Mental Health and Substance Use

Why women?

Marina Morrow, PhD

Reprinted from "Women's" issue of Visions Journal, 2004, 2 (4), p. 6

Those of us who have spent much of our careers championing the concerns of women with mental health and substance use problems are often asked: “Why the focus on women? Don’t men have these problems too?” The simple answer is that, yes, both men and women suffer from mental health and substance use problems.

Men and women are products of their differing social environments. Attention to gender is necessary for understanding how mental health and substance use problems are expressed and experienced differently by women and by men.

did you know that...

  • Women are about twice as likely as men to experience depression and anxiety, while men are about four times more likely than women to have substance use problems or antisocial behaviours

  • There is an established association between poverty, mental illness and substance use problems. Women, especially elderly women, Aboriginal women and single mothers tend to be much poorer than men.

  • Learning to adapt to a new culture may place unique stresses on the mental health of immigrant women.

  • Experiences of racism worsen the mental health and substance use problems of women of colour.

  • Women more often than men are the victims of intimate violence and sexual abuse, both of which are associated with mental health and substance use problems.

  • For women with mental health and substance use problems, reactions to experiences of violence, and symptoms related to anxiety and depression, are common.

Historically, most medical scientists have been men who studied men and we therefore have a body of knowledge that reflects this bias. Also, the current biomedical focus in mental health and substance use research has pushed examination of the social determinants of health into the background. Biological and genetic factors are critically important components of research in the mental health and addictions fields; however, integrative approaches—those which take into account the biological, psychological and social determinants of mental health and substance use problems— make for good scientific practice.

In order to counter these biases in scientific research and practice, researchers concerned with women’s lives have had to build a new body of knowledge addressing the problems specific to women. The work of building this body of scientific knowledge has begun; however, what is known is not always integrated into policy and practice on mental health and substance use.

It remains an important task to not only highlight what is known about women, but to advocate for research—and practice—that applies a ‘gender lens.’ Research and practice must recognize that gender shapes our lived experiences, our expressions of distress, and the ways in which the helping professions respond to us.

In applying a gender lens, it is extremely important that we also recognize the differences among women. Women are not all the same. Their lives and experiences are shaped by their race, ethnicity, culture, sexual orientation, gender identity, social class and physical abilities. And their lives may be variously marked by inferior social status, impaired self-esteem, sexual abuse, sexual discrimination, economic inequities, restricted education and employment opportunities, and the greater burden of family caregiving.

Psychosocial explanations of mental health and substance use problems consider how socialization into the female gender role makes women more vulnerable to poor mental health. A psychosocial approach would look at how the socialization may result in lower self-esteem and greater vulnerability to depression and the ways in which particular social roles and experiences may be associated with poorer mental health and substance use.

Understanding women’s lives and their unique mental health and addictions—and incorporating that understanding into policy and practice—is an important goal for researchers, policy makers and practitioners. In support of this goal, the articles in this edition of Visions provide a window into specific aspects of the lives of diverse women who suffer from mental health and substance use problems.

Applying a gender lens in the field of mental health and addictions promotes better scientific research, enhances mental health outcomes, and strengthens mental health care and policy.

Let us hope that soon the commonly asked question will no longer be “why women?” but rather, “how can we design research, practice and policy to help us better understand and respond to the similarities and differences between women and men and their experiences of mental health and substance use problems?”

 
About the Author

Marina is Research Associate with the BC Centre of Excellence for Women’s Health where she heads a program of research on women and mental health. Marina also teaches women’s studies at UBC

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