The aims of the study were to investigate the prevalence of adult abuse in female users of psychiatric care, the relationship between abuse and self-esteem and self-reported consequences of abuse, and women's self-reported needs of support. A total of 1382 women participated in the study. A self-administrated anonymous questionnaire with both closed-ended and open-ended questions was used. Quantitative data were analysed by mainly descriptive statistics and qualitative data were analysed by content analysis. Forty-six per cent (n = 638) of the women had been exposed to emotional, sexual, and/or physical abuse in adulthood. Twenty-eight per cent (n = 385) reported experiences of moderate physical abuse, 27% (n = 373) reported threats of injury, and 20% (n = 277) reported threats of being killed. Further, 19% (n = 261) reported experience of sexual violence, and 12% (n = 164) had experiences of serious physical violence. Women who had been abused rated lower self-esteem than those who were not abused. Self-reported consequences of abuse included intrapersonal problems such as poor self-esteem, fears, anxiety, and worries but also problems in social relations especially with regard to close relationships and reliance to others. To a lesser extent, disease-specific manifestations were reported. The needs of support included interventions directed to the experiences of abuse by professionals trained in the area, family interventions, self-help groups, medical care, legal support, or practical help to find new housing situations. It is concluded that female users of psychiatric care services constitute a vulnerable group with regard to abuse. To meet the women's needs, the care system has to adopt a perspective that includes personal, social, and societal factors.