WOMEN AND MENTAL HEALTH

Introduction:
Women’s health is inextricably linked to their status in society. It benefits from equality, and suffers from discrimination (WHO, 1996). Women’s family roles involving care of children and ill, disabled, or elderly relatives are more likely to intrude upon their paid employment mentally or in actuality. Women are more likely to ‘‘have two simultaneous roles, whereas men are allowed to have sequential roles’’ generally deferring ‘‘family roles to the evening after work’’ (Barnett & Rivers, 1996). Though some women may suffer from role strain, conflict, or overload, research also shows that women who combine multiple roles are physically and emotionally among the healthiest in contrast to those who do one role exclusively [Nieva, 1985 , Crosby, 1991) ].‘Women are especially stressed by situations that are beyond their control and by those in which they perceive themselves to be responsible for the well-being of others failure causes a marked lowering of self-esteem’’ (Bernstein  & Lenhart, 1993).  The problems are compounded by the reduced availability of competent caregivers due to greater opportunity for women to obtain more lucrative non-traditional employment outside the domestic sphere. 

Research demonstrates that, women who are employed ‘‘report better physical and psychological health than women who are not employed, as well as the women experiencing enhanced financial independence’’ (Barnett  & Rivers, 1996).Women who combine multiple roles (work and family) are physically healthier and are more likely to have a greater sense of well-being and happiness than women who have only career or family roles (Gilbert & Rader, 2001)
 
Concept of Health

• WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
• The Alma Ata Declaration in 1978, is a landmark in the development of the Concept of health.  It viewed health as an individual’s responsibility rather than a service to be delivered to individuals. Promotion of mental health has been included as 8th component of P.H.C.

 
Scope of Mental Health

• Treatment of mentally ill persons.
• Protection of people from conditions that are condusive to mental illness (prevention).
• Upgradation of mental health of normal persons (promotion), i.e. positive mental health – protection and development at all levels.

 
Theories of mental health and illness

• Life Stress
• Social Support
• Societal Network
• Family life

   According to Wig (1990) “Indian culture has always attached great importance to spiritual life, i.e. inner mental life and experiences.”
 
Indicators of Mental Health

• Socially accepted behaviour
• Emotional balance
• To live with one’s fellows happily, where one is able to empathize, relate and to collaborate with one other.
• Mental health refers to “feeling of well-being and an ability to function in full capacity, physically, intellectually and emotionally” (Huq et al, 1985:48)
• Important points to contemplate:
• Woman differ from man in various dimensions – Physical, Mental, Social and Health
• Female character is distinct from that of the male.
• Thus, different factors influence mental health of both the sex and there will be variations in the quality of their mental health.
• Why Is It That Women Are More Prone To Mental Illness Than Men?
• Good mental health is intrinsically important, representing a significant resource to the broader society in which she lives.
• It is imperative to look more closely at how differences in the way women are treated, so evident in the gender development and the gender empowerment rankings, affect their mental health.
• Women are more prone because they have limited their social relations compare to men.
• They tolerate at the initial level and then suffer when in its severity.
• They are not independent to choose what they wish, nor are they motivated for their little good things.
• We find duality and contradictions in the female image - the nurturant one and the destroyer proves to be highly stressful, because:
• Shakti image is evoked only to ensure that women effectively play their traditional, submissive, nurturant roles as daughters, wives, mothers and daughters-in-law.
• Shakti thus, means tenacity to sacrifice oneself and inflict pain on others if necessary for the sake of protection of one’s loved ones (Mane, 1991:81).
• The submissive role is highly oppressive and causes threats to self-survival.  Thus Indian woman’s mental health is likely to be under continuous threat.
• Studies also reveal that an adult woman’s emotional needs are not adequately met in the set up of family (Berlin, 1988:54)
• They are reported to be possessing low-self-esteem, depressive mood, over touchy and morbid sensitivity. (Kakar, 1988:48)
• The stereotype that women develop is having low self-image, immature, subjective, emotional, submissive, easily influenced and inferior.  The feeling of well-being depends upon a positive self-concept, which is denied in the female role itself, and thus her mental health is in a continuous state of jeopardy.
• Thus, psychosomatic problems, religious obsessions, possession phenomenon, etc., manifested in women places them in safe situation of not being dislodged from their familial context and permit expression of their mental anguish.  In the West many studies found that affective disorders to a great extent among women (Klerman and Weissman, 1980,74)
• Kakar (1988) states that “Indian girls are inculcated systematically the sense of worthlessness and helplessness so that compromise and self-denial become the guiding principles of their life.” Rejection of this identity leads to severe psychological strain and women struggle to keep their mental and emotional equilibrium.
• Since marriage and motherhood are the primary status affecting women’s identity-development, their absence, suspension or disruption in any form may cause serious mental health problems.
• On the other hand, the modern educated employed women who may be at an advantage in terms of their social status and their mental health, the actual situation is not so favourable. Now women have to cope with dual responsibilities, deprived with corresponding changes in the definitions of the roles, inadequate social support and work discrimination at work place. 

• The Indian women who dare to step out is often in a worse position than her non-working counterpart, as Taylor (1988, 108) states that “Modern women are now facing an even worse situation…”.  The ones who rise to the forefront have to struggle hard to prove themselves.  Many of them find it difficult to cope and drop out in the midway, hurting the aspirations and self-esteem. 
• The violence and discrimination caused against women is steadily increasing over the years. This statement is supported by the following statistical data in Hubli-Dharwad Corporation area.( Vijaya Karnataka, Daily News Paper, June 2012)
• ‘No society treats its women as well as its men’ equally.                  
• UNDP report
• Poor maternal mental health found to have LBW infants even after adjustments for other confounding factors
• Patel et al, 2006

 
Conclusion:
Indian women undergo many kinds of social and psychological oppression. Yet, it cannot be said that everything is lost in the battle for a better life for Indian women. Legal and social changes are occurring, but a great majority of them remain under a cloud of despair and distress.  Women have a higher rates of mental illness is a Universal Phenomenon (Women’s International Net work, 1985).

• The community level response to women mental health problems have been very Luke warm.
• There is lack of sensitized mental health professionals to address women’s issues.
• Therefore there is the need for improving women’s inferior and powerless social status through:
• Changing patriarchal construction of social relationships.
• By strengthening men and women understanding, handle and bring about change.
• They may show women to have better health in some areas, but they are no good at identifying where women are not as healthy as men, such as mental health”

 
References:

1. Barnett RC, Rivers C (1996) She works/he works: how two-income families are happier, healthier, and better off. New York: Harper Collins;.
2. Berlin (1988:54): as quoted by Mane, P. in her article titled “Mental Health of India Women: Realities and Needed Response,  In the book (eds.) Mane and Katy (1993), titled “Mental Health in India: Issues and Concerns”, TISS, Bombay, 129-141.
3. The psychodynamic treatment of women. Washington, DC: American Psychiatric Press; p. 137, 147, 178, 207.
4. FJ. Juggling (1991): the unexpected advantages of balancing career and home for women and their families. New York: Free Press;.
5. Gilbert LA, Rader J (2001): Current perspectives on women’s adult roles: work, family, and life. In: Unger RD, editor. Psychology of women and gender. New York: John Wiley & Sons;. p. 166, 167.
6. Huq et al (1985:48): as quoted by Mane, P. op.cit.
7. Kakar, Sudir (1988): “Feminine Identity in India’, Women in Indian Society: A Reader, Rehana Ghadially (ed.), New Delhi: Sage Publications, 441-468.
8. Klwean, Gerard, L. and Myrna Weissman (1980): “Depressions among Women: Their Nature and Causes”, The Mental Health of Women, Guttenbag, Marcia et al. (ed), N.Y.: Academic Press, 57-92.
9. Mane, Purnima (1991): “Socialization  of Traditional Hindu Women and Their Adaptation to Change”, Indian Journal of Social WorkVol.LII, No.1 (January): 81-95.
10. Nieva VF (1985): Work and family linkages. In: Larwood L, Stromberg AH, Gutek BA, editors. Women and work: an annual review. Volume 1. London: Sage Publications;. p. 176.
11. Taylor (1988:108): as quoted by Mane, P. op.cit.
12. Wadley, Susan (1988): “Women and Hindu Tradition”, Women in Indian Society: A Reader, Rehana  Ghadially (ed.), New Delhi: Sage Publications, 23-43.
13. Wig (1990): as quoted by Mane, P. op.cit.
14. Women’s International Network (year, Not Known): “Women and Health”, Win News, Vol.2, No.3: 25-38.

 
Dr. Shobhadevi R. Patil
Professor, Dept. of Social Work, Karnatak University, Dharwad.