Mental health | Peace of mind for the fairer sex

The National Council of Women (NCW) hosted a conference to promote awareness on the mental issues facing women today. The conference was keenly attended with not an empty seat in the house. Unfortunately these were mostly of the female gender, including honoured guests such as the Prime Minister’s wife Kate Gonzi, though only a handful of men in attendance.

Among the issues discussed were legal issues facing women with mental health, the impact of poor mental health on the family, empowerment and social integration of women with mental health problems, issues faced by female offenders of the law and mental health issues related to stress at work.

The Minister of Health addressed those in attendance saying that as a psychiatrist, husband and father to a daughter mental health – particularly of women – is an issue close to his heart. He acknowledged that women take over multiple roles of carers and contributors to society and that they are often taken for granted.

Dr Lorraine Schembri Orlando addressed the legal issues facing women with mental health problems. She ascertains that persons suffering from mental health problems are at an immediate disadvantage in the courtroom. As they are incapable of making decisions, which will have an impact on the rest of their lives, Dr Schembri Orlando recommends that the case be adjourned until such a date where the mental health problem has been addressed.

As most legal cases involving mental illness of women have to do with the dissolving of a marriage and custody of children, the magistrate’s primary concern must be for the welfare of the child.

“The role of the justice system is not penalise the woman with a mental illness but to encourage them to seek help. A clean break may be necessary for the well-being of the child if the woman refuses to get help.”

Children of mentally ill mothers may not be taken to see their mothers if they are committed to a mental institution because of the emotional scars such visits would leave. However if they are in halfway houses visitation rights can be awarded to mothers.

Another matter facing the mentally ill is the issue of being committed to a mental institution. Schembri Orlando has received calls in the middle of the night by clients begging her to come to stop husbands or family from committing them to hospital.

She is concerned with the law that gives next of kin the right to commit a person to a mental institution. While she agrees that sometimes this is the only option, in the case where couples are in the process of separating or family members stand to gain financially from the committal, this power may be abused.

Dr Angela Abela, psychologist and family therapist started her presentation with a disturbing fact that by 2020 mental illness will the second largest cause of death and disability worldwide. Anxiety affects three women to every two men while mood disorders affect twice as many women as men. She lists some of the causes of mental illness in women as poverty, violence and abuse, the burden of care and infertility.

In a research piece she conducted with 73 carers of families in Malta it was found that one in three families experienced depression and that people coming from poor families were statistically significantly more depressed than those from non-poor families.

“The main issue here is that poor families do not have access to private support and medication. Government psychologists are few as although the university is investing in training of young psychologists most move on to private practice.”

She identifies verbal violence and infidelity as just as hurtful as physical violence and often can be the cause of mental illness.

The burden of care can lead to women feeling like there is no escape from their lives and that nothing can change.

Women are putting off the bearing of children until later on in life. However, for some, this is too late and results infertility. This leads to a feeling of shame, that they have brought it upon themselves leading to depression and mental illness.

Dr Abela is concerned about the family caring for the mentally ill.

“We need to be aiming towards a more family inclusive form of therapy. It was found that 19% of children living with depressed mothers display challenging behaviours while 13% suffered a lack of concentration. It is important for these children to be seeing psychologists from an early age as these are ending up experiencing similar problems to their parents when they reach adulthood.”

Dolores Gauci has worked in mental healthcare throughout her adult life and is currently CEO of the Richmond Foundation. She too opens with a statistic quoted from the World Health Organisation, which states that by 2020 depression will be the most prevalent illness in the world.

She says that women are more vulnerable to depression than men for a number of reasons. Pre and post-natal depression, for obvious reasons, only affect women – though recent research has shown that some men may also be affected.

Girls are subjected to child abuse more than boys. Women are the victims of domestic violence more than men. The burden of care usually falls onto single mothers who are left looking after children when a marriage dissolves.

Women are financially poorer than males with 60% of the male population in active employment as opposed to only 35% of women. To add to that most jobs occupied by women are clerical or retail, rendering minimal salaries.

Gauci stresses the importance of talking about mental health problems.

“The more people talk about mental health problems the more people will seek out services that will aid in their rehabilitation. Breaking the stigma that is associated with mental health problems is of vital importance.”

During discussion time Anna Vella of Sedqa voiced her concern about the gearing of services towards men. She said that though there are 5 male patients seeking help through this foundation for every woman, this does not represent the reality of people suffering from addictions. Women wishing to fight their addictions are not allowed to do so because of lack of facilities. They are not allowed to be sick and therefore they are not allowed to heal.

Policy makers are mostly male in gender and thus subconsciously create services geared towards men. While this is totally acceptable it needs to be backed up by female perspective to ensure that women are not excluded from these vital services.

Probation officer Mary Anne Zammit tackled the mental health needs required by female offenders of the law. She identifies most crimes committed by women as ones that involve obtaining of finance including theft, prostitution and drug dealing.

She profiled the average female offender as being from poor socio-economic backgrounds, of poor education and few skills. Most are mothers and some have been exposed to some sort of violence or chaotic lifestyle.

Rehabilitation of these women depends on a change in lifestyle that removes them from the chaos surrounding them, otherwise they simply fall back into a life of crime. She is concerned about the minimal number of places available in residential homes that will allow rehabilitation of theses women.

Pricilla Muscat, a health psychologist, talked about the effects of stress at work on women. 22% of the working population experience stress which is detrimental to health.

Stress, which is not managed, often manifests in mental health illnesses. Eating disorders are more common in women while drinking problems are more common in men. She recommends exercise and meditation to control stress.

From an employers perspective Joseph Farrugia, Director General of the Malta Employers Association, tackles the problem of stress at work, particularly related to women.

While statistics in Malta about stress at work are unavailable he takes those in the UK as an example. Stress is attributable to one third of mental health problems where 14 million working days per year are lost as a result of people not being able to cope with the day ahead.

Thus from an employers perspective managing stress of employees, whether it is the result of excessive workload, promotion without training or family problems, is in the economic interest of the organisation. Human resource management is of vital importance.

Family friendly measures need to be introduced to encourage female participation in the workplace. Flexibility is important to women as well as men to ensure that family commitments can be managed around job commitments. However Farrugia warns that women need to be careful in their demands.

“It cannot reach a point where it is more expensive to employ a woman than a man. Economics will always prevail over ethics. A balance needs to be found to encourage a relatively stress free environment that promotes business for employers.”