PUBH6000 Gender, Depression and Levels of  Intervention Assignment Sample

Social, Behavioural and Cultural Factors

Introduction

The leading cause of disability and the highest-burden of non-fatal illnesses is mental health disorders for women in Australia (Begg et al. 2008, Commonwealth of Australia, 2010). In Australia in 2007, 43% of women (3.5 million) had experienced a mental illness at some time. Also, Australian women are more likely than men to have experienced symptoms of a mental disorder during the previous years according to a study conducted in 2015(22% of women compared to 18% of men although men have a higher lifetime prevalence), with young women reporting the highest rates (30% for women aged 16 to 24) (ABS 2012). Women are more likely than men to have (or report symptoms of) the following conditions:

1. anxiety disorders – 18% (11% of men) (AIHW 2014);

2. affective disorder such as depression - 7% (5% of men) (AIHW, 2014);

3. eating disorders – 15% of young women have had an eating disorder at some point in their lives, and eating disorders are the third most common chronic illness amongst young women in Australia (National Eating Disorders Collaboration 2012);1

4. self-harm – females record higher age-adjusted rates of hospitalization due to intentional self-harm than males across all age groups (10–14 to 60–64) (AIHW 2104);

5. perinatal depression – one in five mothers of children aged 24 months or less are diagnosed with depression. More than half of these mothers reported that their diagnosed depression was perinatal (that is, the depression was diagnosed between pregnancy and the child’s first birthday). This represents an estimated 111,000 Australian mothers being diagnosed with depression, and 56,000 with perinatal depression annually. Further, of all the cases of diagnosed depression, just over one in five were diagnosed for the first time perinatally (AIHW 2012a)

6. multimorbid physical illnesses – women are 1.6 times as likely as men to suffer coexisting mental and physical illness. These multimorbidities are associated with increased severity of mental illness and increased disability (AIHW 2007). Besides, the number of hospital admissions for specialized psychiatric care following a principal diagnosis of recurrent depressive disorders and specific personality disorders was substantially higher for females than males during 2007–08 (AIHW 2014). In the same period, females aged 35–44 were the highest consumers of Medicare-subsidised mental health-related GP services (Britt et al, 2012).

The following sections expound on depression among young women in Australia.

Section 1: Understanding Depression Within Young Women.

The second Australian Child and Adolescent Survey of Mental Health and Wellbeing provide worrying, contemporary evidence about the mental health of young women (Lawrence et al, 2015).Nearly one in five teenage girls was found to meet the clinical criteria for depression (based on their reports). Around one-quarter of teenage girls in the 16–17-year age range reported deliberately injuring themselves at some point in their lives. While rates of suicide amongst men are markedly higher than amongst women in all age cohorts, it is of concern is that the trend in increased suicide and suicidality is amongst younger women. In 2013, 637 Australian women and girls died of suicide. Suicide is the leading cause of death among women aged between 20 and 34 years old. All in all, the mental health of young Australian women appears to be worse than that of young men (Mission Australia, 2015).

Determinants for Depression in Young Women

1. Social Inequalities Girls are born into a world structured by inequality – where under their gender, they are likely to earn less money than men, have less freedom than men, undertake certain kinds of work, and spend more time looking after other people than men. It is worth noting that recent Australian statistics on economic security show that the average female wage is 87% of the average male wage, and that figure has remained constant for over a decade (ABS 2016). These Australian Bureau of Statistics data also show the following:

• In 2014-15, over two in five employed women worked part-time (43.8%), compared with 14.6% of employed men. This number rose to 62.2% for employed women with a child under 5 (while part-time rates for fathers of young children were just 7.7%).

• Men aged 55-64 in 2013-14 had a much higher average superannuation balance than women the same age: $321,993 compared with $180,013. There was less discrepancy between men and women aged 44 years and younger, but male superannuation balances were still higher in every age group. Just under a quarter (24.6%) of women aged 15-54 years had no superannuation, compared with 20.5% of men this age. Around 32% of women born overseas had no superannuation coverage. These and other data illustrate the scale of women’s economic disadvantage. Gender inequality affects all women, but there is a gradient of gendered disadvantage, with mostly white, middle-class women higher on the scale and poor women and those from culturally & linguistically diverse (CALD) or Aboriginal and Torres Strait Islander communities lower down (Platt, 2010).

2. Negative Life Experiences

Women in disadvantaged circumstances are at greater risk of some kinds of abuse. It has been argued that the experience of domestic violence is ubiquitous, cutting across social class divisions. Women in the least advantaged groups are the most likely to suffer the most extensive abuse across the life course (Scott et al, 2015). Gendered violence and abuse is a product of gendered power relations. Hence, some of the most severe abuse of girls and women, such as trafficking and involvement in gangs, occurs within the most male-dominated families, subcultures, and coercive contexts (Beckett et al. 2013). Research shows that girls are at greater risk of most kinds of abuse, including severe maltreatment by a parent during childhood and child sexual abuse (McNeish & Scott 2014).

Compared with the sexual abuse of boys, the sexual abuse of girls is more likely to be perpetrated by family members, to begin at an earlier age, and to occur repeatedly. The sexual abuse of boys is more likely to be perpetrated by non-family members, to occur later in childhood, and to be a single incident (Pereda et al, 2009, Radford et al, 2011). These findings are reflected in the 2015 Survey of Child and Adolescent Mental Health and Wellbeing (Lawrence et al, 2015). Childhood sexual abuse is strongly linked to poor physical and mental health in adulthood (Coles et al, 2015), and the negative outcomes of violence and abuse increase the risk of further victimization. For example, women who become homeless, misuse drugs, and/or become involved in criminality are highly likely to experience further violence (McNeish & Scott, 2014).

It is argued that to understand and respond to the impacts of violence and abuse within our communities; it is important to move “beyond the silos of ‘child abuse’ and ‘intimate partner’ violence to address the lifetime experience of girls and women affected by it” (Coles et al. 2015, p.1940).

3. Gendered Expectations

It is suggested that gender socialization normalizes inequality – it makes it simply the way things are (McNeish & Scott, 2014). Gendered hierarchies are discernible within children’s relationships at an early age and later in teenage relationships (Firmin, 2013). Girls, in particular, set limits to self-expression and behavior and appear to be resigned to the experience of ‘everyday sexism’ and sexual harassment, including by social media (Renold, 2013). Indeed, in a deeply sexualized culture, girls are more likely to wear ‘concealing’ clothes, not revealing ones, in an effort to avoid harassment (Renold, 2013).

‘Normality’ for women can involve subordination to men and the development of ‘acceptable’ female behaviors that include being useful, pleasing, and compliant and caring for others. These same characteristics can be risk factors for women’s mental health as they make it harder for women to put their own needs first, to look after their interests, and respond to life stress and exploitation in self-protective ways (Williams, 1996).

Section 2: An Intervention to Prevent Depression and Promote Mental Health

The Australian Health Policy Collaboration proposes a framework for a comprehensive new policy approach to improving women’s mental health across the life course. The framework identifies three underlying drivers and five major policy goals. These actions address the risk factors that occur at critical life-stages for girls and women. Establishing programs that help people access treatment early or help them stay out of the hospital or out of the criminal justice system. Whilst the majority of Australian women participate in the labor force to some degree, the literature on the contribution of paid employment to Australian women’s mental health is sparse; thus, workplace and employability mental health should be enhanced.

Establishing a comprehensive mental health service for women, which is based on the provision of dedicated, specialist, coordinated, and fully inclusive responses to the full range of needs which women manifest across the life course, including the complex needs of women with severe mental illness and social comorbidities. The new policy needs to incentivize a proactive approach to preventing mental illness amongst the small population of extremely vulnerable girls and women most at risk of mental illness as a consequence of abuse and trauma. A proactive, gendered, primary care- driven approach is required to identify women at risk of mental ill-health across the life course and to implement evidence-based supportive interventions. Federal, state, and territory policies can support this development by considering the incentives required to promote and scale effective models so that they move from the margins to the mainstream.

Conclusion:

It is vital that future policy is gendered and takes a life course approach, recognizing that risks fluctuate across the life course and that good mental health is important to women of all ages. Good mental health amongst women is an important asset for Australian society and the economy as well as to individuals. Gender-blind policy approaches stem from incomplete analyses of causes and consequences and, as a result, lead to poor targeting of resources and ineffective policy. This is costly and inefficient and impacts on women’s productivity in both the formal and informal economies. Australia has much to gain from improvements in mental health outcomes amongst women.

References

Walters, V, Denton, R, French, S., Eyles, J, Mayr, J, & Newbold, B. 1996, Paid work, unpaid work and social support: A study of the health of male and female nurses. Social Science & Medicine, 43(11), 1627–1636.

Warner, J, McKeown, E, Griffin, M, Johnson, K, Ramsay, A, Cort, C, & King, M 2004, Rates and predictors of menlesbians and bisexual men and women, The British Journal of Psychiatry, vol. 185, no. 6, pp. 479–485.

Warren, J 2007, Young carers: conventional or exaggerated levels of domestic and caring tasks, Children & Society, vol. 21, pp. 136–146.

Weinfield, NS, Whaley, GJ & Egeland, B 2004, Continuity, discontinuity, and coherence in attachment from infancy to late adolescence: sequelae of organization and disorganization, Attachment & Human Development, vol. 6, no. 1, pp. 73–97.

Williams, J & Watson, G 1996, Mental health services that empower women, in T. Heller, J. Reynold, R. Gomm, R. Muston & S. Pattison (eds), Mental health matters, Macmillan, London, UK. pp. 242-251.

Williams, J 1996, Social inequalities and mental health: developing services and developing knowledge, Journal of Community & Applied Social Psychology, vol. 6, no. 5, pp. 311–316.

Woolhouse, H, Gartland, D, Perlen, S, Donath, S & Brown, SJ 2014, Physical health after childbirth and maternal depression in the first 12 months post-partum: results of an Australian nulliparous pregnancy cohort study, Midwifery, vol. 30, no. 3, pp. 378–384.

World Health Organization (WHO) 2000 Women’s mental health: an evidence-based review, viewed 4th November 2015, http://apps.who.int/iris/bitstream/10665/66539/1/WHO_MSD_MDP_00.1.pdf.

Yelland, J., Sutherland, G., & Brown, S. J. (2010). Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC Public Health, 10(1), 1. Viewed 7th April 2016 http://bmcpublichealthbiomedcentral.com/articles/10.1186/1471-2458-10-771.

Zhang, Y, Chow, V, Vitry, AI, Ryan, P, Roughead, EE., Caughey, GE, & Luszcz, M. A. 2010, Antidepressant use and depres-sive symptomatology among older people from the Australian Longitudinal Study of Ageing. International Psychogeriatric 22(03) pp 437-444

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Get Full Assignment SolutionRequest Now