Making Gender-Sensitive 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. The second speaker for day 1 was Dr. Aparna Joshi who started the session with the importance of mental health. She mentioned the related concepts such as Mental well-being, Mental health, Well-being, Quality of life, Coping, Resilience, Recovery, Psychosocial Disability, Distress &Mental illness:(DSM-5).

Gender bias in mental health understanding

1971: Broverman and Broverman: Groundbreaking study on the traits mental health workers ascribed to males and females. Later, when asked to describe the characteristics of a healthy person (not gender specific), the list was nearly identical to that of a male. This study uncovered the general assumption that being female is associated with being somewhat unhealthy or not of sound mind 2006: Seem and Clark replicated the study and found similar results.

Gender and Research on Mental Health

Gender blind theories: Sought evidence to prove women’s greater, biologically based vulnerability or proneness to mental disorder. Obsession with biological and reproductive vulnerability as against social origins of women’s vulnerability (Neglected). Neglect of the contribution that men’s reproductive functioning might make to their mental health has been virtually ignored. Several studies have now shown men as well as women can experience depression following the birth of a child and a significant correlation exists between parents regarding depressive symptoms. Exclusion of women from research on such significant health issues as cardiovascular disease: delayed discovery of the relationship between major depression in women and an increased risk of cardiovascular morbidity and mortality.

Mental health as a gendered issue

Research shows that socially constructed differences between women and men in roles and responsibilities status and power, interact with biological differences between the sexes to contribute to differences like mental health problems suffered, health-seeking behaviour of those affected, and responses of the health sector and society as a whole.

What do we know?
The WHO has recognized gender as a critical determinant of mental health and illness and there is growing awareness of the need to consider policy and practice through a gendered lens.

Gender-sensitive to MH Care

A gender-sensitive approach recognizes how the socio-political and cultural context, in addition to biological factors, shape care needs and care delivery. This approach also acknowledges how gender affects access to and experience of health care, as well as the presentation of need, particularly for women and girls experiencing multiple marginalizations (for example, when gender intersects with race, ethnicity, disability, and other socio-economic factors). A gender-sensitive approach attempts to embed awareness of these wider structural inequalities into the design of health systems and the delivery of health care, and in doing so, attempts to mitigate the impact of these.

Mental Health Services in India include Mental hospitals, National and District Mental Health Programs, General hospital psychiatric units, Mental health services provided by civil society organizations, Private mental health care, Workplace mental health, Digital mental health services, Traditional healing,

National mental health program and women’s needs

The NMHP: A psychiatric preserve and is characterized by an illness-driven approach to mental health. Because of its exclusive reliance on the bio-medical approach, the NMHP prioritizes severe mental disorders and medical interventions. This is problematic for women given the greater prevalence of CMDs, with a psychosocial causation. Clinicians therefore need to discriminate between an ‘illness language’ from a ‘distress language’ which is more appropriate for women

Away from bio-medical focus: Mental health policies and programs should incorporate an understanding of gender and be developed in consultation with people across the gender spectrum (women, men, and all genders), Gender-based barriers to access to mental health care need to be addressed in program planning. The inclusion of gender as an important ingredient in mental health curricula, and training for building health providers’ capacity to identify and treat mental disorders in primary health care services needs to integrate a gender analysis:

  1. Training mental health professionals to treat and respond to gender-sensitive health areas such as domestic violence, unwanted pregnancies, child neglect, and intimate partner violence.
  2. Ensuring private spaces for physical examination.
  3. Using a life course approach in service planning and delivery, i.e., how life events and stages in a woman’s life cycle affect mental health
  4. Assistance for women who find it difficult to understand and navigate the mental health care system.
  5. Provision of mother-baby units to allow for and encourage bonding with babies in the postpartum period.
  6. Choice of being assessed and examined by women doctors/nurses in women reporting sexual assault and women with a history of intimate partner violence
  7. Quick assessments and special provisions to bypass routine hospital queues and lengthy procedures in case of sexual assault.
  8. Short waiting times for women with young children.

She concluded her sessions by taking and clearing the doubts of the session and enlightening the students with her views.

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

Read more event reports of IMPRI here:
Women and Mental Health
Unveiling Gendered Dimensions of Mental Health