![Emily Marshall
A45066819
SSC 499
Dec. 5, 2015
9
Bekhet, A., & Zauszniewski, J. (2012). Mental Health of Elders in Retirement Communities: Is
Loneliness a Key Factor? Archives of Psychiatric Nursing, 26(3), 214-224.
Carolan, M. US and Global Violence Against Women and Children [PowerPoint]. Retrieved
from: https://d2l.msu.edu/d2l/le/content/324966/viewContent/2933318/View?ou=324966
Cheng, T., & Lo, C. (2014). Domestic Violence and Treatment Seeking: A Longitudinal Study of
Low-Income Women and Mental Health/Substance Abuse Care. International Journal of
Health Services,44(4), 735-759.
Daley, A. (2012). Becoming Seen, Becoming Known: Lesbian Women's Self-Disclosures of
Sexual Orientation to Mental Health Service Providers. Journal of Gay & Lesbian
Mental Health, 16(3), 215-234.
Denmark, F. (2008). Women and Mental Health. In Psychology of women handbook of issues
and theories (2nd ed., pp. 440-484). Westport, Connecticut: Praeger.
In brief: Depression at menopause. (2007, 03). Harvard Health Publications. The Harvard Mental
Health Letter, Retrieved from MSU Libraries.
Kira Hudson Banks and Laura P. Kohn-Wood. "Gender, Ethnicity and Depression:
Intersectionality in Mental Health Research with African American Women" African
American Research Perspectives 8.1 (2002): 174-200. Available at:
http://works.bepress.com/kira_banks/8](https://image.slidesharecdn.com/1d36708b-fdd3-4af1-bf33-5e73c44e634a-160216212237/85/Final-paper-9-320.jpg)
Final paper
- 1. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 1 Women’s Mental Health Disparity Women are disproportionately affected by mental health problems (Patel, Arava, Lima, Ludermir & Todd, 1999). Mental health conditions result in disrupted mental functioning that greatly affects everyday life. Mental illness is associated with a significant burden of morbidity and disability (WHO). The most common disorders among women include anxiety, posttraumatic stress disorders, depression, and eating disorders (Denmark, 2008). Women’s higher risk for depression compared to men is one of the most consistent findings across literatures and can be contributed to differences in gender roles and life stresses (Denmark, 2008). Female gender, social, economic and interpersonal factors remain the most common risk factors for mental disorders in industrialized societies (Patel et al, 1999). Disparities across gender, race, ethnicity, socioeconomic status, and age influence the rate of mental disorders among women. Violence against women and access to mental health care are the greatest disparities to women regarding their mental health. With proper mental health treatment, between 70 and 90% of people with mental illnesses experience a significant reduction of symptoms and an improved quality of life (National Alliance on Mental Illness). This is among the most important reasons why mentally ill patients need for proper care is so crucial. Without adequate care, people living with mental conditions have a greater likelihood of failing to be productive members of society. Prevalence of mental health disorders in women vary across age. Mental disorders primarily evolve during adolescence and are evident in early adult hood. About half of mental health disorders develop in individuals by age fourteen and 75% of mental disorders develop by age 24 (National Alliance on Mental Illness). Eating disorders pose serious mental and physical health problems among young females. Anorexia nervosa more commonly occurs during adolescence
- 2. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 2 while bulimia nervosa commonly occurs among females 20 to 39 years old (Lewinsohn, Striegel- Moorem & Seeley, 2000). Societal pressures at this age influence strong ideas of body image in young ladies. Females with eating disorders have a high comorbidity with other mental disorders; 89.5% of participants with an eating disorder had at least one comorbid mental disorder(Lewinsohn, Striegel-Moorem & Seeley, 2000). The highest comorbid disorders that exist in females with eating disorders are depressive and anxiety disorders (Lewinsohn, Striegel- Moorem & Seeley, 2000). As women age their bodies go through intense hormonal changes. A study of premenopausal women whom had no previous diagnosis of depression were four times more likely to report a number of depressive symptoms during perimenopause and were twice as likely to be diagnosed as depressed (The Harvard Mental Health Letter, 2007). The increase in depression during menopause is due to “the fluctuating levels of female hormones” (HMHL, 2007). Similar hormonal changes occur to younger females during and after pregnancy. A study of mental disorders in women from Uganda found that 30% of mothers suffered psychiatric morbidity during pregnancy. A six week after birth follow-up showed 10% of the mothers suffered from postnatal depression (Patel et. al, 1999). The same article documented a community study from Zimbabwe were 18% of mothers in their eighth month of pregnancy had major emotional disorder and 16% suffered postnatal depression (Patel et. al,1999). As age increases rates of depression also increase. Measurements of loneliness among elders in a retirement community showed that feelings of loneliness affected rates of mental health. Thirty percent of elder women in the retirement community reported feeling lonely (Bekhet & Zauszniewski, 2012). Elders who reported feeling lonely had higher anxiety and higher rates of depressive symptoms. Although the reports of loneliness affected mental health there was no association of lonely feelings among physical health ((Bekhet & Zauszniewski, 2012). Often
- 3. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 3 times in old age, the loss of loved ones, decline in physical function and feelings of sadness can affect mental health. Women’s mental health also varies across race and ethnicity. According to Denmark (2008), there is a double burden of gender and ethnic discrimination in mental health and its treatment. Although African American women do not experience depression at higher rates than white women, they do experience depression more than African American men (Banks & Kohn-Wood, 2002). Among members of the African American population, there is a double burden of mental illness for African American women. Prolonged exposure to racial and gender discrimination increases physiological stress. Race-related stress is common among African American women and is related to poor psychological health including depression (Banks & Kohn-Wood, 2002). However, African American women have lower rates of eating disorders compared to white women. According to Lovejoy (2001), research on ethnic differences in body image and eating behaviors provide strong evidence that black and white women hold different attitudes and perceptions of their bodies and that these differences lead to different eating problems and health risks. Studies on ethnicity and eating disorders among women have shown that white women have more negative attitudes towards their weight while African American women are more satisfied with their weight (Lovejoy, 2001). One study found that 40% of African American women, across different age-groups and status backgrounds, considered their body figure to be attractive or very attractive despite be categorized as moderately to severely overweight in medical terms (Lovejoy, 2001). As mentioned previously, African American women face discrimination more often than white women. Eating habits among black women have been explained as a means of coping with the emotional pain due to a variety of oppressions including racism, sexism, poverty and sexual abuse (Lovejoy, 2001). The previous two articles prove that
- 4. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 4 race is detrimental to both the mental and physical health of African American women. An article according to Wong, Wu, Gregorich, and Pérez-Stable (2014) on the study of social support for women aged 50-80 years old, found that emotional support was significantly and positively associated with women’s mental health across all four racial and ethnic groups; non- Latino White, Latino, African American, or Asian. A wide range of mental health problems exist within the Asian community including depression, anxiety, eating disorders, and various psychotic disorders (Wilson, 2001). The lifetime rate of any mental disorder among the Asian population in the United States was 17.3% (Takeuchi et. al., 2007). Distress is particularly high among Asian women and often linked to social isolation and lack of social support within their homes (Wilson, 2001). Women tend to express their distress more emotionally than men do. Although it is reported that Asian women have lower rates of most disorders compared to white women, Asian women have a 20% higher rate of suicide than the national average for women (Wilson, 2001). Stress and coping mechanisms largely contribute to the gender gap in rates of psychological disorders (Denmark, 2008). Cultural differences among social support and coping styles of Asian women and white women contribute to their mental health differences. Some of the racial and ethnic differences in mental health amongst women can be contributed to their socioeconomic status. Women’s mental health is linked to the status they enjoy in society (Tandon & Rao, 2015). Women are more likely to fall subject of discrimination and have lower levels of perceived power compared to men. Gender discrimination inhibits women’s educational opportunity and because education reflects socioeconomic status, more women are living in poverty, both domestically and globally. Poverty and female gender have been associated with depression and anxiety disorders (Patel et. al., 1999). This provides explanation as to why more women suffer from common mental disorders (CMDs) like anxiety
- 5. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 5 and depression. Many studies have reported that the lifetime prevalence rate of depression among women is twice the rate of men (Banks & Kohn-Wood, 2002). The relationship between poverty and mental illness is not one directional; living in poverty can cause mental illness and living with mental conditions can result in poverty. Common mental disorders are marked by a “breakdown in normal functioning” (Patel, et. al, 1999). Anxiety and mood disorders can interfere with everyday functions like waking up, going to work, completing tasks at work, and having positive social relationships. For these reasons people living with CMDs may lack jobs and thus financial ability to receive proper mental treatments. The relationship between poverty and mental disorder exists in the opposite; people living in poverty are exposed to extreme stressors that can cause anxiety and depression among other chronic illnesses. Studies have shown that there are lower morbidity in common mental disorders as income levels increase (Patel et. al., 1999). Overall, poverty is a statistically powerful risk factor for the development of depressive disorders (Banks & Kohn-Wood, 2002). Along with poverty and discrimination females are more likely to be victims of interpersonal and domestic violence (Carolan, 2015). Estimates suggest that one in five women are victims of sexual abuse (Denmark, 2008). The emotional stress from physical and sexual abuse can be mentally debilitating. Studies have shown strong evidence that relates women with serious or chronic mental illness to high rates of violence (Mont & Forte, 2014). Domestic violence predicts mental health problems and vice versa (Cheng & Lo, 2014). Women who are victims of abuse are vulnerable to mental health problems and women with mental health problems are vulnerable to abuse. According to Mont & Forte (2014), women with mental health problems are at heightened risk for intimate partner violence (IPV). Among women diagnosed with major depressive disorder, schizophrenia, schizoaffective disorder or bipolar disorder the prevalence of
- 6. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 6 IPV ranged 21% to 70% (Mont & Forte, 2014). Battered women are at heightened risk for psychological problems like posttraumatic stress disorder, depression, anxiety, and learned helplessness (Cheng & Lo, 2014). Along with mental disorders, women of sexual abuse have a higher chance of depression, thought of suicide, substance abuse and alcohol dependence (Reza et. al., 2009). Women living in poverty are more likely to be victims of sexual abuse. Among low income women as well as among women in general, substance abuse and mental disorders can be a manifestation of domestic violence (Cheng & Lo, 2014). Poverty, discrimination and victimization create an “emerging profile of vulnerability” of mental and addictive disorders (Denmark, 2008). One of the biggest disparities for women with mental health conditions is their access to proper medical treatment. Their access is affected across multiple interdisciplinary perspectives. From an anthropological perspective there is a stigma placed on people with mental health conditions. Women with mental conditions have long experienced stigma and discrimination which increases social exclusion and leads to a reduced likelihood of them to find employment and access to health care (Mont & Forte, 2014). A sociological perspective creates a disparity in access to mental health care for women of minority groups. Minority women have been denied access to appropriate mental health care and treatment (Wilson, 2001). A report from the Department of Health reported that African Americans who are in need of mental services are more likely to be removed by police, be detained, be diagnosed with schizophrenia or other psychotic disorders, or be sent to psychiatric hospitals (Wilson, 2001). Women in the Asian community lack access to adequate mental health services because of language barriers and stereotypes of good mental health (Wilson, 2001). Not only are minority women denied access because of their ethnicity but their culture keeps them from trying to access treatment. African
- 7. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 7 American women hold important values of spirituality in the process of both mental and physical healing (Wilson, 2001). The difference in culture in response to mental illness often leads African American women to decide not to seek mental health treatment but turn to religion during times of distress. The stigma associated with mental disorders also leads to delay in treatment in hopes the problem will resolve on its own or negative attitudes towards seeking help (Cheng & Lo, 2014). Minorities are also less likely to report mental health problems. Research indicates that Latinos and African Americans report a lower risk of having psychiatric disorders (Carolan, 2015). This could be likely due to the fear and stigma attached to having mental health problems. Sociological, economic, and political perspectives affect women’s financial ability to access medical care. As previously discussed women fall into lower social status in society compared to men. This affects their ability to receive higher education, finding employment opportunities, thus having the financial means to afford mental health care. Failure to obtain mental health care appears to be closely associated with lack of or inadequate insurance coverage (Roll, Kennedy, Tran & Howell, 2013). The United States government has created policies in effort to make health insurance obtainable to all American people. In 2010 the Affordable Care Act and in 2008 the Mental Health Parity and Addiction Equity Act were created with intention to reduce the number of uninsured people and improve their access to mental health services (Roll, Kennedy, Tran & Howell, 2013). People with no insurance coverage and who had lower levels of income were more likely to report unmet need for mental health services (Roll, Kennedy, Tran & Howell, 2013). These disparities in mental health care affect women more than men because of their lower status in society, less financial stability, and less access to medical treatment. Low income women who receive Temporary Assistance for Needy Families (TANF) from the
- 8. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 8 government are more likely to receive treatment following a mental condition is diagnosed. With the financial help while on welfare, women in low income communities, who are subject to high rates of domestic violence, have the ability to afford or have the insurance to receive mental health treatment. However, with increasingly restrictive TANF policies, welfare beneficiaries are being kicked off of TANF and 10 to 41% of them are uninsured (Cheng & Lo, 2014). Without financial support from the government to receive mental care these women go without proper treatment. Even if these women are able to hold part time jobs they usually lack medical coverage (Cheng & Lo, 2014). Geography plays a role in access to mental health treatment as well. Proximity to mental health facilities influences the access to mental care. In rural areas, a person with a mental health condition may be discouraged to get proper treatment because of the distance to a facility.
- 9. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 9 Bekhet, A., & Zauszniewski, J. (2012). Mental Health of Elders in Retirement Communities: Is Loneliness a Key Factor? Archives of Psychiatric Nursing, 26(3), 214-224. Carolan, M. US and Global Violence Against Women and Children [PowerPoint]. Retrieved from: https://d2l.msu.edu/d2l/le/content/324966/viewContent/2933318/View?ou=324966 Cheng, T., & Lo, C. (2014). Domestic Violence and Treatment Seeking: A Longitudinal Study of Low-Income Women and Mental Health/Substance Abuse Care. International Journal of Health Services,44(4), 735-759. Daley, A. (2012). Becoming Seen, Becoming Known: Lesbian Women's Self-Disclosures of Sexual Orientation to Mental Health Service Providers. Journal of Gay & Lesbian Mental Health, 16(3), 215-234. Denmark, F. (2008). Women and Mental Health. In Psychology of women handbook of issues and theories (2nd ed., pp. 440-484). Westport, Connecticut: Praeger. In brief: Depression at menopause. (2007, 03). Harvard Health Publications. The Harvard Mental Health Letter, Retrieved from MSU Libraries. Kira Hudson Banks and Laura P. Kohn-Wood. "Gender, Ethnicity and Depression: Intersectionality in Mental Health Research with African American Women" African American Research Perspectives 8.1 (2002): 174-200. Available at: http://works.bepress.com/kira_banks/8
- 10. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 10 Lewinsohn, P., Striegel-Moore, R., & Seeley, J. (2000). Epidemiology and Natural Course of Eating Disorders in Young Women From Adolescence to Young Adulthood. Journal of the American Academy of Child & Adolescent Psychiatry, 39(10), 1284-1292. Lovejoy, M. (2001). DISTURBANCES IN THE SOCIAL BODY: Differences in Body Image and Eating Problems among African American and white Women. Gender & Society, 15(2), 239-261 Mont, J., & Forte, T. (2014). Intimate partner violence among women with mental health-related activity limitations: A Canadian population based study. BMC Public Health, 51-51. Newbigging, K. (2006). Women and mental health. The Mental Health Review, 11(4), 45-46. Retrieved from MSU Libraries. Patel, V., Araya, R., Lima, M., Ludermir, A., & Todd, C. (1999). Women, poverty and common mental disorders in four restructuring societies. Social Science & Medicine, 49(11), 1461-1471. Reza, A., Breiding, M., Gulaid, J., Mercy, J., Blanton, C., Mthethwa, Z., Bamrah, S., Dahlberg, L., Anderson, M. (2009). Sexual violence and its health consequences for female children in Swaziland: A cluster survey study. The Lancet, 1966-1972. Roll, J. M., Kennedy, J., Tran, M., & Howell, D. (2013). Disparities in unmet need for mental health services in the united states, 1997-2010. Psychiatric Services, 64(1), 80-2. Retrieved from MSU Libraries.
- 11. Emily Marshall A45066819 SSC 499 Dec. 5, 2015 11 Takeuchi, D., Zane, N., Hong, S., Chae, D., Gong, F., Gee, G., Alegría, M. (2007). Immigration-Related Factors and Mental Disorders Among Asian Americans. Am J Public Health American Journal of Public Health,97(1), 84-90. Tandon, A., & Rao, T. (2015). Women and mental health: Bridging the gap. Indian Journal of Psychiatry Indian J Psychiatry, 57(2), 199-199. Wilson, M. (2001). Black Women and Mental Health: Working Towards Inclusive Mental Health Services. Fem Rev Feminist Review, 34-51. Retrieved December 10, 2015, from MSU Libraries. Wong, S., Wu, A., Gregorich, S., & Perez-Stable, E. (2014). What Type of Social Support Influences Self-Reported Physical and Mental Health Among Older Women? Journal of Aging and Health, 663-678.