Keeping Women in Mind on World Mental Health Day

By Katharine Sacks-Jones, Director of Agenda

The most basic thing that any of us would wish, when struggling with mental ill-health, is for treatment which reflects our needs. We would want care which is relevant to our experiences, which recognises us as people, and which holds out hope of good mental health, whatever that looks like for us. For women, though, mental health services too often aren’t considering their specific needs.

Women suffer mental illness at higher rates than men, In an alarming wakeup call NHS Digital research out last week showed that women aged 16-24 are at the highest risk of mental health problems with more than a quarter with a diagnosable mental health condition – our research has shown this gap can be largely explained by women’s greater likelihood of experiencing abuse. There are also gender differences in the kinds of problems men and women face. Women are more likely to suffer anxiety, depression, PTSD, or eating disorders. Men are more likely to face substance misuse, psychosis and are at greater risk of suicide.

Men and women face different, gendered experiences, and their mental health problems tend to have different roots. It follows that support they need will be different too. For example, women with mental illness often report needing a female-only space to feel safe opening up about past experiences of abuse in therapy. For the most vulnerable women, those who also face homelessness, substance misuse, poverty, and disability, that woman-centred care is even more essential. The best practice guidance reflects this, calling for gender specific mental health support which recognises how women’s different issues can interrelate.

Our Freedom of Information request to mental health trusts which was released last week shows that in most parts of the country, mental health services aren’t taking gender into account. In fact only one respondent has a women’s mental health strategy. None of the rest have policies which recognise or plan for women’s needs.

Even more striking, over half of the trusts who responded said they had no policy for asking patients about their experiences of abuse. This is despite clear NICE guidelines saying this kind of enquiry should be routine in mental health services. Of those who did have a policy, many weren’t training their staff on how to ask the question sensitively, and even more had no processes for how to support women who said they had experienced abuse.

This lack of gender-specific support is a huge missed opportunity for a health service under strain. Asking about abuse, and then making sure a woman’s healthcare team know how to respond to her experiences, isn’t that costly or difficult – much of it can be built into work that services are already doing. Planning specific services to meet women’s needs doesn’t need to be complicated or overly costly. Some areas are already managing it, it just means looking at the resources we’ve already got differently.

Staff training and set-up costs might be higher up-front, but providing the right help to vulnerable women first time can prevent them spiralling from crisis to crisis. By providing trauma-informed and gender specific care, trusts can prevent repeat admissions, reduce the burden on other services like A&E and social care, and, perhaps most importantly, make a real difference to their patients.

Our FOI launches our new women’s mental health campaign, Women in Mind which will be advocating to ensure women’s needs are at the front of people’s minds when planning and delivering services. The Government is about to appoint a Mental Health Equalities Champion – we’re calling for that Champion to have a focus on women’s mental health, to encourage a gender-focussed approach across the treatment spectrum. We’re calling for every local area to have a women’s mental health strategy and clinical lead, whose job it is to listen to female patients and champion their needs locally. And we’re calling for every trust to implement NICE guidance and make sure properly trained staff ask women about their experiences of abuse when they come into mental health services, and that woman can then access appropriate help.

Women suffer disproportionately from mental ill-health, and that has a wider impact on women’s lives. The NHS has a real chance to address some of that inequality, and support women to live healthier, happier lives.