Unpacking the Female Mental Health Crisis

By Jessica Sutton.

Content warning: This article contains discussion of mental illness, violence, and suicide which readers may find distressing.

Last week, Olympic cyclist Olivia Podmore took her life. The tragedy has kickstarted conversations about mental health concerns in elite sport, alongside broader discussions about mental health challenges faced by young women.

In New Zealand and globally, discussions about mental health challenges are being had more often and with greater visibility. However, focus tends to fall on mental illness in men. There are some good reasons for this. One of the key negative impacts of patriarchy on men is increased rates of mental illness, addictive behaviours, and suicide.[1] Research indicates that men who conform to traditional masculinity are more vulnerable to mental health problems.[2] Patriarchal gender roles about “strong men” and “emotional women” mean that men are more likely than women to supress their emotions out of fear of seeming weak or feminine. This effect causes men that identify with traditional gender roles to be less likely than women to seek out therapy.[3] Men are also four times more likely than women to die by suicide, as suicidal ideation is reportedly intensified by the stressors of traditional masculinity, and men typically use more violent methods of suicide.[4]

In short, male mental health issues need significant attention. But it is equally important to address the implications of the mental health crisis for women. The specific needs and risk factors associated with female mental health are often neglected in the mental health conversation, and this needs to change.

The nature of the crisis

Women are more likely than men to share with and seek solace from friends and family, meaning they typically have better emotional health and more social support.  Yet, one in five women experience mental illness in their lifetime, compared with one in eight men.[5]

The American Psychiatric Association found that:[6]

  • Women are twice as likely to experience depression than men;
  • Women are twice as likely to experience PTSD than men;
  • Women are twice as likely to experience anxiety disorders than men;
  • Women attempt suicide three times more often than men, but use less lethal methods;
  • 85-95% of people with anorexia nervosa or bulimia are women.

There is no one factor that can explain why women experience significantly higher rates of certain mental illnesses than men. Knowledge about mental health issues is constantly evolving, and the different impacts of gender identity, race, sexuality, disability, and class make every woman’s experience different. But the oppression women face daily under patriarchy, in all its many forms, is acknowledged as playing a part in driving the female mental health crisis.

Patriarchy and violence:

A ground-breaking 1993 study by the World Health Organisation, entitled Psychosocial and Mental Health Aspects of Women’s Health,drew a link between poorer mental health outcomes for women and their position as an oppressed group under patriarchy.[7] Systemic misogyny and sexism have an inescapable impact on female mental health. For example, patriarchal gender roles likely contribute to the shockingly high rates of eating disorders among women. Patriarchy tells girls from a worryingly young age that their self-worth is determined by male attention, and that male attention depends on their dress size. Research suggests that capitalist and patriarchal pressures push women to try to attain an ultra-thin “ideal weight” based on societal indicators rather than medical reality.[8] Other restrictions under patriarchy, such as lack of reproductive freedom, can also have severe negative impacts on the mental health of women and girls.[9]

A key risk factor for mental illness identified in the WHO report was physical and sexual violence. Women and girls are disproportionately impacted by these forms of violence. 1 in 3 women globally experience physical or sexual violence.[10] Rates of violence are higher for women of colour, queer women, and trans women. Women with mental illnesses also experience higher rates of violence than men with mental illnesses or neurotypical women.[11] Additionally, mental health concerns may arise as a result of gendered violence, including PTSD after a traumatic violent incident or pattern of abuse. A 2015 study found a strong link “between physical safety concerns and psychological distress” in women.[12]

Poverty:

The disproportionate rates of poverty among women and girls also contribute to the female mental health crisis. Women make up over 75% of those living below the poverty line globally.[13] They earn only 10% of global income. Yet, women, particularly women of colour, work the most hours and produce the most food globally. This effect is known as the feminisation of poverty.

The women most severely affected by poverty are mothers heading single parent families, their children, and elderly women. The compounding effects of the gender wage gap, lack of financial control, lack of access to basic necessities, insecure housing, the gig economy, unpaid care work, and gender bias at work decrease women’s economic parity with men.[14] Financial stress and the physical impact of poverty is strongly correlated with an increase in depressive and anxiety disorders.[15]

Traditional heterosexual partnerships:

Women’s mental health can also be impacted by traditional heterosexual relationships, pregnancy, childbirth, and childcare.[16] Research has found that women who are married or in long-term relationships with men average notably high rates of mental illness.[17] Single, separated, or widowed women display lower rates of mental illness. This may be explained in part by the burden of unpaid domestic work that still falls on many women in heterosexual relationships. The 2020 Global Gender Gap report found that in every country in the world women are doing more unpaid domestic work than men.[18]

Even in countries such as Norway, which are famed for their work on gender equality, women spend approximately twice as much time doing unpaid work than men. The situation worsens if couples have children. Pregnancy and childbirth can be physically and mentally traumatic, and the increased unpaid caring work that follows can leave women burnt out and vulnerable to developing or worsening mental illnesses. The physical and mental load of being the “perfect mother and partner” weighs heavily on women. Their mental health suffers as a result, with increased incidence of panic disorders and depression.[19]

Help-seeking

Women typically display higher rates of help-seeking for mental health concerns than men.[20] However, women of colour are half as likely as white women to seek help for mental health problems.[21] It is possible that this hesitancy is partially explained by the harmful stereotype for women of colour to be staunch and prioritise their family over themselves. Additionally, under-funding and under-staffing of mental health providers mean that the wait-times for help are often excessive, leaving vulnerable people without professional support.[22]

Women are also less likely to be taken seriously when they do reach out for help.[23] The stereotype of the “hysterical” or “crazy” woman still exists and can have serious effects on medical care. Myths about women exaggerating their pain mean that when women seek medical care, they are more likely to be delayed, denied medication, or ignored altogether.[24] Women are also unlikely to disclose a history of violence to medical professionals, meaning doctors or therapists often only have partial knowledge of patients’ needs.

All of the above factors can compound existing mental health concerns, leaving women exhausted and mentally distressed. Women living under patriarchy are swimming against the tide, and it’s no surprise that some of them are getting swept away.

What to do?

Gendered bias needs to be actively stamped out of mental health responses. Women are not more likely to fabricate or be hysterical. The impact of gendered violence, the feminisation of poverty and patriarchal gender roles around childcare need to be centralised in understandings of how women can be supported to manage and recover from mental illness. The mental health issues facing women and girls need to have equal coverage in the media and in the efforts of the government and charitable organisations. Only when the conversation about mental health is inclusive of the experiences of men, women, and gender diverse people will we be able to truly address the mental health crisis.

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[1] https://www.washingtonpost.com/outlook/why-the-patriarchy-is-killing-men/2019/09/12/2490fa7e-d3ea-11e9-86ac-0f250cc91758_story.html

[2] https://www.sciencedirect.com/science/article/abs/pii/S0272735816300046

[3]https://www.researchgate.net/publication/315256781_Impact_of_gender_role_conflict_traditional_masculinity_ideology_alexithymia_and_age_on_men’s_attitudes_toward_psychological_help_seeking_Erratum

[4]https://www.tandfonline.com/doi/abs/10.1080/13811118.2014.957453?scroll=top&needAccess=true&journalCode=usui20

[5] https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/adult-psychiatric-morbidity-survey-survey-of-mental-health-and-wellbeing-england-2014#key-facts

[6] https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-Women.pdf

[7]http://apps.who.int/iris/bitstream/handle/10665/61376/WHO_FHE_MNH_93.1.pdf;jsessionid=415B46F92D7739B7DC622D5068DCD959?sequence=1

[8] https://www.sciencedirect.com/science/article/abs/pii/027753959190109U

[9] https://pubmed.ncbi.nlm.nih.gov/28477657/

[10] https://www.who.int/news/item/09-03-2021-devastatingly-pervasive-1-in-3-women-globally-experience-violence

[11] https://pubmed.ncbi.nlm.nih.gov/21047165/

[12] https://link.springer.com/article/10.1007/s11199-014-0444-y#page-1

[13] https://www.oxfam.org.nz/what-we-do/ending-poverty-inequality/womens-rights/

[14] https://shesright.co.nz/2020/06/29/pay-gaps-and-pensions-retired-women-deserve-better/

[15]http://apps.who.int/iris/bitstream/handle/10665/61376/WHO_FHE_MNH_93.1.pdf;jsessionid=415B46F92D7739B7DC622D5068DCD959?sequence=1.

[16] https://www.independent.co.uk/news/world/americas/women-mental-health-motherhood-family-emotional-labour-study-research-a8740501.html

[17]http://apps.who.int/iris/bitstream/handle/10665/61376/WHO_FHE_MNH_93.1.pdf;jsessionid=415B46F92D7739B7DC622D5068DCD959?sequence=1

[18] http://www3.weforum.org/docs/WEF_GGGR_2020.pdf

[19] https://psycnet.apa.org/record/2015-40710-001

[20] https://pubmed.ncbi.nlm.nih.gov/18058440/

[21] https://www.hopkinsmedicine.org/health/wellness-and-prevention/mental-health-among-african-american-women

[22] https://www.rnz.co.nz/news/national/447009/fears-lives-are-being-put-at-risk-due-to-mental-health-wait-times

[23] https://www.mindpathcare.com/blog/womens-mental-health-concerns-are-often-dismissed-heres-what-to-do-about-it/

[24] https://shesright.co.nz/2020/05/25/unpacking-the-gender-health-gap/


Photo by Matthew Ball on Unsplash

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