ABSTRACT
Mainstream mental health services fail women, who have experienced child sexual abuse, when they conceptualize the effects of abuse, and women's coping strategies, in negative and pathological terms. In particular, the medical model has been repeatedly criticized for underscoring the impact of abuse and exploitation in shaping women's experiences of `madness'. A corollary of this is that prescriptive pathways to recovery and health, that re¯ect dominant values around heteronormativity, can be reinstated as the unacknowledged goals of psychiatry and psychology. Such values are further augmented through the mass media, which perpetuates well-rehearsed and familiar narratives about abusers and victims. This means that abused women, who are further marginalized through structural oppressions such as race, culture and psychiatric status, often receive poor mental health and social care because the general public cannot be galvanized into caring about their fate. It is little wonder then that sexually abused women, with the most serious and enduring mental health problems, who end up being involuntarily detained in secure hospitals, often have the poorest service of all. Indeed, women's mistreatment in mental-health care institutions has long been documented around the world (e.g. Aitkin and Heenan 2004; Allen 1987; Chesler 1972/1989; Hemingway 1996; Horn and Warner 2000; Warner 1996b, 1996c; Wile 2001).
