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Monday, August 1

Mental health forum: Women and Mental Health

Jan Wolff Bensdorf, ACSW, LCSW, Second Vice President, NASW Illinois Chapter, doctoral student, New York University

Introduction:

The mission of social work is to “enhance human well-being and help meet the basic human needs of people who are vulnerable, oppressed or living in poverty.” (NASW Code of Ethics, 1999). This collection of essays, written by members of the Mental Health Task Force, focuses on addressing the issues facing our membership as we strive to fulfill the mandate in the Code of Ethics. This particular essay focuses on Women and Mental Health as women are particularly vulnerable and oppressed and more likely to be living in poverty. It is more the case when in addition to being women, they also have a mental illness.

 Women and Mental Health:

“Traditional psychotherapy for women was male-oriented, did not address women’s specific needs or interests or assumed a biased and unhealthy vision of women’s functioning.” (Mowbray, 2003, P, 101) From an historical perspective, theories of human development and accompanying treatment strategies were proposed by men: Freud, Adler, Jung, Malan, Mann, Beck, etc. The assumption was that women were just like men and their psychopathology was also similar. Ellen Frank (2000) talks about three reasons why this assumption is erroneous. Specifically, she cites the facts that women’s endocrine receptors are different, the concept that gender and gender role influence experiences related to diagnoses and symptom identification, and the fact that gender determines social roles in society. In citing these three differences, the core areas of social work knowledge, the bio, the psycho and the social are specified for those who wish to further explore the role of gender in mental health issues.

 In the 1960’s there were many disenfranchised groups who organized in order to speak for their rights, among them the “feminists.” The more radical, when addressing mental health issues, decried the concept of diagnosis as negative labeling which pathologized survival strategies and tacitly supported oppressive understandings of woman’s behaviors and expressions of distress. The less radical called for expanding research to include more women and minorities as participants with the goal of providing a more balanced understanding of mental health issues and the reduction of gender bias in diagnosis and treatment.

 What we have discovered when viewing mental health through a gendered lens is that women seek and receive outpatient mental health services more often. We also know that women are the major providers of mental health services. This knowledge is wide spread. The implications, however, need to be underscored. Because more women seek treatment, they outnumber men in all major diagnostic categories. They are also thought to need treatment more than men. They receive more prescriptions for psychotropic medication than men. In addition the concept of the “cost of caring” (Rhodes & Goering, 1998) which is related to women being socialized as caregivers leads to more distress as women are more affected by disruptions in their relationships. The result is often a lowered sense of self-worth and efficacy. Some examples of this in specific diagnostic categories are the following: depression is seen to occur in women more than twice as often as in men, schizophrenia has a later onset and generally a more favorable course in women and there are few men diagnosed with Histrionic Personality Disorders

 There is a danger in all of this as well. By highlighting the above facts, we face stereotyping women as more dependent, more symptomatic, more crisis prone, more emotional and so on. In so viewing women, we tend to perpetuate just what it is that we are trying to change.

Conclusion:

The best way to make changes in how women’s mental health needs are understood is through the helping process itself. Through the relationship that we form with our clients, most of them women, we will have the most profound effect on the health of individuals. In jointly viewing these issues through female lenses, we can make changes not only in an individual’s well being but in their worldview as well. In addition, altering basic perceptions will go a long way to enhance and support broader views on mental health issues.

 Our Code of Ethics says, “Social Workers are sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty and other forms of social injustice.” Finally, as social workers, we must go beyond the relationships we form to advocate appropriate treatment for women based on accurate knowledge and not that which is biased and stereotypical.

 Mowbray, C.T. (2003). Women and psychiatric rehabilitation practice. Psychiatric Rehabilitation Journal. 27 (2), 101-103.

 Frank, Ellen, Ed. (2000) Gender and its effects on psychopathology. Washington, DC: American Psychiatric Press.

 NASW Code of Ethics, Preamble. Retrieved from the web, http://www.naswdc.org. 6/10/05.

Posted on 08/01/05 at 12:51 PM

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