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I felt a Funeral, in my Brain,
And Mourners to and fro Kept treading - treading - till it seemed That Sense was breaking through - And when they all were seated, A Service, like a Drum - Kept beating - beating - till I thought My mind was going numb - And then I heard them lift a Box And creak across my Soul With those same Boots of Lead, again, Then Space - began to toll, As all the Heavens were a Bell, And Being, but an Ear, And I, and Silence, some strange Race, Wrecked, solitary, here - And then a Plank in Reason, broke, And I dropped down, and down - And hit a World, at every plunge, And Finished knowing - then- Emily Dickinson |
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Women's Mental Health
According to the World Health Organization:
Health is a state of complete physical, mental and social well being
Women's mental health: The Facts
Depression, anxiety, psychological distress, sexual violence, domestic violence and escalating rates of substance use affect women to a greater extent than men across different countries and different settings. Pressures created by their multiple roles, gender discrimination and associated factors of poverty, hunger, malnutrition, overwork, domestic violence and sexual abuse, combine to account for women's poor mental health. There is a positive relationship between the frequency and severity of such social factors and the frequency and severity of mental health problems in women. Severe life events that cause a sense of loss, inferiority, humiliation or entrapment can predict depression.
Up to 20% of those attending primary health care in developing countries suffer from anxiety and/or depressive disorders. In most centres, these patients are not recognized and therefore not treated. Communication between health workers and women patients is extremely authoritarian in many countries, making a woman's disclosure of psychological and emotional distress difficult, and often stigmatized. When women dare to disclose their problems, many health workers tend to have gender biases which lead them to either over-treat or under-treat women.
Research shows that there are 3 main factors which are highly protective against the development of mental problems especially depression. These are:
Health is a state of complete physical, mental and social well being
Women's mental health: The Facts
- Depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.
- Leading mental health problems of the older adults are depression, organic brain syndromes and dementias. A majority are women.
- An estimated 80% of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children.
- Lifetime prevalence rate of violence against women ranges from 16% to 50%.
- At least one in five women suffer rape or attempted rape in their lifetime.
Depression, anxiety, psychological distress, sexual violence, domestic violence and escalating rates of substance use affect women to a greater extent than men across different countries and different settings. Pressures created by their multiple roles, gender discrimination and associated factors of poverty, hunger, malnutrition, overwork, domestic violence and sexual abuse, combine to account for women's poor mental health. There is a positive relationship between the frequency and severity of such social factors and the frequency and severity of mental health problems in women. Severe life events that cause a sense of loss, inferiority, humiliation or entrapment can predict depression.
Up to 20% of those attending primary health care in developing countries suffer from anxiety and/or depressive disorders. In most centres, these patients are not recognized and therefore not treated. Communication between health workers and women patients is extremely authoritarian in many countries, making a woman's disclosure of psychological and emotional distress difficult, and often stigmatized. When women dare to disclose their problems, many health workers tend to have gender biases which lead them to either over-treat or under-treat women.
Research shows that there are 3 main factors which are highly protective against the development of mental problems especially depression. These are:
- having sufficient autonomy to exercise some control in response to severe events.
- access to some material resources that allow the possibility of making choices in the face of severe events.
- psychological support from family, friends, or health providers is powerfully protective.
Maternal Mental Health
Worldwide about 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. In developing countries this is even higher, i.e. 15.6% during pregnancy and 19.8% after child birth. In severe cases mothers’ suffering might be so severe that they may even commit suicide. In addition, the affected mothers cannot function properly. As a result, the children’s growth and development may be negatively affected as well. Maternal mental disorders are treatable. Effective interventions can be delivered even by well-trained non-specialist health providers.
Mental health of the mothers
A recent meta-analysis showed that about 20 % of mothers in developing countries experience clinical depression after childbirth. This is much higher than the previous figures on prevalence coming mostly from high income countries. Suicide is an important cause of death among pregnant and post- partum women. Psychosis is much less common but may also lead to suicide and in some cases even harming the newborn. Depression causes enormous suffering and disability and reduced response to child’s need. Evidence indicates that treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhoea and malnutrition among them.
Globally maternal mental health problems are considered as a major public health challenge. Though maternal mortality still lies at the heart of maternal health indicators; for the post 2015 agenda for development goals, WHO is considering Universal Health Coverage (UHC) and proposing Healthy Life Expectancy (HLE) related indicators as well. This implies stronger focus on mental health conditions in the integrated delivery of services for maternal and child health. The need is not just felt in high income countries. In fact, some academic and public health institutions in low and middle income countries have already initiated integrated maternal mental health programmes. These have been low cost interventions with the involvement of non-specialized or community health providers. Impact has been demonstrated not only on mothers but also on growth and development of children.
Who is at risk of these disorders?
Virtually all women can develop mental disorders during pregnancy and in the first year after delivery, but poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), emergency and conflict situations, natural disasters, and low social support generally increase risks for specific disorders.
Effects of maternal mental disorders after birth on the mother and the infant After the birth, the mother with depression suffers a lot and may fail to adequately eat, bathe or care for herself in other ways. This may increase the risks of ill health. The risk of suicide is also a consideration, and in psychotic illnesses, the risk of infanticide, though rare, must be taken into consideration.
Very young infants can be affected by and are highly sensitive to the environment and the quality of care, and are likely to be affected by mothers with mental disorders as well. Prolonged or severe mental illness hampers the mother-infant attachment, breastfeeding and infant care.
Mental health of the mothers
A recent meta-analysis showed that about 20 % of mothers in developing countries experience clinical depression after childbirth. This is much higher than the previous figures on prevalence coming mostly from high income countries. Suicide is an important cause of death among pregnant and post- partum women. Psychosis is much less common but may also lead to suicide and in some cases even harming the newborn. Depression causes enormous suffering and disability and reduced response to child’s need. Evidence indicates that treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhoea and malnutrition among them.
Globally maternal mental health problems are considered as a major public health challenge. Though maternal mortality still lies at the heart of maternal health indicators; for the post 2015 agenda for development goals, WHO is considering Universal Health Coverage (UHC) and proposing Healthy Life Expectancy (HLE) related indicators as well. This implies stronger focus on mental health conditions in the integrated delivery of services for maternal and child health. The need is not just felt in high income countries. In fact, some academic and public health institutions in low and middle income countries have already initiated integrated maternal mental health programmes. These have been low cost interventions with the involvement of non-specialized or community health providers. Impact has been demonstrated not only on mothers but also on growth and development of children.
Who is at risk of these disorders?
Virtually all women can develop mental disorders during pregnancy and in the first year after delivery, but poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), emergency and conflict situations, natural disasters, and low social support generally increase risks for specific disorders.
Effects of maternal mental disorders after birth on the mother and the infant After the birth, the mother with depression suffers a lot and may fail to adequately eat, bathe or care for herself in other ways. This may increase the risks of ill health. The risk of suicide is also a consideration, and in psychotic illnesses, the risk of infanticide, though rare, must be taken into consideration.
Very young infants can be affected by and are highly sensitive to the environment and the quality of care, and are likely to be affected by mothers with mental disorders as well. Prolonged or severe mental illness hampers the mother-infant attachment, breastfeeding and infant care.
