So - the single sex ward thing

Entirely in favour of single sex wards. Almost no down sides. Should have common communal areas for those that want to mix but safe single sex areas.

Not that single sex wards do away with all the risks but they must drastically reduce the chances of anything nasty happening.

I agree with Dazedandconfused. I don’t object to the unit being mixed so long as there are safe single sex areas.

Thanks for this Beakie - excellent post.

I have been inpatient in an acute ward three times. The first 2 admissions were in a single sex ward in 2001. The third was in a mixed ward in 2003. This experience made me extremely wary of the words “might” “have” and “to admit you.”

I have two points I’d like to make. My second point comes from a female personal perspective. I’m not suggesting that men cannot be victims of rape or sexual abuse.

1) Why should mental health units be any different from say, a Cancer Ward? Would someone suggest mixing up the gender ratio in the Renal Unit to make the women less bitchy and the men less likely to punch holes in the bed pans?

2) Many female patients (and I do like the word patients because we’re ill, no?) find themselves in an acute unit because they have been sexually or physically abused. They may be victims of rape. They may be extremely traumatised. Surely this trauma is only compounded by the potential risks of assault, rape or sexual harassment in a ward that should be a place of safety.

As dazedandconfused so rightly points out, single sex wards don’t do away with all the risks, but they must drastically reduce the chances of anything nasty happening.

I’m not suggesting that all mental illnesses are caused by sexual abuse or something equally nasty in the woodshed. However, it cannot be denied that there are vulnerable people who are being badly failed by the system.

Rosalind McManus was one of them.

reposting my comment in the shoutbox here before it disappears into the ether:

having been a patient on a mixed sex ward and working in an all female unit (and a forensic one at that) i can kind of see both sides. being hit on/flashed at/fought over (that’s never happened before or since!) by male patients was actually pretty traumatising, much more so than being randomly clocked round the head by a female patient during the same admission. i think the genders can have a neutralising effect on each other - women curbing some of the aggression from men, men curbing some of the bitchiness from women (sorry, horrendous gender sterotyping here, obviously this is a generalisation). ultimately, i think service users should be given a choice of whether they want to be on a mixed sex or single sex ward - preferably considered beforehand at some point if poss and written down in an advance decision type document. if i was ever admitted to hospital again, i would choose a single sex ward. when i’m ill, i’m extremely vulnerable and i couldn’t trust the nursing staff to protect me from abuse/exploitation. that may sound harsh, but unfortunately past experience leads me to this belief …

As dazedandconfused so rightly points out, single sex wards don’t do away with all the risks, but they must drastically reduce the chances of anything nasty happening.

yep, i would agree with this. amongst other things, research in my local area shows that incidences of self-harm amongst female service users reduced significantly when the wards went single sex, despite everyone’s predictions to the contrary.

i’ve heard male service users express fears that the move to single sex wards will increase the risk of male-on-male sexual assault - i don’t think this will be the case as mixed sex wards don’t preclude this possibility, but why they should imagine that female service users should act as a foil to this (presumably by being the victims instead) i don’t know!

Survivorworker said: “I think service users should be given a choice of whether they want to be on a mixed sex or single sex ward - preferably considered beforehand at some point if poss and written down in an advance decision type document.”

I think this is a great idea, but I can’t see it happening. Most patients don’t even get a choice to go inpatient locally. My second admission in 2001 was 2 hours away from my home. I didn’t get a choice because 1) There were no beds locally and 2) I was on a section.

i know, i know … that’s the ideal world solution :o)

it sucks that people still get admitted so far away from home - there was a bit of a bed crisis at the beginning of last year in a large area of the country, resulting in a friend of mine who lives in the midlands being admitted to a private unit in london - it was the nearest place that had a bed. the bed management system in the area of the uk where i am means that someone could live 5 mins away from their local inpatient unit but get admitted to a unit on the other side of the Trust over an hour away. people usually get “repatriated” once a bed becomes available in the unit nearest to their home, but of course this distruption in itself can be distressing

Any comments from nursing staff?

I’m actually wondering if this is a resources (or lack of) issue. What is the rationale behind the decision to have mixed sex wards? Is it (gasp) about money? Or just convenience?

From a male service user perspective I’m all for single sex wards. I’ve had some bad experiences whilst being an inpatient, most notably getting involved with a drug addict who I later found out had hep C.
Sex on the ward was common and it can only lead to the spread of sexual infections and pregnancies, people in a vulnerable state should be protected from that.

I don’t think that mixed wards have a neutralising effectr, I’ve seen men physically assault female patients.

If I had the choice I’d go single sex every time

I think a very telling point is raised by the comment “couldn’t trust the nursing staff to protect me from abuse/exploitation.” My views on this issue are complex. First and foremost, at no time should anyone be subjected to sexual harrassment of any kind. Secondly the ward is an artificial environment: we live in a mixed sex world that has opportunities for segregation, and I felt less rehabilitated by my stay on a single-sex ward. And thirdly can I echo a cry that’s been made many times on this site by workers and service users alike - get out of the office and mix with the patients, your presence will be therapeutic and will enhance safety.

I work on a mixed rehabilitation ward which seems to work well, and I would like to make some observations.
The sleeping accommodation is divided into two separate areas, one for men and one for women, so it is quite possible to have a waiting list for one gender, and an empty bed for the other. The communal areas are mixed.
The people we help are not in an acute phase. If people become too unwell, we have to return them to acute wards, which are single sex.
I think that, in these circumstances, there is a place for mixed sex wards, although I agree that they are unsuitable for people who are more acutely ill.
I agree with Jan (and many others) about the office. In the office there’s paperwork and, errrm, more paperwork. Out on the ward, there’s nice people, television, the pool table, the garden. No contest really.

As usual I’ll be the polarised opposite from the rest of you, apologies in advance.

Lou mentioned resources, this is certainly a big issue in my part of the country. I live in a rural area where there is one acute admission unit covering a huge geographical area. This unit is the single resource for everyone between 16 and 65 whether they have an eating disorder, a substance problem or psychosis. This is a new purpose built unit which is mixed sex but does have separate sleeping areas. I’m certainly not suggesting this is ideal, indeed there has been one rape that I know of. Ironically, this was an horrific attack carried out by a member of staff. All the units in my region are widely dispersed and all are mixed sex. Bed use sometimes ends up being the best of a bad job. I have seen people with functional illness placed in dementia units and vice versa. Even amidst all this hotch-potch, people are commonly placed in units an hour away from their home and family. There are often great difficulties arranging for even 1 RMN to cover some of these units, I have stayed on 2 hours after a late shift waiting on an agency nurse travelling 100 miles to provide cover. So it is unlikely that even if these disparate units were split physically in two that there would be resources to staff them. I don’t think single sex wards are a remote possibility where I live.

In an ideal world I think units should be single sex with access to mixed sex areas. As Jan points out staff supervision/involvement should be a priority whatever the type of unit. Apart from the terrible incidents that occur in acute units, it’s always saddening to witness the almost daily occurrence of men and women undressing in front of each other and visitors in dementia units. It must be so distressing for their relatives and this is surely even more painful in mixed sex wards.

I’m sorry if all my entries sound negative and unconstructive at the moment but I just thought some of you might want to hear an alternative point of view.

Just a quick note regarding the problem of the wrong gender bed being available - in our local units in addition to male/female dormitories there are also single rooms, set apart, which can be used for either gender.
It’s not rocket science.

*agrees with Ariel*

The male acute ward near me had some problems. A very strong smell of testiclosterone, or whatever it is called, poor personal hygiene and a seemingly permanent infestation of fleas.

Not sure how common it is …

Of course that was just the staff

We only have one single sex ward in the whole trust…for men.

The rest are mixed.

We constantly have to ’separate’ patients that are ‘getting it on’.

Said patients report that they need a single sexed ward because the temptation and frustration levels are so high.

Allegations of assault, rape etc..are sky high !

Trying to keep them away from each other even when it’s consensual (although without capacity to consent perhaps) is very hard work.

It’s a big problem

Oh and in reply to Ariels post….Sometimes we have had to place a female in the male corridor through lack of beds in the appropriate female space. This takes up more staff due to having to have 1:1 obs precisely for that purpose.

The design is crap, causes massive conflicts and personally the whole lot should be bulldozed down and done properly…

Won’t hold my breath though…

Oh..and do you have ‘dorms’ where you work..as in 4 males in one room ?

Now that has been problematic….beyond belief !

We (the nurses) are always very concerned when we have female patients at our forensic unit. It’s ostensibly a mixed sex unit, but out of 30 patients, we’ll typically have 1-2 females.

These women will usually come with a horrendous history of abuse, and land on the wards a couple of days after a violent sex offender arrives.

Fortunately, we have good staffing levels, and alarms on bedroom doors, but them being abused is always a matter for concern.

I found my two stays on our local acute ward a grim experience. However, reading the posts on this topic, I realise that although it is a mixed sex ward, it wasn’t anything like as bad as other wards elsewhere in the UK. The accommodation comprised single rooms, or sharing with a maximum of two others, with (mostly) ensuite bathrooms and a few communal ones. Other areas such as lounges and the dining room were mixed sex. I never saw or heard of sexual harassment and only knew of one romance (what they got up to and where is none of my business). Mostly, the blokes were just too ill, or not inclined to hit on the women. I am wondering what made the unit I was on so different? Or maybe I just went around with my eyes shut.

One thing - the nurses were often to be found out on the ward, talking to us, albeit briefly as they had - yes - mounds of paperwork to do. The staff who smoked would take their breaks with us in the cancer stick suite. A pity they can’t now as it was an informal way of making contact. I must say I would have found it very hard to give up smoking in that environment.