Women & Mental Health
Clarion Call For Timely Intervention

By Chandrakala Sharma

IN 1946, the World Health Organisation defined health as, "a state of complete physical, mental and social well being and not merely the absence of disease or infirmity". The issue of "women health" as a separate field has emerged recently. Traditional definition of women’s health should be broadened to reach beyond the reproductive and the maternal incorporating mental and physical health across the life cycle.

The state of women’s mental health is indeed in a state of flux. The World Health Report says, " Women’s Health is inextricably linked to their status in society. Today the status and wellbeing of countless millions of women world wide remain tragically low".

"A woman’s health is her total wellbeing, not determined solely by biological factors and reproduction, but also by the effects of workload, nutrition, stress, war, and migration, among others".

A major problem area for women is that of mental health . Mental health cannot be separated from total health. There are a number of factors affecting women’s mental health in Nepal.

Biological factors

The stress response represents the epitome of mind-body interaction that underpins physiological and emotional arousal. A major role in the stress response is played by the individual in the ways she selectively interprets stress stimuli and their effects. Women experience and respond to stress quite differently than men, do.

Likewise the motherhood represents a major change in the life cycle, biological, psychological, social and cultural events, due to the changes in the bodily functions.

Changes in the hormone levels and change in the physiological function could be cited as some examples.

Psychological factors

Psychological stress provide numerous instances where demands can outstrip the women’s capabilities to successfully manage her new state as wife, mother, daughter – in-law, etc.

Links between economic hardship, child death, emotional deprivation and psychological distress in women have been traced in anthropological studies in different countries.

Physical, sexual and psychological violence occurring in the family including battering, sexual abuse of female children in the household, dowry – related violence, marital rape, and other traditional practices harmful to women have a negative impact on their mental health.

Beside these, sexual harassment and intimidation at work in educational institutions and elsewhere, trafficking in women , etc can have an negative impact on their mental health. Many of the individuals suffer from illness related to domestic violence and abuse.

Socio-economic factors

The quality of women’s lives is deeply related to their economic status.

Poverty , in equality, domestic violence, isolation, powerlessness (resulting for example, from low levels of education and economic dependence) and patriarchal oppression, are all associated with higher prevalence of psychiatric morbidity in women. The origins of much of these pain and sufferings can be traced to their social circumstances and many of these are the by product of hunger, overwork, violence and economic hardship.

Understanding the sources of ill health for women means understanding how cultural and economic forces interact to undermine their social status.

A comparative study of mental disorders reveals symptoms of depression and anxiety and psychological distress are more prevalent among women than men. The data tabulated by the World Bank ( 1993) reflect these differences. Depressive disorders account for close to 30% of disability from neuropsychiatric disorders among women.

Psychological problems during adulthood may be associated with menstruation, such as pre-menstrual tension, fertility control and infertility. Women’s experiences of difficulties in their sexual relationships range from communication problems to severe physical and sexual abuse, which increase their vulnerability to psychiatric disorder.

Pregnancy involves a critical role transition for most women; it is a stress leading to resolution and growth. Maladaptation will lead to personal distress and threatens the integration of the family unit. Epidemiological studies have found this to be the time of greatest risk for psychiatric illness in a woman’s life if not handled properly.

The disorders associated with postpartum blues, postpartum psychosis, postpartum depression, and disorders of mother-infant interaction.

The problems of old age are largely the problems of women. Research in several countries suggests that a large proportion of the longer life span women can expect is actually spent in pain and ill-health (Kane,1991)

Geriatric population is increasing due the longevity as mortality rate is decreasing day by day. The rapid urbanisation and modernisation also leads to the family disintegration and consequently increases the nuclear family system in the society. Thus most of the elderly are lacking family support which again leads to psychological distress. Also the traditionally seen cohesiveness among the family members is disappearing because of the changing socio-cultural and economic system of the society.

Conclusion

Women’s mental health cannot be considered in isolation from social, political, and economic issues. When women’s position in society is examined, it is clear that there are sufficient causes in current social arrangements to account for the surfeit of depression and anxiety experienced by women. This reflects the greater number of social roles women fill as wife, mother, daughter, employee, and the care taker of other family members. Thus the possible intervention for the women at risk include psychological or social techniques such as increased family and social support, and marital counseling.

Increased recognition and earlier treatment is needed to help promote mental health and prevent sequelae both for the women and her family.

Planners also play a critical role since any comprehensive strategy to improve the mental health of women necessitates coordinated action. This involves improvement of policies and legislation, better access and availability of health care facilities, better health education, and determination of safety at the places where women live and work.

An enhanced gender sensitivity in all walks of life will certainly augur a better future for the mental health of women.

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