Introduction A few years ago whilst working for a now closed psychiatric hospital I witnessed an elderly female patient being forced to masturbate a young male patient. They were sitting in the grounds of the hospital in full view of the reception desk. The woman was crying and the young man was laughing as he gripped her hands around his penis. I intervened to stop what was happening, the young man ran off and the elderly woman sat sobbing. When I reported the matter it was apparently well-known that the same incident had happened before. A Police enquiry came to nothing because the woman who was chronically mentally ill was not seen as fit to give evidence. This distressing violation symbolised for me what I had already discovered about the way in which the institution of psychiatry has its own set of rules and norms that often silence and humiliate women service users.