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Gender and mental health: The need for a wider lens
Mental illness is very common in Australia. According to the National Survey of Mental Health and Wellbeing, almost half of the total population experienced a mental disorder at some point in their lifetime. Depression has the third highest burden of all diseases, and the World Health Organisation estimates that it will be the number one health concern by 2030.
While the statistics show some gender differences in mental disorders, do these numbers actually tell the full story? And how should we study the role of gender in relation to mental health? Today, PhD student Julia Brown provides insights from the field of anthropology, and argues that we need to broaden the lens in order to fully understand how gender influences mental disorders.
“Did you know human men and human women have more in common… than they don’t? Did you know that? I don’t think many people do know that because we always focus on the difference.”
Sometimes gender explanations and differences do not tell enough of the story, even for people who face disparities. While it is important to recognise that gender colours our experiences of the world, it is also important to ask: how much do gendered meanings apply to an individual’s lived experience of themselves? And, at what point - when considering the role of gender – are we perhaps inadvertently overlooking potentials to surpass gender-related expectations? I found myself contemplating these questions when studying schizophrenia and its treatment from an anthropological perspective.
Across the world, more females than males are diagnosed with the most common types of mental disorders, such as depression and anxiety. This may be partly due to experiences of violence being higher amongst females than males, and partly due to the fact that when females express their difficulties to their support networks, their concerns are more easily received and responded to.
Health professionals are more likely to diagnose and treat depression in female patients
Health professionals are more likely to diagnose and treat depression in female patients, compared to male patients exhibiting the same symptoms. Meanwhile, help-seeking and admitting to feelings of losing control have become more socially acceptable for females compared to males.
When it comes to schizophrenia, the pendulum swings the other way. The male:female ratio for schizophrenia patients is approximately 1.4:1. Across cultures females also appear to ‘recover’ more often than males. When I spent 18 months working with chronic, ‘treatment-resistant’ schizophrenia patients in Australia and the UK, 35 patient participants in my research were indeed male, while only eight were female. Yet, the role of gender in my participants’ actual experiences did not stand out as more significant than any other social factors.
As feminist philosopher Gail Weiss has argued, when analysing the situations of people who are socially marginalised, it is important to privilege the ‘truths’ in which people experience and imagine their own lives, “rather than reserving the ascription of truth only for those experiences that will lead to their emancipation in the future”. Even though the gender ratio in my study was predictable, and gendered experiences surfaced in the narratives of my participants, the role of gender could not be singled out.
People with schizophrenia may be misunderstood as ‘genderless’ or lacking in sexual desires
This is not because gendered experiences between males and females were not distinguishable enough to prompt a gendered analysis. To be clear, as anthropologist Janis Jenkins has observed, people with schizophrenia may be misunderstood as ‘genderless’ or lacking in sexual desires, when really they are not markedly different from anybody else when it comes to gendered expressions and sexuality.
On the face of it, when accounting for so-called health behaviours, it was predominantly females in my research who sought out both additional psychological therapies and weight loss programs (to grapple with the metabolic side effects of medication). When digging a little deeper though, the central element of these health behaviours was the experience of being proactive as an individual, not as a man or a woman, nor as a person with schizophrenia.
All the participants were similarly inclined in their everyday efforts and intentions. They empowered themselves through a common and hopeful humanity wherein their behaviours as they appeared from the outside (i.e. more females being concerned about body weight) did not reflect a deeper motivation that everyone shared.
Keeping futures open
With the goal of gender equity in mind, gender is perhaps best viewed non-deterministically. As an anthropologist, I pay attention to both outside and inside viewpoints. Differences in opportunity and expectations matter. But we should not deprive people of their individuality and their imaginations for futures that do not neatly fit predictions based on gender or other categories.
It would help if we didn’t start by seeing females and males as being from different planets
As the Australian comedian Hannah Gadsby powerfully put it, it would help if we didn’t start by seeing females and males as being from different planets. Experiences of violence and the broader social receptiveness to vulnerability, along with the manifestation of mental disorders and treatment, are influenced - but not entirely determined by gender.
Widening the lens so that gendered experiences sit within a range of social influences might get us closer to seeing everybody on the same page.