Service responses to South Asian women who attempt suicide or self-harm: challenges for service commissioning and delivery

This article draws on an investigation of service responses to women of South Asian background who have attempted suicide or self-harm within northwest England to outline policy challenges for adequate provision to this population. This article highlights, in particular, the challenges for service managers arising from and documented within the study, outlining implications for improving policy, service commissioning and provision. We suggest that these omissions have resulted in the distress of South Asian women going unrecognized in the name of respect for cultural diversity, thereby sanctioning policies and practices that further the oppression of South Asian women. Four main issues emerging from the interviews are discussed: 1) the impact of the contract culture on the form and structure of service provision; 2) limitations of current partnership arrangements with South Asian communities; 3) practical and conceptual problems within models of both consultation and change; and, 4) key practical consequences of the covert ways in which the structure and interpretation of service responses work to treat `race' as more important than gender. In terms of specific implications, it is suggested that the current policy focus on addressing service inequalities via recruitment of South Asian workers warrants critical re-evaluation, while training and management development should take as central the intersections of `race', culture, class and gender as systemic issues to be worked with rather than marginal or optional considerations. It is argued that attending to the specific needs and conditions of South Asian women attempting suicide or self-harm by providing integrated culturally and gender-sensitive services highlights good practice for everyone.