Women are twice as likely as men to receive a diagnosis of panic disorder or specific phobia.
The prevalence of Serious Mental Illness is 70% higher among women than men.
And women are twice as likely as men to experience depression, anxiety and PTSD.
It’s imperative that mental health providers develop an understanding of the factors that contribute to these observed differences in the impact of mental health issues on women so that we can meet their needs. Let’s take a look at some of these special risk factors, some of the major barriers women face in their efforts to address them, and some basic strategies for tailoring treatment to certain needs our female-identifying clients might have.
Risk factors for women’s mental health
There are several factors that contribute to discrepancies in mental health impacts between women and men.
Violence and other forms of trauma: Women are disproportionately impacted by various forms of trauma, including sexual assault and domestic violence. Approximately one in three women will experience physical violence, sexual violence or stalking by an intimate partner. Approximately 20% of women experience rape at some point in their lives. Women who have been through trauma have been found to be more likely than men who have experienced trauma to subsequently develop PTSD symptoms.
Biological factors: Certain mental disorders are much more prevalent among women in comparison to the general population, and researchers believe this difference is partly due to biological factors. For instance, hormonal fluctuations are thought to contribute to two subsets of depression experienced by women exclusively, Perinatal Depression and Postpartum Depression. Another biological factor which may play a role in the different mental health impacts on women and men relates to the role of testosterone. This hormone is typically found in larger amounts in men than in women and has been found to have both antidepressant and anti-anxiety effects.
Sociocultural factors: Various social forces that women frequently experience likely contribute to the higher prevalence of various mental disorders among women. Some have noted that women are raised in a patriarchal system that emphasizes perfection on the part of women (in work performance, in parenting, in appearance, etc.), and the stress that presenting an image of perfection creates can often lead to or exacerbate common mental health issues such as anxiety and depression. The National Eating Disorder Association (NEDA) cites perfectionism as one of the strongest risk factors for eating disorders, which afflict about twice as many women as men.
Barriers to mental health treatment for women
Along with increased risk of many common mental health issues, women often face significant barriers in accessing the mental health care they need.
Stigma: The stigma that women face in seeking treatment for mental health issues has been well documented.For many women, self-image is largely shaped by the perceptions of others. Due to this “internalized or self-stigma,” women may be more likely than men to avoid seeking care when experiencing symptoms of mental illness. Women of color are disproportionately impacted by this stigma: According to one study, Black and Latina women were more likely to avoid seeking treatment than White women due to concerns about how they would be perceived by their communities.
Social and cultural expectations: The demands of filling multiple social roles — from parent to professional to caregiver — leave many women feeling overwhelmed and at risk of burnout. Focusing on the needs of others leads many women to neglect self-care, which can stand in the way of accessing mental health care and can significantly exacerbate mental health symptoms.
Lack of resources: Economic factors can sometimes serve as barriers for women in their efforts to seek and obtain mental health care. While both men and women are impacted by the costs of healthcare, women earn less than men on average, have fewer financial assets and less wealth, and have higher rates of poverty than men. Unfortunately, these factors too often lead women to delay or forgo needed treatment. According to a Kaiser Family Foundation study published in 2018, concerns about cost (i.e. lack of insurance), led a significant number of women to forgo mental health care.
Strategies for supporting the women in our care
While the challenges women face in accessing mental health treatment are profound, keeping some basic strategies in mind can help us align with our clients and better care for them.
Providing access to external resources: As providers, it’s crucial that we maintain up-to-date knowledge of the resources available to our female clients beyond our services, including support groups, psychoeducational materials, and resources that may assist them in addressing financial barriers to engaging in care (i.e. insurance-related resources).
Encouraging self-care: It’s important to discuss basic self-care with our female clients, not just at the beginning of treatment, but throughout, as it is often not a priority of theirs. Improving basic self-care —including regular exercise, balanced nutrition, and stress management —can help ameliorate the symptoms of many common mental health issues.
Addressing stigma: By continually providing a safe space for our female clients to discuss stigma-related barriers they’re facing in accessing care, we can support them in making mental health care a consistent part of their routine.
Examining the challenges and special considerations for women regarding their mental health is complex, and each of these intertwining issues deserves its own spotlight. Meeting the needs of our women clients also often requires us to have difficult conversations that involve intense, painful emotions and very few easy answers. It’s hard work, but gaining a deeper understanding of these issues and strategies for addressing them can help us better serve our female-identifying clients and personalize their care to help them reach their goals.