Mental Health Promotion and Women

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What is Mental Health Promotion?

The promotion of positive mental health has become an integral part of public policies and psychiatry alike. 'Mental health' is achieved when there is 'harmony between values, interests and attitudes with the scope of the action of the individuals and, consequently, realistic life planning and purposeful implementation of life concepts' (Neumann et al, 1989a: 4).

Mental Health Promotion (MHP) covers a range of meanings and paradigms, it has emerged as a 'unifying concept, which has brought together a number of separate, even disparate, fields of study under one umbrella' (MacDonald & Bunton, 1992:2). Since the early 1960's the term MHP has been used, often interchangeably with prevention (Eisenberg, 1981; Perlmutter; 1982a). MHP is essential, since everyone has mental health needs the need fro MHP is universal and of relevance to everyone.

MHP utilizes a variety of strategies, from working with individuals to passing legislation (Beattie, 1991). MHP can improve physical health and well-being, prevent or reduce the risk of some mental health problems such as behavioural disorders (anxiety & depression). MHP has also been applied to increase the 'mental health literacy' of organisations, individuals and communities.

MHP can work on three levels, by 'strengthening individual's' through increasing emotional resilience with interventions designed to promote self-esteem and coping skills. 'Strengthening Communities' involving increasing social inclusion and participation, improving neighbourhood environments and developing health and social services. And by, 'reducing structural barriers' to mental health - through initiatives reducing discrimination, inequalities and promoting access to education, meaningful employment, and housing.

A MHP strategy needs to address ways of strengthening protective factors and working to reduce risk factors at an individual, community and structural policy level. There is a wide range of theoretical perspectives on MHP and a number of different models that can be used to develop a strategic framework (see - Mental Health Promotion: A Quality Framework HEA, 1997).

Many different areas of society have been targeted for MHP, for example Turner & Hatton (1998) assess the approach with relation to people with intellectual disabilities. Much MHP has also been directed at women, Of all the people diagnosed as 'mentally ill' 55% are women (Thompson & Pudney, 1990), women are a also twice as likely to be diagnosed with 'clinical depression' than men (DHSS, 1986) and are one and a half times more likely to be admitted to psychiatric hospitals than men (DHSS, 1986). This evidence renders the intriguing question, why? Is MHP directed at women not working? Or is there something theoretically wrong with the approach?

Firstly it is imperative to uncover what specific mental health problems women exhibit. Johnstone, in, Users and Abusers of Psychiatry (2000) asserts that many of the problems that bring people into contact with the psychiatric system - depression, eating disorders, anxiety and self-harm are found more frequently in women than men.

Johnstone (2000) offers an explanation for this by taking a closer look at the roles that women are expected to fulfill in society. De Beauvoir (1972: 16) advocates that women represent the 'other' in a duality based on the male 'self' as the subject, which is 'as primordial as consciousness' and is maintained by dualistic thought and oppression. Busfield (1988) brings together two arguments about women and mental health; firstly, that, women's mental health issues are the product of their oppression; and secondly, that mental illness is used as a label to control and confine women's action, one that involves the exercise of patriarchal power. This could explain the differing treatment of men and women in the diagnostic process.

Numerous other writers have reached the same conclusion, Klerman & Weissman (1980) argue that women's 'maladaptive role', leads to depression in the face of difficulties in life. Paykel (1991) proposes depression may cumulatively result from the social effects of stress, social vulnerability and the absence of support.

Depression is one of the most common mental illness women present with. Johnstone (2000) sites the idea of the 'depressed housewife', who is a common recipient of psychiatric treatment. The housewife's characteristics include devoting her life to others, while at the same time believing that she is being selfish to have anything for herself. Bart (1971) traced similar themes over 500 American Women ...