EPISODE 4 SHOW NOTES: MENTAL WELLBEING

GET IN TOUCH:
If you are a woman with lived experience of selling or exchanging sex or images – or a service with experience of providing support to women – and would like to be featured on the podcast, please get in touch. You can take part in any way that suits you – from recorded interviews, to soundbites, to anonymised quotes and stories. Drop us a message here. We can’t wait to hear from you!

To find out more about the emotional, practical and financial support provided by CLiCK, check out www.click.scot

If you are a woman with lived experience of selling/exchanging sex or images online, you can anonymously make your voice heard on how you have been feeling during the coronavirus pandemic and your experiences of accessing support for your mental wellbeing by completing our mental wellbeing survey

NATIONAL HELPLINES:
  • Samaritans: You can contact Samaritans via phone on 116 123. This service is available 24 hours a day. You can also email them at jo@samaritans.org or write them a letter  
  • Breathing Space: Breathing Space is a confidential phoneline for anyone in Scotland over the age of 16, feeling low, anxious, or depressed. Their number is 0800 83 85 87 and they are open:
    Weekdays: Monday-Thursday 6pm to 2am
    Weekend: Friday 6pm-Monday 6am
  • Rape Crisis Scotland: Rape Crisis Scotland provides a national rape crisis helpline and email support for anyone affected by sexual violence, no matter when or how it happened. You can contact Rape Crisis Scotland on 08088 01 03 02 everyday from 6pm to midnight
  • Scotland’s Domestic Abuse and Forced Marriage Helpline: Scotland’s Domestic Abuse and Forced Marriage Helpline is open 24/7 with support available by phone, web chat, and email. You can call the helpline on 0800 027 1234

FEATURED SERVICES:
KEY ARTICLES

MENTAL WELLBEING

We've arranged our show notes into easy-to-read sections.
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**This episode contains discussion of domestic abuse, sexual abuse and assault, trauma, suicidal ideation and self-harm behaviours. If you are affected by any of these issues and would like to access support, please see the list of organisations in GET IN TOUCH**
CORONAVIRUS AND THE POTENTIAL MENTAL HEALTH CRISIS
Six months on from the start of lockdown, and with the UK now preparing to face a second wave of coronavirus, many of us are struggling with our mental wellbeing. A recent study by researchers the University of Bath highlights that, of the 800 people who took part, a quarter had significantly elevated anxiety and depression, exacerbated by lockdown and isolation. A study by researchers at University College London has also found that 8,000 out of 44,000 people (18%) surveyed reported thoughts of self-harm or suicide during lockdown. Worryingly, there has been a 44% drop in referrals into psychological therapies in Scotland during the pandemic. With the country facing restrictions once again, and mental health services struggling to cope, there are real concerns about a mental health crisis. 
WOMEN’S MENTAL WELLBEING DURING THE CORONAVIRUS PANDEMIC
​Whilst many of us have struggled with our mental wellbeing during lockdown, we’re not all in the same boat. Mental wellbeing in the context of coronavirus is complex and isn’t something that can be addressed in isolation. Our mental wellbeing needs to be put in context of our financial situation, our housing, our connections with other people and for women who sell or exchange sex these factors have been so significantly impacted during the pandemic. 
MONEY
Money was, and continues to be, women’s most urgent need and greatest concern. As face-to-face bookings began to slow at the beginning of the year, many women made the expensive move online to private gallery and webcamming platforms which quickly became saturated. However, not all women were able to move online and as a result have had no option but to continue seeing clients face-to-face throughout the pandemic to make an income. As a result, many women are having to put their own health and wellbeing at risk to keep a roof over their head and food on the table. Rachel, a Women’s Worker for Edinburgh-based service Another Way, highlights that uncertainties around money and the future have had a considerable impact on the mental wellbeing of women she supports:

“There’s a lot of worry about money and the future […] The women that we work with just now are experiencing heightened anxiety, a lot of that comes down to things like money. A lot of that comes down to things like worrying about health as well and worrying about their loved ones. A lot of women maybe nobody in their life knows that they’re involved in selling sex so for them just now they maybe don’t feel like they have anyone they can share those anxieties with about their finances or just in general about how they no longer can work. […] Having this time away for some women is really helpful, they have a safe time where they can reflect […] for some women it’s more of a difficult experience as it was unplanned and unexpected – they don’t know what the future looks like.”
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Whilst some women were able to stop seeing clients face-to-face at the start of the pandemic, many women have now returned. Yet, with cases of coronavirus rising and restrictions tightening as we enter a second wave – women are once again having to choose between their wellbeing and the need to make an income. 
SEXUAL HEALTH
​Women who have no other option but to continue seeing clients face-to-face are not only experiencing anxiety around potential exposure to coronavirus, but also concerns about their sexual health and wellbeing. The coronavirus pandemic has meant that many sexual health services across Scotland have had to operate in very different ways, often having to prioritise emergencies. This can impact on women’s ability to access routine check-ups and long acting contraception which can lead to feeling out of control of their own body and health. 
CHILDCARE
​At the start of lockdown when nurseries and schools closed, many women were forced into the difficult situation of attempting to juggle selling or exchanging sex alongside home-schooling and caring for their children. Whilst nurseries and schools have now re-opened, there are worries about whether childcare will be taken away again as coronavirus cases rise in schools and whole classes are sent home to isolate, as well as concerns for their children’s wellbeing as cases in school continue to rise. 
SOCIAL ISOLATION AND DISCONNECTION
Whilst we have all experienced feelings of social isolation during the pandemic, for women who sell or exchange sex, deep-rooted stigma can amplify this social isolation as women may be unable to reach out to their family and friends about how they are feeling as they are not aware of their involvement in selling or exchanging sex. Jenna, a Women’s Worker at Dundee-based service Vice Versa, notes that lockdown measures made some of the women she supports feel “other”:

“…One woman said to me that it was really obvious to her what her situation was now, and what her life was like now. She said, and this is a quote, ‘it’s just aw the junkies that are out’. She said that the only people she sees when she goes out and about is people in the same sort of situation as her. Whereas before, when things were normal and there wasn’t any lockdown, there was loads of people. She just went about her day and she didn’t feel like anybody saw her and she didn’t really look at anybody either. Now it’s a lot more obvious to her what her situation is.”

We’ve also heard from women that lockdown restrictions have impacted their routines which can affect mental wellbeing. One woman said:
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“My sleeping patterns have all been to pot because sometimes I can sleep through an entire day, or I can sleep for two days”
 
Many women are also feeling disconnected from services and other support networks as they do not have access to stable internet and the other resources you would need to get online. TARA, a national service in Scotland supporting women who have experienced trafficking, have highlighted that many of their service users are digitally excluded which amplifies feelings of social isolation and loneliness as they are not able to connect with their friends or support. 
ABUSE AND TRAUMA
Whilst being digitally connected can be positive for our mental wellbeing by reducing feelings of isolation and loneliness, being constantly connected can also have a negative impact on our wellbeing – especially for those who have experienced abuse online. Research by Glitch UK has highlighted that almost 1 in 2 women and non-binary people report experiencing online abuse since the beginning of the pandemic, and 1 in 3 of those who had experienced online abuse prior to the pandemic reported it being worse during Covid-19. 84% experienced abuse from strangers and women of colour were disproportionately impacted. Women who use platforms like OnlyFans and AdmireMe have reported having their boundaries pushed by subscribers, as well as experiencing abuse, harassment, doxing, and content piracy. The platforms themselves provide little support around this abuse but women often have little option to block users, or stop using these platforms, due to the need to make an income.

For some women, lockdown restrictions can echo abusive situations where agency and control have been reduced and actively taken away. This can echo the experience of being in the sex industry for some women, as well as experiences of abuse and assault more generally. Marsha Scott, Chief Executive of Scottish Women’s Aid, notes:

“The mental health issues are really most significant when women are most isolated […] Evan Stark, who wrote the book Coercive Control, talks about women creating areas of control in their lives. Those will be related to going to work, seeing friends, being involved in professional contact, taking your child to school and seeing other mothers […] all of the little pieces of our everyday lives. Women’s mental wellbeing is intimately related to how well they are connected to the people around them. The more isolated one feels, the less power one has.”
SOCIAL POLICING AND STIGMA
​The minister for policing in England recently encouraged people to report their neighbours to the police for breaking lockdown regulations. For women who sell or exchange sex, there is always a fear of being reported to the police. However, this fear is amplified by the re-introduction of restrictions to household mixing in Scotland as well as unethical reporting in Scottish tabloids which has fuelled public stigma towards women who sell or exchange sex throughout the pandemic by reporting on the number of women showing as “available” on escorting sites. 
SUBSTANCE USE
Mel, the CLiCK Women’s Worker based in Alcohol and Drugs Action (ADA) in Aberdeen highlights that some of the people supported by ADA have reported an increase in their alcohol and drug use during the pandemic in order to cope with feelings of isolation, boredom, and anxiety. For some women, using drugs or alcohol is part of selling or exchanging sex. Some women also sell or exchange to support their substance use. As a result, there can be anxiety during the pandemic of making enough money to support substance use or finding clients who will support this use. 
POSITIVE IMPACT ON MENTAL WELLBEING
It is important to point out that, for some women, lockdown measures were actually positive for their mental health. Some women were in a position to take a break from selling or exchanging sex and had space to reflect on whether selling or exchanging sex would be part of their future. For others, lockdown meant having time away from toxic people in their lives. One woman supported by CLiCK said:
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“Lockdown for me has had its ups and downs. It meant that I didn’t need to see people who were negative in my life or treat me poorly. I have suffered financially due to things that happened just prior to lockdown and of course, little or no sex work. It’s been OK apart from the whole financial state of affairs”
WHAT IS BEING DONE TO SUPPORT WOMEN’S WELLBEING?
Mental health care isn’t just about addressing or treating poor mental health but about promoting and maintaining positive mental health, too. However, much of the support out there does not meet the needs of women who sell/exchange sex. Stigma, and a refusal or inability to see beyond women’s involvement in selling or exchanging sex, can impact the care women receive for both the physical and mental health. Many women do not feel comfortable disclosing their involvement in selling or exchanging sex to health professionals. A woman supported by CLiCK said:

“I’ve never actually admitted to any of the services about the sex work, it’s only yourselves that knows about the sex work. I’ve never disclosed it to any other agency or my GP”

Women also often face a postcode lottery in terms of the accessibility and quality of mental health support due to staff shortages and long waiting lists. There is also often a failure to support women’s mental wellbeing using a holistic approach (e.g. only providing mental health support when women can show they are drug or substance free)

Through our wellbeing project Together, Alone women have been telling us about how they have been looking after their own wellbeing during lockdown through things like gardening, decorating, having a clear out, and getting outside. However, women should not have to cope with this alone. Thankfully, there are a number of services who are designing and delivering mental health support that has the needs and rights of women who sell or exchange sex at the core.

You My Sister is a charity which provides practical and emotional support to women with lived experience of any aspect of the sex industry. You My Sister has recently developed an online, peer-led mental health recovery programme for women who have exited the sex industry and who are now seeking emotional support in processing their experiences and moving on. Jade, a freelance consultant using her own lived experience of the sex industry to shape You My Sister, gave some insight into what it’s been like to be part of this peer network:

“Going through the sex industry and coming out the other side, no matter how far away you get from it, there’s still – I think – for many a lingering feeling of being alienated from everyone else in quite a negative way and that you should hide what has happened to you and never speak of it again. So, being able to use those experiences for such a positive outcome in order to help other women and to be able to speak openly without fear of judgement is quite liberating, it helps to make you feel like you’re assimilating back in with yourself”

Jade also had some advice for women who may be struggling with their mental wellbeing right now:

“Really do whatever makes you feel more like you. It’s about letting go of the guilt. If the way you get through the pandemic is to wrap yourself in a duvet and find a whole new genre of favourite films or whether it’s going for a two hour run round the park – there is really no right way to support your own mental health. My advice really would be to try and keep in touch with the things you know make you feel good.”

“I think the idea that we’re all working from the same base line level of achievement is actually really harmful. Y’know, everyone has their own baseline for what is a good day. It’s only by consistently achieving your personal idea of a good day that you’re ever able to advance beyond that. If you’re always reaching for someone else’s idea and never making it, then you’re never going to motivate yourself to go any further because you’re going to feel like you’re failing.”

To find out more about You My Sister and their online mental health recovery programme, which starts on 9 October 2020, check out www.youmysister.org.uk

Another peer-led network providing support to women is Umbrella Lane. Umbrella Lane have recently partnered with Wellbeing Scotland to provide sex workers with free counselling. As part of this partnership, Umbrella Lane have delivered sex worker-led training to Wellbeing Scotland counsellors to ensure people’s wellbeing is not reduced to their experiences of selling sex.  Get in touch with Umbrella Lane to find out more.

At CLiCK, we have been supporting women to access up to 8 free counselling sessions via the Encompass Fund. Eleni, one of our counsellors, had this to say:

“I practice person-centred counselling which is a humanistic and compassionate approach to therapy. My focus is to offer a warm, safe, transparent, and supportive environment to my clients and follow their own pace in therapy […] CLiCK counselling is a space where you can feel heard and understood without any judgements. It’s a space where you can talk about your story if you wish to, but also your day-to-day living, your wellbeing, your hopes and worries and anything that feels helpful to you in that moment. Counselling is not limited only to telling our story and focusing on the past, counselling is also about having a better understanding of ourselves and our interactions with the world and others. It’s about creating more options and paths to take, and it’s about showing kindness to ourselves and moving forward in life.”

There are also specialist services in Scotland with many years of experience in supporting women through experiences of trauma such as domestic abuse, rape, and sexual assault. Scottish Women’s Aid run Scotland’s Domestic Abuse and Forced Marriage Helpline which is open 24/7 with support available by phone, web chat, and email. You can call the helpline on 0800 027 1234. Scottish Women’s Aid also provide one-to-one support through their network of local Women’s Aid services. Find your local service here. Rape Crisis Scotland provides a national rape crisis helpline and email support for anyone affected by sexual violence, no matter when or how it happened. You can contact Rape Crisis Scotland on 08088 01 03 02 every day from 6pm to midnight and you can also access one-to-one support via local rape crisis centres.

Chayn is a global network of volunteers working against gender-based violence by creating intersectional, survivor-led digital resources. Chayn have recently developed Bloom, a free web-based support service designed for anyone who is currently experiencing or has experienced domestic and sexual abuse. Two new courses starting are starting on 5 October 2020 which are focused on managing anxiety and creating boundaries. Find out more here.
WHAT NEEDS TO CHANGE?
As Scotland begins to look towards recovery from the coronavirus pandemic, we cannot ignore the role of structural inequality and the intersections of systemic oppression – such as racism, poverty, sexism, and disability – and the impacts these systems have on our mental health and wellbeing. We need a holistic, intersectional approach at the Government decision making level which filters down to how we deliver mental health support in practice. Right now, there are a number of advisory groups at the Scottish Government level working to support Scotland through the coronavirus recovery phase. However, many of these advisory groups – such as financial advisory groups and mental health and suicide prevention groups – are working separately on their own issues.  This lack of knowledge sharing at the Government level then filters down into the types of support we can design and deliver in our local communities.

Specialist mental health services and third sector services need longer term funding in order to be in a position to design and develop appropriate, holistic, fully resourced support. Through the CLiCK Encompass Fund, we have been able to provide financial support to women, with some recipients reporting that this has had a positive impact on their mental wellbeing as it has eased stress and anxiety around money worries. We have also been able to support women to access counselling via this fund. However, this short-term funding is due to end very soon and we still don’t know what future funding may look like. Women may not always access support for their mental wellbeing through specific mental health support, this often comes via third sector organisations, many of which operate under continuously precarious funding situations. Recent Glasgow City Council cuts to third sector services have also had a devastating impact on the service landscape. Whilst we must work to improve the support that is currently available, we must also endeavour to keep vital services in place, but this cannot be done without concentrated support from Scottish Government and local authorities.

Services, local authorities, and the Scottish Government must continually work to ensure that women with lived experience of selling or exchanging sex are actively involved in the design, development, and delivery of mental health support in order to address deep-rooted stigma and prejudice in mental health care. Concerted efforts should also be made to create more opportunities for peer-led mental health support for women who sell or exchange sex, building a space for women to amplify their voices and experiences and push for change from a community level.