Planning Community Mental Health Services for Women: A Multiprofessional Handbook
The unique needs of women have often been overlooked in planning and developing community mental health services. In order to provide more equitable, accessible, and effective services for women, we need to recognize the ways in which clinical and social problems are intertwined and to take into account the full range of women's experiences and choices. These assertions are recurring themes in this very thoughtful 18-chapter compendium that grew out of an international conference on women and mental health organized by the editors.
Based on work in the United Kingdom, this handbook has much to recommend it to mental health professionals elsewhere, especially to those who are planners and directors of clinical programs. The topics covered are comprehensive and relevant. Included are chapters about women and homelessness, aging, lesbian concerns, substance use, black women, trauma survivors, women as abusers, motherhood, women as carers for those with mental illness, and consumer perspectives, among others. Each of these contributions is relatively independent of the whole, and the reader may well choose to select those of special interest first.
Although the content of the chapters varies in both quality and generalizability, the book has notable strengths. It demonstrates numerous cogent approaches to the process of planning community mental health services: careful attention to consumer needs and wishes, to resources and their constraints, and to the personal and social dimensions of clinical programming. Throughout, the authors place appropriate emphasis on problem identification and "good practice" models, moving clearly from an overview of a specific problem's scope and prevalence to concrete plans and interventions. Although the chapters adopt explicitly feminist language and principles in varying degrees, a commitment both to women's empowerment and to clinical pragmatism is consistently evident. Excellent introductory and concluding chapters provide organizing and summarizing frameworks.
Many of the book's thematic recommendations are applicable to services for men as well as women. Accessibility, services integration, engagement in treatment, and attention to consumer perspectives are widely shared goals. But the authors make it clear that these goals have particular meanings for women experiencing specific difficulties. And an understanding of these specifics is essential to effective services. Desires for women-only programs (in and out of the hospital), for being able to choose a therapist of a particular gender, for assurance of physical as well as emotional safety, and for child care assistance are just some of the priorities that may reshape service delivery. This book offers many instances of programs, some adapted from existing services and some newly created, that are responsive to these desires.
However, precisely because of its reliance on such specifics, outside of the United Kingdom this book is best read as a collection of case studies illustrating a generalizable process of tailored service planning and as a source for comparing international service needs and resources. The best lessons of the book lie not in importing directly all of its concrete recommendations; too many of them are appropriately tied to the United Kingdom's health care system and its public-policy priorities. The best lessons lie in its attentive listening to the mental health service needs and preferences of women, in its assiduous attempts to translate those needs into helpful services, and in its many models for accomplishing just this task.
Dr. Fallot is codirector of Community Connections in Washington, D.C.
