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Experiences of abuse are common among women in Sweden and being abusedduring childhood as well as adulthood has consequences for the lives of girlsand women. One consequence of abuse is the impact on their mental health,which entails them seeking psychiatric care as a consequence of this. Beingabused as a child has consequences during childhood as well as duringadolescence and adulthood and there is a link between childhood abuse andmental ill health as an adult. Adults who have experienced abuse during theirchildhood have poorer mental health as adults and are overrepresented withinthe health care systems. Women who experience abuse as adults often describeconsequences such as depression, posttraumatic stress disorder and anxiety.The psychiatric context is often described as being unhelpful when you haveexperience of abuse and women could be reluctant to disclose theirexperiences to staff for a variety of reasons.This thesis aims to identify experiences of abuse during childhood andadulthood among women who have experienced abuse and have mental illhealth. The thesis also aims to explore women’s disclosure of abuse andexperiences of the care provided in a general psychiatric context.The first study aimed to explore women’s disclosure of experiencing physical,emotional and/or sexual abuse to staff during their latest contact at a generalpsychiatric clinic. The study also aimed to explore whether the women hadever disclosed abuse to anyone at all. Seventy-seven women completed aquestionnaire at the clinic and the results showed that the women oftendisclosed their experiences of abuse to others, but they had often chosen not todisclose their experiences during their latest contact with staff at the generalpsychiatric clinic. In the second study 10 women were interviewed regardingtheir experiences of physical, emotional and/or sexual abuse and its influenceon their self-reported mental ill health. The overall theme evolving from theinterviews were, “Being vulnerable and without protection in a frightful realitythat limits one’s possibilities of living and being the person one wishes to be”.The categories that emerged were: ”Living in fear that persistently influencesthe substance of life”, “Living with the sense of being worthless”, “Livingwith a constant question about who you are” and “Living between hope anddespair”. The third study aimed to elucidate how women subjected tophysical, emotional and/or sexual abuse experience the care provided at ageneral psychiatric clinic after the disclosure of abuse. The overall themecapturing the essence of the nine interviews was visualized as ”Dependency asa reality containing a duality of suffering and trust”. The categories thatemerged in the text were: “Being belittled”, “Being misinterpreted” and“Being cared for”. The fourth study aimed to investigate the life course ofwomen within psychiatric care who had experienced abuse. The study alsoaimed to focus on the women’s resources, stressful events, experience of abuse,perpetrators, mental ill health and care and support throughout the life course.The subcategories that shaped the categories were presented within the lifespans; childhood 0-12 years, adolescence 13-19 years and adulthood 20 yearsand above. The life charts revealed that adulthood was the period of life thathad most frequent events of abuse. The women who had few experiences ofabuse during childhood had also only a few noted events of mental ill healthduring that period of life. Emotional abuse was most frequent throughout thelife course. Sexual abuse was the lesser noted abuse during childhood, butincreased during adolescence and adulthood. The life charts also visualize thatthe women had seldom revealed the abuse during their childhood to othersgrowing up and as adults the women often went to formal networks forsupport and care.The results of the thesis show that the general psychiatric care must improvetheir efforts to identify and support women who have experienced abuse. Thewomen’s own stories regarding experiences of abuse during the life coursemust be recognized and integrated with traditional biomedical care

Vulnerable and without protection: Lifetime experiences of abuse and its influence on mental ill health