6 things you should know about the women whose stories you never hear
Meet Vera, the ‘everywoman’ of Little Village.
She struggles to think about herself clearly as someone who deserves services, whose needs ought to be attended to. By amazing coincidence, the world agrees with her: it doesn’t really think she deserves help either, it was her fault she ended up here in the first place, and now she’s here, she’ll never escape.
She sees what’s out there as persecuting — people are always looking for opportunities to criticise her. She carries a lot of shame, and a lot of pain, and every contact with a service risks reawakening those emotions. She feels she says the same things again and again, and she’s beginning to lose hope of something good coming out of it. She drags herself to try things she’s not that confident about, not confident she deserves it, not sure if it’s going to hurt her more than help her.
She’s caught in a twilight zone — the past is too painful to think about, and the future is without hope. She wants connection but often the pain she feels means she makes relationships with people who increase that pain. She’s in retreat, she’s bewildered, and she’s defensive.
At Little Village we frequently see women dealing with emotional, physical and sexual abuse. We see women who have given up hope for themselves because everyone around them has too. Women who have turned to drink, to drugs, to childbearing, to ease a pain that’s been left unresolved for too long. Women who are angry, ashamed, defensive and furious at the situation they’ve found themselves in, and who certainly didn’t get there by choice.
I am troubled by what this means for each and every woman who walks through our doors in this situation, and also because the issue seems to be systemic.
International Women’s Day is a great moment to celebrate the brilliant and strong women who are shaping our world. It’s a wonderful opportunity to acknowledge and express gratitude to the women who have impacted our own lives directly.
But I want to hold on to it first and foremost as a day for sisterhood: where we express solidarity for all women across the world. And I don’t believe we can do that by celebration alone. We also need to acknowledge where the sisterhood is needed more; where there are women being failed by our systems and our society. So while I think there is so much to celebrate on a day like today, I also want to use it to remind people about a group of women who are at best, invisible, and at worst, vilified.
To do that I’ve highlighted six systemic challenges that I think we need to address before we can truly claim the ‘sisterhood’ word. What I’ve written here draws upon my own experiences at Little Village, as well as the research findings of a Point People/Agenda project I was part of with Jennie McShannon, Cassie Robinson. and Giselle Cory last year.
1. Vulnerable women are often invisible to policy makers
‘Women experiencing multiple disadvantage’, as the policy wonks call this group, are not well understood by decision makers. Historically, very little has been done to consider the gendering of disadvantage, and traditionally, ‘multiple disadvantage’ has been counted by looking at the intersection of homelessness, substance misuse and offending. This makes it look like a very male problem.
But if you look instead at the interplay of homelessness, gender-based violence and mental health, multiple disadvantage becomes an overwhelmingly female issue. Women face a distinctive and challenging set of issues by virtue of their gender. Whichever way we look at this group of women, violence is a major factor in their lives, and specifically gender-based violence.
One in four women are likely to experience some form of gender-based violence, and one in 20 women experience extensive physical and sexual abuse right across their lifetime as both children and adults. A history of abuse and violence is correlated to a host of other factors, including homelessness and substance misuse, and mental health issues.
Women’s trajectories through public services are also very different to men’s. Women are more likely to show up in mental health or children’s services, rather than the justice system, or drug and alcohol services. They are more likely to enter services later, with very high needs, having stayed invisible to services for longer. This is often driven by a fear of losing children, or because they are trapped in a situation where violence makes it harder to escape. Once women present to a service they are more likely to bring more entrenched and complex issues.
‘Their numbers may appear to be smaller, and their issues can be so much bigger’ — women’s service provider
I get into trouble sometimes for saying that behind most of the strong women we meet at Little Village lies a shit man. By that I mean it is notable how many women are dealing with absent partners, violent dads, abusive family members. Yet so often this is treated as incidental to their story, and goes unrecognised, uncounted and untreated.
2. Their lives are shaped by toxic social attitudes
In the criminal justice system, women who have been involved in street sex work and heavy shoplifting have much harsher sentences than men who have committed equivalent crimes. This gender bias is present in the criminal justice system and everywhere else from the pay gap to public service design, despite the weight of evidence about what these ‘bad women’ share: neglect in childhood, early or prolonged exposure to violence and abuse, early loss — and negative experiences of agencies trying to help.
“The journey to where they are is symptomatic of wider social attitudes, which are toxic.” — commissioning manager
Last year at Little Village we ran a series of workshops with mums we’ve supported, to encourage them to share their stories with each other and a wider audience. One of these sessions, facilitated by sounddelivery, explored labels and judgement. The women talked about being judged repeatedly, by members of the public and professionals. Their awareness of the media was heartbreakingly clear: as women in poverty they knew they were defined as ‘scum’, ‘scroungers’, ‘on the take’, ‘drug addicts’ and ‘bad mums’.
These labels make it a great deal harder for public services to then support women in the way we know is effective — by building trust and hope, by offering time and friendship, by meeting the women where they are without judgement. These are the things that are needed precisely because the difficulties women experiencing multiple disadvantage face can make it very hard for them to build positive relationships.
3. Public service cuts have fallen disproportionately on women, and especially those experiencing multiple disadvantage
It is notable how often an assumption is made that ‘equality’ means men and women should be treated the same, with access to the same services. But there is no evidence that equal treatment leads to equal outcomes: in fact what we can see is the vital role that gender-specific services can play in supporting women and helping them to move on in life.
The widespread failure to recognise the importance of gender-specific services has led to very patchy provision for women experiencing the most pressing needs across the country. For example:
- The overwhelming majority of substance misuse services in the UK are mixed gender services, and only half of local authorities report having women-specific substance misuse services.
- Three quarters of the councils in England reduced the amount they spent on refuges between 2010 and 2017. Nearly a third of local authority funding for domestic violence and abuse was cut between 2010/11 and 2011/12, with the most significant cuts to the smallest organisations.
- There is also evidence of greater insecurity and reduced services in the voluntary sector, with women’s organisations and specialists such as those providing services to Black, Asian and Minority Ethnic (BAME) women particularly affected. An EHRC study found those organisations most at risk were those offering holistic services capable of reaching the most disadvantaged women.
Broader public service cuts are exacerbating this situation. Local authorities had their government funding cut by 50 per cent between 2010/11 and 2017/18, at the same time as demand rose for key social services. Many local welfare funds have been closed, and councils have reported reducing their related expenditure by 72.5% between 2013 and 2018. The collapse of this resource — at the same time as designing in five week waits with the rollout of Universal Credit — is nothing short of a disaster for households where there are no savings to fall back on.
“2.5 million people in the UK survive with incomes no more than 10% above the poverty line. They are thus just one crisis away from of falling into poverty through no fault of their own” — Statement on Visit to the United Kingdom, by Professor Philip Alston, UN Special Rapporteur on extreme poverty and human rights
The fallout of reforms to our social welfare system fall disproportionately on those who are most disadvantaged. Women, as the majority of informal carers, carry the burden of cuts to social care services. Women, as the majority of single parents, are hit hardest by benefits caps (two thirds of UC recipients who had their benefits capped in 2018 were single parents). Single payments to households mean that women are less able to control the family income, playing into the unhealthy gender dynamics that are present in domestic abuse.
“There is a really remarkable gender dimension to many of the reforms. If you got a group of misogynists together in a room and said ‘how can we make a system that works for men but not women?’ they wouldn’t have come up with too many other ideas than what’s in place.” —Professor Philip Alston, UN Special Rapporteur on extreme poverty and human rights, in a briefing in Westminster
I am furious about the possibility that organisations like Little Village are stepping into this breach. Foodbank usage is up fourfold since 2012. Baby banks now number over 100, where fewer than 10 existed in 2010. Our work should not be celebrated as some nostalgic idea of communities looking out for each other. It cannot become an alternative to government obligations or our collective commitment to a social security net that helps people get back on their feet rather than dragging them deeper into poverty. It is a constant dilemma for me to strike the balance between alleviating the very distressing levels of need we see daily, and fighting a system that assumes that poverty is an inevitable fact of life, and that we, and organisations like us, will pick up the pieces.
4. We’re obsessed with ‘managing’ the immediate presenting risk, rather than exploring how a woman can thrive longer-term
During our work with Agenda last year, we used an approach called ‘causal loop analysis’ to try to understand how we so regularly and repeatedly fail some of the most vulnerable and excluded women in society. This methodology operates on the premise that different parts of the ‘system’ around a woman interact in unpredictable ways. Rather than looking for inputs and outputs, we were looking for feedback loops and multiplier effects. These are where apparently small factors interact with other elements of the system to create much larger outcomes than we might otherwise expect.
One of the most significant feedback loops we identified was centred on risk. When women’s needs are not met because of some of the issues outlined in points 1 to 3 above, the problems they are dealing with become more severe and enduring. That in turn leads to greater vulnerability, often in the form of increased victimisation, involvement in criminality, and not coping well with parenthood.
A professional making an assessment of the situation at this point is likely to note that there’s an increased risk for any children involved, or that a crime might be committed. The immediate response becomes a risk-based one. Understandably, the focus goes to the child, or the crime, rather than staying on the woman herself and her unmet needs.
This risk-based approach is reinforced by other factors, such as a system of legal duties that focus on children more than mothers, and the targets set by the criminal justice system itself. Political pressures and social expectations are strong. There are concerns about the immediate risk to children’s wellbeing, as well as a fear of trauma being passed on to the next generation.
The net result of these feedback loops is that our current system of public services focuses primarily on risk reduction, rather than on enabling a woman to thrive. Of course, it’s vital to address pressing risks. But unless the system can also stay focused on the woman herself, it will be hard to break out of the current cycle we identified that drives driving risk-based commissioning. And that focus on risk is to the long-term cost of the women we’re talking about here.
5. Mental health services are in danger of making things much, much worse
Women experience mental ill-health at higher rates than men. Agenda has shown that women’s mental health is closely linked to gendered life experiences, including abuse and violence. For example, women are twice as likely as men to experience PTSD, a fact often attributed to women’s more frequent experiences of sexual violence.
In every interview and workshop we conducted for the Agenda work, people acknowledged the difficulty in getting mental health professionals around the table when working with women experiencing deep disadvantage. We heard about how limited resources create barriers. We encounted endless complicated and energy draining re-structures and re-organisations that made accountability more opaque than ever.
We seem to be in a bizarre and troubling situation where local areas are being forced to measure women’s needs based on their capacity to deal with them. As one frontline mental health professional commented, “A lot of barriers are created to protect services from people.”
Another practitioner painted a picture of three islands of support that are narrowly defined. The first island is the local hospital surgery. GPs struggle to do what they can within their limited appointment slots, and often fall back on prescription drugs. The second island is IAPT services, which work for people whose problems can be dealt with by cognitive behavioural therapy, or where issues are neatly defined and specific. The third island are psychiatrists. To access an adult psychiatrist more than once, a woman would need to be on the border of hospitalisation.
As this practitioner noted, many people fall between these tiny islands. Historically holistic services such as the Drug and Alcohol Teams, Family Recovery Projects, and Family Nurse Partnerships filled the gaps. But it is precisely these services which are disappearing as funding runs out, leaving many vulnerable women with nowhere to go between short courses of Cognitive Behavioural Therapy and a serious mental health crisis.
We heard stories of how the culture and structure of mental health provision makes this worse. Mental health providers are seen to have rigid requirements, for example around women attending appointments on time, and without having used substances, that simply aren’t appropriate or realistic for women whose lives are in crisis.
“It’s a very black-and-white view of the world” —social work professional
As a sector mental health could be leading the way in designing new ways of supporting the most vulnerable women in society. We know so much now about the impact of gender violence on mental health. It’s impossible to deny the evidence that ‘Adverse Childhood Experiences’ can shape entire lives and the lives of a woman’s children. And so I find it utterly bewildering that mental health services can be so disengaged from women, distant from other services supporting this group and unable to take a more holistic view of impact.
6. The professionals supporting women in crisis are often overworked and struggling to process trauma themselves
In systems where traumatised women are judged and deprived of agency it is not that surprising that they will feel angry, anxious, stressed, helpless and hopeless. And it is perhaps not surprising that these feelings can rub off on professionals. These are people who are constantly dealing with high levels of need, without enough resources to respond. It’s hardly surprising that in this situation, staff can become deeply frustrated and emotionally unavailable, as a coping mechanism in the face of what can feel like voracious demand that’s impossible to meet.
Social workers and others certainly feel the very same feelings of the women — anger, fatigue, hopelessness — effectively replicating them and reflecting them back. The Stand Up for Social Work campaign showed that 91 per cent of social workers suffered from emotional exhaustion, and 61 per cent suffered from ‘depersonalisation’.
And herein lies another feedback loop we identified through our causal loop analysis with Agenda. All of these difficult emotions reduce the capacity of organisations to sustain relationships with women, because it ultimately reduces expectations about the positive change a woman might be able to achieve.
And when a service fails to build good relationships, it increases the chances of the woman herself choosing to disengage. In turn, that diminishes professional views of what’s possible, which, in the end, impacts on funding decisions as the woman begins to be seen as a “hopeless case “- an “antisocial tenant”, a “bad mother”, an “unreliable witness”.
We noticed how many of the organisations trying to support women experiencing multiple disadvantage talk of their own powerlessness to effect change, their own unmet needs in terms of funding and agency. Lack of sustained resources has led to poor staff retention and disrupted relationships with their clients. In this way, the system has come to mirror the experiences of the women themselves. It’s worth speculating that what we see here reflects the fact that systems are inherently fractal — what happens in one part of the system is unconsciously replicated throughout the rest of it.
To conclude— we’re failing some of the most vulnerable and excluded women
Women experiencing multiple disadvantage are losing out because of the way services are currently configured; they are losing out disproportionately after a decade of cuts which have hit specialist services hard; and they are losing out because of wider social attitudes to them, which remain prejudiced and problematic.
We are failing some of the most vulnerable and excluded women in society thanks to powerful social attitudes and political pressures. These drive the culture and spending priorities of public services. I believe that these things reinforce the exclusion of many women and cement the growing inequalities we can observe in the UK every way we turn.
With all this going on, we should probably see the professionals I write about here as survivors alongside the women they are helping. I don’t want to argue that we should apportion blame to workers who are often struggling on low incomes themselves, and internalising other people’s traumas with very little support.
But there is no denying that the structures within which they are operating are failing women with a depressing regularity. That is what we should really be talking about today.
