Services designed by women for women – Taking a gender transformative approach

Phoenix Futures’ Lucie Mauger, senior marketing manager, speaks to Helen Brewin, innovations and improvement manager, about taking a gender transformative approach to the design and delivery at Ophelia House.

As a woman with lived experience, a graduate of Phoenix’s residential rehab and a former residential service manager, I am highly aware of the need for a more gendered response to substance use treatment.

We have very recently opened an important new service, Ophelia House. This is a new residential rehab only for women. We knew from the outset that getting this service right demanded a gender transformative approach to service design, development, implementation, and delivery. The core principle of Ophelia House is that it is designed by women, for women. We worked with women with lived experience, female friends, family and loved ones and experts from across the sector to better understand the needs of the women that we will serve.

Why is it important?

Despite widespread acceptance of the need for a gendered approach to substance use treatment, many local authorities in England do not deliver gender-specific support.

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 – domestic violence, coercive and controlling behaviour and being forced into sex work are common experiences for many women that use substances; the perpetrators of these crimes are most often men.

Substance use treatment services are male-dominated environments; only 32% of people in drug and alcohol treatment in England are women. These services have usually been designed by men and consequently are more catered towards meeting the needs of men. This means that the specific gendered needs of women are often overlooked. Consequently, women who have been abused by men can find it difficult to maintain treatment in mixed-gender settings.

‘Female-only environments can help to create a sense of safety and address the specific treatment needs of women. These environments can help foster healthy attachments, provide positive peer reinforcement, strengthen self-expression, and support with developing skills.’ – Abigail Jones, Psychologist Phoenix Futures

What do the statistics say?

Gender based violence (GBV) is disproportionately experienced by women who use substances. Women who experience domestic abuse are eight times more likely to have a substance use need compared to those who have not and twice as likely to have an alcohol use need.

The rate of alcohol-related hospital admissions made by women to NHS hospitals has risen by over 30% since 2008/09 to 2014/15. 2,851 women died of alcohol-related causes in the UK in 2013, a mortality rate of 9.1 per 100,000 population; this increased to 9.6 in 2014 (IAS 2015).

Understanding barriers to accessing help

When developing Ophelia House, our research helped us better understand the barriers that women are facing when accessing a residential rehab placement. This has led us to create an internal ED&I women’s working group and will inform our policy and campaigning approaches calling for equity of access and a gender transformative approach to substance use treatment.

Our consultation group confirmed that women require a coordinated approach to drug and alcohol treatment with intensive support across a range of different needs. Therefore, Ophelia House offers a safe and therapeutic environment, with trauma-responsive delivery, onsite counselling, and mental health support. As well as specialist interventions for women who have experienced domestic violence, housing, health and family support.

The consultation group also felt that the group programme needed to be gender specific and responsive to the needs of women. The Ophelia House programme aims to create a safe and empathic therapeutic environment to address gender-specific needs in a strength-based approach developing social skills such as validation, empowerment, and empathy, which have been considered critical for attachment and recovery in groups of women.

The programme at Ophelia House is delivered by a multi-disciplinary, all female staff team which over 70 per cent of the women that we consulted at the outset said was important. At Ophelia House, women live together and learn from each other. The community of women offers emotional support and the development of healthy boundaries, behaviours, and values.

In addition to the broader consultation group, we created a smaller focus group of women with living and lived experience to advise in more depth on service design and delivery, they helped inform the physical environment, choosing colour schemes and layouts deciding the look and feel of Ophelia House, they advised on the group programme and feedback on policy and processes.

What’s in-store for Ophelia House?

I was glad to be asked to lead on the consultation of the development of Ophelia House and witness it take shape from the initial concept to CQC registration. As we look forward to welcoming our first community members, we stand in the knowledge that we have created a well-informed start point for a much-needed service that I hope will provide many women with a safe, nurturing environment for healing and growth.

As we take our learning forwards and use it to inform delivery across our other specialist services, we will work together with commissioners and key stakeholders to consider how to overcome the significant barriers to accessing residential treatment for women with multiple support needs so that they can experience the benefits of an environment designed by women for women.

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

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