Unveiling Gendered Dimensions of Mental Health

The IMPRI Impact and Policy Research Institute, New Delhi hosted a Three-Day Immersive Gender and Mental Health certificate training course from February 13-15. This programme was chaired by Professor Vibhuti Patel who started Day 1 of the session by reflecting on the greater concern toward gender and mental health post-pandemic. She describes how gender is a critical social determinant of mental health. The pattern of psychological distress and psychic disorder among women are different from those seen in men as material reality impacting the lives of men, women, and sexual minorities are different. 

Women, Physically challenged and Minorities have higher levels of internalizing disorder whereas men show higher levels of externalizing disorder. The rates of mental order-disorder also occur differentially according to enabling or disabling sociocultural economic privileges or weaker section possibilities. The girls prone to early marriage or child labor, being transgender, and being physically challenged can affect their mental health. It was even witnessed in the premium institutions that the prevalence of socio-economic factors, belonging to a certain gender community, or being physically challenged did harm to the mental health of the students. She mentioned on multiple factors of how multiple factors such as domestic violence, comparison, bullying, etc disturbed mental health. 

Additionally, she put forward the data that around 20% of women in India are prone to domestic violence. The data from developed and developing countries reflected people belonging to poor socio-economic backgrounds and belonging to marginalized communities suffered from mental health issues. Women among themselves are more vulnerable. Population with intersections vulnerabilities such as Dalits, sexual minorities surviving sexual violence, persons with disabilities, and the poor face discrimination, dehumanization, and exclusion from society. That results in acute mental health challenges, the experience of both industrializing countries and developing countries revealed that the prevalence of common mental disorders is high among low-income and marginalized populations.

Women among them are even more vulnerable. Macro forces such as globalization, and structural adjustment programs resulting in a reduction in social sector fund allocation by the state, conflict with the neighbouring country’s ongoing sectarian violence based on caste and communal lines within the country had put the population of a county at a high risk of mental illnesses. Women who had to deal with financial hardship experience tremendous trace within the family and the community they are affected differentially depending on their place within the Indian socio-hierarchy.

Women-headed households managed by widows, separated singles, and women who are facing long-term male migration face more mental disorders. As they are at the bottom of the poverty line so respect for gender diversity and plurality. Compared to institutionalization based mainly earned by medical intervention community or family-based support structures are far more effective in ensuring overall human well-being She mentioned how the interim budget recognized mental health as a social problem and also understood the importance of the same. She emphasizes how govt recognized mental health and its social determinants and allocated funds for the same.

The Session was further carried on by Dr. M Manjula, She began by talking more about gender and mental health and how Gender-culturally prescribed roles to males and females have evolved.

Dr. M Manjula on Gendered MH

Mental health (MH), a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community, exists on a continuum. Gender is one of the critical determinants of MH. Patterns of Mental Illness (MI) and psychological distress are different across genders. Common mental illnesses are 2-3 times more common among women, higher internalizing disorders. Sex differences in mental health can be explained by sex hormones and dysregulations in the hypothalamic-pituitary-adrenal (HPA) axis especially for stress-related psychiatric disorders.

Risk Factors

  • Gender-based roles
  • Stressors
  • Social Position, status, and treatment in society
  • Physical vulnerability
  • Caring for others
  • Discrimination and associated factors of poverty
  • Malnutrition
  • Overwork
  • Domestic violence, and sexual abuse,
  • Dowry practices

Women and MI

Common forms of violence- female feticide, domestic violence, dowry death or harassment, mental and physical torture, sexual trafficking, and public humiliation (Davar, 1999), 30% experienced (psychiatric pts) Sexual coercion, intimate partner violence

Reproductive Mental Health

Mood and behavioral changes during pre and menstrual periods are irritability, restlessness, anxiety, tension, migraine, sleep disturbances, sadness, dysphoria, and lack of concentration. The pooled prevalence of reproductive-age women affected with PMS worldwide – is 47.8%; 20% experience severe symptoms that disrupt their functioning (Frey et al. 2020). Mental disturbances during late pregnancy and in the postpartum period are common (within 6 weeks in the majority of cases). Postpartum blues – 50-80% of new mothers (O’Hara, 1991). Post-natal depression and anxiety are seen in 10-15% of women.

Risk factors for depression in India – the birth of a daughter when a son was desired, relationship difficulties with mother-in-law and parents, adverse life events during pregnancy, and lack of physical help are all risk factors for the onset of postpartum depression (Chandan et al 2002). Systematic review of common perinatal disorders in LMIC-1 in 6 women experience it (Fisher et al 2013). 1 woman for every three men attends public health psychiatric outpatient clinics in urban India – greater stigma and lower importance to their health (Soud, 2015) Beds in psychiatric hospitals – 73%:27% (Davar, 1999). More than 50% experience sexual dysfunctions but do not seek help.

Conclusion 

Women’s mental health cannot be considered in isolation from social, political, and economic issues. Incorporate mental and physical health across the life cycle. Risk factors across the broader, social, economic, and legal factors. Education, training, and interventions targeting the social and physical environment are crucial for addressing women’s mental health. Interventions at various levels aiming at both individual women and women as a large section of society are essential.

It is imperative to improve the criminal justice response to violence against women and develop and adopt strategies that will improve the social status of women, remove gender disparities, provide economic and political power, and increase awareness of their rights.  Women must act as social activists to fight against the social evils, which are responsible for their woes.

Acknowledgement: This article was published by Rehmat Arora, a Research Intern at IMPRI.

Read more event reports of IMPRI here:
Making Gender-Sensitive Mental Health
Women and Mental Health

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