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WOMEN’S RIGHT TO MENTAL HEALTH

Presented at SCWSD, Sophia College, 14-9-2006

by

Dr. Vibhuti PatelDirector, PGSR

Professor and Head, University Department of Economics

SNDT Wpomen’s University, New Marine Lines, Smt. Nathibai Road, Mumbai-400020

Phone-022-26770227 Mobile-932104004811

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Fresh inputs from the Women’s Movement

“Consciousness Raising” (CR) i.e. sharing of experiences, problems, feelings, dreams, utopia.

CR to be done in a non-threatening & non-power-oriented atmosphere.

CR enables women to overcome false consciousness & empowers to form SHGs.

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Manifestations of Depression Headaches,sleepless nights, constant tension,

detachment, irritability, loss of appetite, dryness of mouth, fear, self-blame, lack of concentration, lack of interest in any kind of activity.

Two types of stressors-Biomedical and psycho-social.

Coping mechanism-crying, talking it over, praying, engaging in creative work, team-building,community work.

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Psychological stages through which women pass Enduring, suffering, reckoning,

reconciling and normalising. The successful completion of therapeutic

cycle depends on how conducive the physical and emotional systems are.

Sometimes hysteria can also open up more opportunities and increased freedom /space with added costs.

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Approach - I Universalist ETIC approach uses

diagnostic categories of mental illnesses such as neurosis, schizophrenia, psychosis, mania, phobia, paranoia.

Does psychiatric labeling take into consideration women’s material reality?

Medicalisation of Mental Health in MHP, 2001.

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Approach - II EMIC approach-Understanding of mental

illness, keeping into consideration multicultural aspects of women’s existential reality.

Traditional treatment- meditation, yoga, group singing, listening to discourser, aroma and colour therapy.

Culturally sensitive counseling based on custom, religion, code of conduct, ethos of community, …

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Psychiatry and psychotherapy Psychiatrists use chemotherapy & ECT,

administer anti-depressants & sedatives. Psychotherapists use counseling

techniques-hypnosis, suggestions, supportive therapy, re-education.

desensitisation, group & family psychotherapy, psychoanalysis.

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4 Phases of Healing Cycles Enduring-anxiety, grieving & loss of

past Acceptance- reality testing, recuperating Recovery-rebuilding life, maximising

options Normalising- stability and routines,

building relationships and community.

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Counselor and Seeker Unequal relationship between professional

counselor who is “up there” and seeker who is “Down below”, gets compounded in case of women. Belief-Man as ‘rational’ & woman as “emotional’, ‘hysterical’, ‘sentimental’

Subjugation of women by patriarchally structured psychiatric system.

Myth of “Feminine qualities”- so called normal versus deviant behavior and women’s choices.

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Marginalisation of Mental Health Concern of women Mental distress is treated as an

individual’s personal problem. Instead of changing the condition of life,

targeting the individual only. Role of collective efforts, social &

women’s movements, media, human rights concerns.

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Worsening socio-economic and political condition Experiences of NGOs- Alert India,

Dilaasa Caste and communal violence Worsening survival struggles in the

rural, urban and tribal belts Addiction in the absence of food security Displacement due to mega projects- SAP Job-losses, agrarian crisis, globalisation

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Violence-Sexual and Domestic Anxiety, fear, avoidance, guilt, loss of

efficiency, lack of coordination, depression, sexual dysfunction, substance abuse, relieving the traumatic incident through memory, suicidal attempts, eating disorders, disturbed sleep patterns, loss of self esteem.

Power relations within family determine women’s predicament in domestic violence.

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Adolescent Girls Mental health of girls depend on

parental expectations, values & norms, rising levels of competition, pressure- anxiety during examination time.

“More problem parents than problem children”. Decision-making process concerning their career & marriage.

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Counseling for Substance Abuse Support resources-De addiction centers,

half way homes, counselors, family members, important peers, school/college, treatment staff.

Experience sharing can be an empowering experience for the victims of abuse.

Awareness about HIV-AIDs

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HIV-AIDS Patients Dealing with social stigma Creating an alternate support network Drop-in meetings Rights- Health care, Employment,

terminal dues like gratuity, pension, Marital rights relating to maintenance, custody of child/children, housing.

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Media and Mental Health Projection of different standard of morality

for men and women. Dehumanisation of women- spare part for sale Anxiety about figure, beauty, colour of skin Pornography and violence- physical and

psychological coercion of unmarried girls and newly married brides.

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Reproductive Rights of Women Women as “son producing machines”. Pre Menstrual Syndrome Post Natal Depression New Reproductive Treatment- abortion,

contraceptives, infertility treatment. Repeated pregnancy, reproductive

morbidity.

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Menopause Societal attitude towards aging women. “OLD HAG” Pathologisation of menopause- HRT Line of counseling- self actualisation,

diet, vitamin supplement, exercise. Community work, group life enhances

sense of self-worth.

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Women and Epilepsy Disability & impaired quality of life caused by

epilepsy can be reduced by “psychiatric and psycho-social referral counseling on how to live with refractory seizures and advise on vocational rehabilitation.

Public education to prevent persecution and discrimination against epileptic women.

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Geriatric Care Dementia-loss of cognitive functioning,

memory, language abilities, abstract thinking and planning

Estrogen replacement therapy, non-steroidal anti-inflammatory drugs, vitamins.

Spiritually rich and intellectually stimulating group life- VARDHANA

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Women in Mental Hospitals Stigmatisation- “Pigeon-holing of

women into set slots must stop.” “Madness certificate” & witch hunting. Experiences of women’s groups. Sex role stereotypes of judges, police

officials, staff of mental hospitals. Side effects of bio-medical approach.

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Women in Police Custody Social stigma causing marginalisation Impact of solitary confinement Interpersonal violence in prison Women political prisoners Prison reforms for re-integration of ex-

prisoners. Human Rights Organisations

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SHGs and Developmental Input Mental health morbidity associated with

women’s lives.Financial security. Budgetary provision- Rs. 200 crores-

HALF WAY HOMES. Training programmes for skill

development De-institutionlisation-care at home Supervised domiciliary after care

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WHO approach to deal with biological, psychological & Social factors has components of

Prevention-Treatment –Rehabilitation. WHO recommends

Pharmacotherapy Psychotherapy Psychosocial rehabilitation Vocational rehabilitation Housing-process of de-institutionalisation

& psychiatric reform

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Needs of women with Mental Disorder

Women with mental disorders need support from the medical practitioners, community, family and institutions providing support to women in distress.

Medical-Early recognition, Information about illness & treatment, Medical care, Support, hospitalisation

Community-No stigma, No discrimination, Social participation, Human rights

Family-Skills for care, family cohesion, networking, crisis support, financial support, respite care

Rehabilitation-Social support, Education, Vocational support, day care, long term care, spiritual needs

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WHO recommendations for Mental HealthCare

include the following aspects: Provide treatment in primary care Make psychotropic drugs available Give care in community Educate the public Involve communities, families & consumers Establish National policies, programmes & legislations Develop human resource Link with other sectors Monitor community mental health Support more research

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Conclusion Civil society and state should ensure more &

more opportunities to women of all age groups so that they can attain high level of mental health.

Respect for diversity, plurality and multicultural outlook ensure democratic and tolerant milieu necessary for women’s mental growth.

Discrimination threatens & Equality guarantees women’s right to sanity and mental health.

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Thank you