach to drug and alcohol treatment with intensive support across a range of different needs – as well as specialist interventions for women who have experienced domestic violence, there’s also housing, health, and family support on offer.
As we take our learning forwards from our first six months in operation and use it to inform delivery of our other specialist services, we’ll 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 – so that they can experience the benefits of an environment designed by women for women.
Alice Smallwood is residential engagement manager at Phoenix Futures
For more information on Ophelia House or to talk to us about equity of access for women contact alice.smallwood@phoenixfutures.org.uk