Women, alcohol and mental health: Achieving authenticity in a hostile environment Patsy Staddon, University of Plymout

1. Women, alcohol and mental health: Achieving authenticity in a hostile environment Patsy Staddon, University of Plymouth Research funded by

2. Social models of mental illness • From ‘what is wrong with me?’ to ‘what difficulties are caused for me by how society works?’ • Major difficulty: public perception of difference as problematic • Service users not only impaired but dissident (Beresford 2009)

3. A social model of alcohol use would: • Address issues poverty, power imbalance and abuse • Recognise value of experiential rights—i.e. the recognition of own experience +identity (Cresswell 2009) • Dismantle moral discourse of blame+ shame • Reject compulsory treatment

4. A social model would also: • Encourage self-determination • Value subjective experience • Acknowledge diverse needs, including substance use • Support search for authenticity (i.e. freedom to find out who ‘you’ are, and to feel OK about who you are)

5. Hard for women to experience authenticity • Secondary position in social structure ignored (de Beauvoir 1945) • Poorer and more likely to have mental health issues • Most women with mental health issues self-medicate, as do many other women who have been abused or abandoned • Alcohol accessible but doubly deviant for women

6. This service user led research: • Investigated why women needed alcohol and why most reported treatment as unsatisfactory • Interviewed + ran focus groups with 23 women who had or had had alcohol issues • Interviewed 21 GPs and treatment specialists

7. Findings (1) Alcohol helped dealing with: • Depression • Other mental health problems • Domestic and sexual abuse • Feelings of worthlessness • Poverty • Fear of losing children/home • Feelings of hopelessness

8. Findings (2) • Women’s well-being had been adversely affected less by actual alcohol consumption than by social causes including their treatment • ALCOHOL WAS ‘A PLACE OF MY OWN’

9. Findings (3)Listening to GPs and treatment professionals • GPs poor info and training • Pressed for time • ‘Dirty work patients’ • Lay prejudices+moral perspective • Treaters similarly judgemental • Few examples holistic approaches to alcohol use • Generally saw alcohol as cause, not consequence, of distress

10. Medicine as agent of social control • ‘Health’ and ‘temperance’ seen as moral virtues • But mental ‘health’ not an objective reality; a fragile balance between reality+unreality • For some people, substances are an essential part of this balance • Authenticity is not always best served by ‘treatment’ • ‘Treatment’ as social control

11. Recovery is more than symptom control • Different ways of perceiving reality +understanding ourselves • Different experiences of own bodies • Authenticity achieved differently by different people • Inappropriate to see search for authenticity as ‘illness’

12. Authenticity is ahuman rights issue We must be able to choose whether or not to have ‘treatment’, whether we see visions, hear voices, or need a special space we only find with alcohol, drugs or cutting. Thank you. Patsy Staddon (service user and treatment survivor) Women’s Independent Alcohol Support wias@blueyonder.co.uk 0117-373-8797