Jane Dodsworth

Perception of need and barriers to access: the mental health needs of young people attending a Youth Offending Team in the UK

This study used a mixed methodology with young offenders attending a Youth Offending Service to identify, with regard to mental health problems, perceptions of level of need, experiences of and views on support and perceptions of barriers in accessing services. Between May and September 2008, 44 young offenders completed a questionnaire about their self-reported levels of mental health need, and their behaviour, preferences and evaluation regarding different sources of support and advice for mental health issues. Six young people were interviewed about their experiences and these data were analysed using thematic analysis. Findings showed that these vulnerable young people had a high level of mental health need, and were most likely to seek support from people with whom they had a confiding and long-standing relationship (parents and friends). For these young people, low levels of service use were not the result of a lack of provision, but because there were psychological, social, structural and cultural barriers to accessing those services including issues of understanding, stigma and confidentiality.

Group Two: ‘What I Do’

This chapter will examine the similarities and differences between the experiences of the eight women in Group Two and those of the previous group in order to explore why ‘sex worker’ has not, unlike for Group One, become the core identity, and sex work a self-defining aspect, of their lives. A similar chronological journey through the women’s narratives will be taken to explore developmental pathways and the interaction between them and their social environment. How early childhood experiences, including those of abuse, rejection and rebellion, feeling different, running away and secrecy have been managed is explored. Adult experiences of partnering and parenting are examined in terms of the management of these roles and identities alongside involvement in sex work. The women’s stories of sex work or decisions to leave are considered in terms of issues of agency, coercion or drift, their attitudes to ‘pimps’, clients, violence, and the management strategies of secrecy, codes of conduct and dissociation employed to survive their experiences.

Managing Involvement in Selling Sex: Staying, Leaving, Surviving

This chapter considers research on how, once involved in sex work, women ‘manage’ involvement, and how they define that in terms of both ‘managing’ to stay and ‘managing’ to exit. Sex work is, as Sanders (2005a) notes, ‘a risky business’ in which women employ a range of coping strategies to ‘manage’ the hazards inherent in the experience.

Group Three: ‘Not for Me’

There are four women in this group, all of whom have exited sex work. This chapter considers the similarities and differences in the experiences of these women from those of the previous groups, examining why they have rejected sex worker as any part of their self-identity. A chronological journey through the women’s narratives will again be taken, to examine developmental pathways and the interaction between the individual women and their social environment.

Managing the Coexistence of Roles and Identities

Part I has established what research indicates about the historical, legislative and theoretical context underpinning how young people at risk of, and involved in, sexual exploitation and adult women involved in sex work have been perceived and treated over the last 200 years. Part II integrates this research into an examination of the findings of a study which explored the pathways of young and adult women involved in selling and swapping sex. This chapter identifies the methodological approach taken and outlines how the emerging analytical themes are organised into three chapters corresponding to three groups identified from the women’s narratives.

Group One: ‘Who I Am’

Of the 12 women in this group, 11 see no alternative to continued involvement in sex work, and one woman, Jo, had had to stop or risk dying, but longs to return. This chapter explores how sex work appears to be the core identity and major self-defining aspect of these women’s lives. Their narratives are explored chronologically through memories of childhood, adult experiences, sexual exploitation and sex work. The focus is on how they see themselves in their roles as daughter, partner, mother, friend and sex worker. It is clear that, although this group share commonalities with the other two groups, it is the differences in the meaning they attribute to their life experiences that determined their ability, or lack of it, to manage different roles and identities.

Selling Sex: A Historical, Legislative and Policy Perspective

In most societies and throughout the ages, prostitutes, children and adults alike, have been shunned, reviled and punished. The prostitute is often viewed as ‘unlike us’, and consequently it is often his or her reformation or removal, at least from the public gaze, that has motivated responses (Lee and O’Brien 1995:7).

Routes into Sex Work: Who, Why and How?

Both children and adults involved in selling sex have, from a historical and legislative perspective, been perceived as a public nuisance. Government guidance on safeguarding children and young people from sexual exploitation (DoH 2000), which was revised in 2009 (DSCF 2009), sanctioned a change in perception to regarding them as victims of abuse rather than as offenders. Prior to that, the prevailing view was one in which the children were defined as the problem, not the adults who abuse them or the social, economic and cultural conditions that increase their vulnerability to exploitation (Lee and O’Brien 1995).

Resilience and Agency

As the literature considered in Part I indicates, children and adults involved in selling sex in the UK are still a largely ‘stigmatised marginalised and criminalised group’ (Shaw and Butler 1998:190). Society holds contradictory perspectives, perceiving those involved as ‘sad’ or ‘bad’, ‘victim’ or ‘criminal’. Legal and moral responses are often based on those perceptions, not on an understanding of the structural disadvantages affecting many who become involved in selling sex, or on childhood experiences of adversity and maltreatment which impact on identity and choice. Polarised and recurring themes of victimhood and agency are evident in the perception and treatment of both the children and adults involved (Pearce 2009, Sanders et al. 2009, Dodsworth 2012).