It also describes how women with mental health problems are treated in the health, social and criminal justice systems, outlines policies on improving services for women in mental distress, and details the mainstream and voluntary sector services that are available.
Copyright note for Mind factsheets: You are welcome to print and photocopy this page of Mind's website. Organisations are free to distribute copies to service users and colleagues, but must ensure they always use the latest version, as available on the website, at the time of distribution.
Introduction
Some facts about women’s mental health
What difference does gender make in mental health?
Gender inequality and risks to women’s mental health
Gender stereotyping and bias
Gender differences in mental health disorders
Diagnoses most commonly given to women
Depression
Anxiety
Eating disorders
Self-harm and suicidal behaviour
Borderline personality disorder (BPD)
Diagnoses related to reproductive functions
Premenstrual syndrome
Perinatal mental disorders
Diagnoses women receive less frequently
Schizophrenia and bipolar disorder
Substance dependence
Social factors that affect women’s mental health
Economic issues
Trauma, violence and abuse in childhood or adulthood
Family and social roles
Younger women
Older women
Women in prison and secure psychiatric services
Women refugees and asylum seekers
Race, ethnicity and mental health
Sexuality
Social factors that support women’s mental health
Physical and mental health interactions
Medically unexplained symptoms
Unrecognised physical ill-health
Treatment and services
Anxiety and depression
Eating disorders
Self-harm
Borderline personality disorder
Perinatal disorders
Treatment for women diagnosed with severe mental illnesses such as schizophrenia
Women who have experienced abuse or violence
Services for women in prison or secure hospitals
General issues relating to medication
Side effects and interactions
Motherhood and medication
Safety issues for women in psychiatric hospitals
Improving mental health policy and practice for women
Voluntary sector support
Further reading
Useful organisations
References
This factsheet has been written for women in mental distress, their friends, relatives, partners and those who care for them. It will be also be of interest to students and health professionals working with women in mental distress.
‘Gender’ refers to culturally and socially determined differences between men and women. It is related to how we are perceived and expected to think and act as women and men because of the way society is organised, not because of our sex (‘which refers to biologically determined characteristics). [9]
Gender influences how much control men and women have over key aspects of their lives that can affect mental health, such as economic position and social status. Research that takes gender into account is considered to lead to better treatments and outcomes. [10]
Gender awareness in mental health is required in law. The Equality Act 2010 [11] reinforces the legal status of the Gender Equality Duty, which requires all public bodies to eliminate unlawful discrimination and harassment on the grounds of gender, and to promote equality of opportunity between women and men. All mental health and social care organisations have a duty to prepare gender equality policies for staff and services, to consult their stakeholders and to monitor the impact of their policies annually.
Gender inequality in society leads to differences in the life experiences of men and women, which affect mental health in different ways. Gender inequality is described as a system that tends to give more advantages to men in terms of employment, status and ownership. Women are much more often expected to look after others in the home or in society, often doing work that is undervalued and unpaid or poorly paid. [12]
Some risk factors for mental health problems affect women more often than men. These include gender-based violence, social and economic disadvantage, low income and income inequality, low or subordinate social status and rank, and major responsibility for the care of others. [13]
Both women and men can be adversely affected by gender-based assumptions, stereotypes and social pressures. For example, beliefs that women are emotionally or psychologically vulnerable, while men are strong, can be unhelpful for people’s mental health. [14]
A World Health Organization (WHO) report [15] claims that researchers have over-emphasised the impact on women’s mental health of biological factors such as menstruation, pregnancy and childbirth. The report says that the impact on women’s mental health often has more to do with what is happening in their social and emotional lives than with biological changes.
Women receive more services than men for mental health problems at the level of primary care, though this difference is less at the level of secondary care (specialist and hospital treatment). It is difficult to know whether more mental health problems are diagnosed in women at primary care level because they seek help more often than men, or because they actually experience more distress. [16]
According to another WHO report, [17] there is little difference in the prevalence of mental health disorders between men and women, but the types of disorders and the stages of life at which mental health problems are most likely to be diagnosed differ. In childhood, boys are more often identified as having mental disorders, such as attention-deficit hyperactivity disorder, and substance abuse is more common. Young women experience more depression, self-harm and eating disorders. In adulthood, women are far more likely to be diagnosed with depression. Psychotic disorders such as schizophrenia and bipolar disorder are similarly likely in both sexes. In old age, women are more likely to be diagnosed with depression and psychoses.
Women are more likely than men to have more than one disorder, which increases disability. [18]
First episodes of depression are more frequent in women than men, and are likely to result from a mixture of social, psychological and biological factors. Fluctuating hormone levels may partly explain the higher rates of depression in women; [19] however, hormones are likely to affect other aspects of women’s lives, such as their general health, relationships and living environment, and with social factors, such as the position of women in society and the value placed on women’s roles, rather than being the sole cause of depression. [20]
First episodes of depression in women have been linked to the onset of puberty and menstruation, childbirth, and the transition to menopause. Depression is more frequent in married than never-married women, and in unsupported mothers. [21], [22]
Anxiety is more frequent in women than in men, though this may partially reflect the relative unwillingness of men to seek help. Men are more likely to turn to drugs or alcohol (in particular) to cope with stress problems, [23] and are more likely to develop substance abuse problems than women. [24], [25]
Anxiety problems, including panic, agoraphobia, obsessive–compulsive disorder (OCD) and PTSD, are reported up to twice as often by women as by men. [26], [27] People with PTSD may have a range of symptoms, including re-experiencing painful events, avoidance, muscular and emotional tension, depression, emotional numbing, drug or alcohol misuse and anger. [28]
Disordered eating patterns, such as compulsive dieting or eating, with or without induced vomiting and purging, can affect men and women, but the overwhelming majority of those affected are girls and women aged between 14 and 25 years. Girls are becoming weight conscious as young as five years of age. [29] Since eating disorders are more common in developed and industrialised countries, it seems likely that the main causes are social and psychological, and relate to cultural pressures on young women to look slim. [30] Young women from other ethnicities and cultures living in the UK and USA also acquire eating disorders, and may be at greater risk than White women.
Mind has produced a booklet, Understanding eating distress, that covers these disorders in more detail, and My name is Chris, a comic-style book written for young people.
The majority of people who self-harm are young women. Self-harming behaviour is also significant among minority groups discriminated against by society. Someone who has mental health problems is more likely to self-harm. So are those who are dependent on drugs or alcohol, or who are faced with a number of major life problems. Women are most likely to self-harm by cutting or poisoning themselves. [31]
A study by an Asian women’s group found that the issues affecting young women’s emotional health included domestic violence, racism, bullying, family and home life, education, work/employment, sexual abuse, and the experience of being a refugee. Non-fatal deliberate self-harm was seen by young women as one of few accessible options in the management of their distress, allowing them to maintain privacy while providing a method of release. [32]
The majority of people who self-harm are not suicidal, but, people who self-harm are at higher risk of suicide than any other group. Men have a higher rate of suicide than women – 17.4 men per 100,000 compared to 5.3 women. Reasons for this include the idea that women form more socially supportive networks than men, since isolation appears to be a factor in suicide. However, deaths by hanging have increased among young women in recent years. [33]
See Mind’s booklets Understanding self harm, About self-harm (written for young people), and also How to cope with suicidal feelings.
The majority (70 per cent) of people diagnosed with BPD are women, and suicide rates are high among this group (10 per cent). BPD has been linked to a history of trauma in childhood and PTSD. [34]
More information can be found in Mind’s booklet Understanding personality disorders.
Hormonal and reproductive changes can contribute to some mental health problems, and some diagnoses that women receive relate to aspects of their reproductive functions, including menstruation, pregnancy and childbirth, and menopause.
Premenstrual hormonal changes have been linked to problems that can range from mild feelings of depression or irritation to, very rarely, premenstrual dysphoric disorder, characterised by anxiety, depression, insomnia, food cravings and feelings of being out of control. [35], [36]
Women are particularly vulnerable to mental health problems in the time just before and after childbirth – the perinatal period. [37] The main types of mental health problem that arise are:
While pregnancy is widely believed to reduce depression, some studies have found that depression in pregnancy is more widespread than expected, especially in the third trimester. [38], [39]
‘Postnatal blues’ is a normal emotional change that occurs in up to 50 per cent of women after childbirth, [40] and is thought to be linked to rapid changes in hormones. It is usually brief, although it is advised that women are monitored to ensure that this is not the start of postnatal depression. [41]
Postnatal depression and puerperal psychosis are no different from depression or psychosis experienced at any other time. Some experts believe that giving birth acts as a major stress factor that can trigger the onset of these disorders in women who are predisposed to them. Postnatal depression can begin in the weeks following childbirth, or up to a year afterwards. The woman may feel low in mood and energy, worried about her child, and unable to sleep, or even have thoughts about abandoning or harming her child. [42]
While 13–15 per cent of women experience postnatal depression, [43] puerperal psychosis is much rarer, affecting only about 1 in 1000. It is a serious mental illness that can develop in a woman who has recently given birth, usually with no obvious cause. The baby may be healthy and wanted, and the birth is not unusually complicated. [44] (See Mind’s booklet Understanding postnatal depression.)
For women who already have mental disorders, such as schizophrenia or bipolar disorder, pregnancy can bring additional stress. Some women with bipolar disorder may experience a worsening of their symptoms during pregnancy and after the birth. [45]
Further information on treatment and services for perinatal disorders is given later in this factsheet.
While there are no marked differences in the incidence of schizophrenia between the sexes, women tend to be older than men by three to six years when first diagnosed, often in their late 20s, and there is a further peak of onset in women after 45 years of age. There are also differences in the types of symptoms women experience and in rates of recovery. Researchers therefore recommend a gender-sensitive approach to the diagnosis and management of schizophrenia. [46]
The type of bipolar disorder experienced by women is usually characterised by mild 'hypomanic' episodes, but with a greater burden of depression; researchers also recommend a gender-sensitive approach. [47]
Substance (drug and alcohol) dependence is more common in men [48] but the experience of substance dependence is often different for women. Traditionally, a greater social stigma is attached to women who are dependent on illegal drugs or alcohol, which can lead them to hide their problems, and choose not to access health or social care services. Women who are lone parents are particularly likely to hide their problems through fear that they may lose custody of their children. In these situations, substance dependence and co-existing mental health problems are likely to become more severe over time, with serious consequences for a woman’s health and wellbeing. [49], [50]
Women are more likely than men to become dependent on prescription medication, including antidepressants and tranquillisers (for anxiety or use as sleeping pills). This is partly because women are more frequently diagnosed with anxiety and depression and given medication to treat these conditions. [51]
Far more women than men use primary care services for mental health problems, and one reason suggested is that women are more likely to report symptoms of common mental health problems. Rates of undiagnosed depression could be equally high in men, but evidence suggests that men are less likely to talk about their problems or consult a doctor about their mental health [52]. By contrast, women are more likely to acknowledge their mental distress and to seek help.
Some mental disorders, such as depression, are more common among those living in poverty. [53] Women are more likely to be poor because their jobs are likely to be lower paid, they are more likely to work part-time, to take time out of the labour market to bring up children, to be lone parents, and, because of their different working history, likely to receive a lower pension. This goes a long way to explain why rates of depression are higher in women. [54]
Gender-based violence is strongly linked with mental health issues, including depression, anxiety and stress-related syndromes, substance misuse and suicide. [55], [56]
Up to 13 per cent of children experience sexual abuse, physical abuse, neglect, or disruption such as being in care, with slightly higher figures for girls than boys. [57] One in four adult women experience IPV (domestic violence). [58] IPV is defined as any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are (or who have been) intimate partners or family members, regardless of gender or sexuality. This includes so-called 'honour killings’ that are of concern in black and minority ethnic (BME) communities. [59]
Women are much more likely than men to experience repeated and severe forms of IPV, although this is not always evident in statistical summaries such as Home Office studies, which may focus on single incidents rather than on repeated abuse. Women are also more likely to experience sexual abuse and violence, and their experience is more likely to have a long-lasting psychological/emotional impact or result in injury or death. [60] In some cases, mental illness, such as schizophrenia, can increase the risk of IPV. [61]
Experience of IPV can lead to feelings of guilt and shame, anxiety, depression, low self-esteem, lack of confidence, vulnerability to abusive relationships, inability to trust people, anger, sexual difficulties and self-hate. Women can also experience physical symptoms related to abuse, such as abdominal pain, insomnia and headaches. [62] Further, these problems can lead to the diagnosis of a wide range of mental disorders, including PTSD, BPD, self-harm, suicide (or suicide attempts), multiple personality disorder, mania, bulimia, eating disorders and substance abuse. [63]
For some women, family life may contribute to mental distress. Many women have primary or sole care of children, and women are more likely than men to take on caring responsibilities (e.g. for older family members). Women also tend to work in part-time jobs, and are over-represented in low paid occupations and sectors such as teaching and care work.[64] The low social status traditionally associated with domestic and caring work can damage feelings of self-worth, while the stresses of overwork, extensive responsibilities and feeling undervalued can damage women’s mental health. [65], [66] While the extent of gender-based disadvantages varies according to social class and ethnicity, it has been argued that women bear the brunt of reconciling paid work with family life. [67]
Women who are mothers, or who want to have children, can experience particular barriers to the use of mental health services. They may avoid disclosing their problems for fear of losing custody of their children, leave hospital sooner than they otherwise would, in order to look after children, or find themselves unable to use services because of childcare commitments.
Childhood and adolescent mental health difficulties are strongly correlated with mental health problems in adulthood. [68] Problems that are more likely to be diagnosed in women than men, such as eating disorders, BPD and self-harm, often start in teenage years or early adulthood.
Teenage girls and young women are at high risk for traumatic experiences such as sexual abuse, rape and domestic violence. [69] As discussed above (‘Trauma, violence and abuse in childhood or adulthood’), girls who experience sexual or physical abuse are more likely to develop mental health problems later in life.
Issues around old age are particularly relevant to women’s mental health.
However, the higher rates of diagnosed mental health problems in older women may partly reflect the fact that women are, in general, more likely than men to acknowledge their distress and seek appropriate help.
Women in prison often have complex problems. A high proportion have had adverse childhood experiences, problems at school and poor employment records. Rates of mental disorder and substance abuse are high, and being in prison can increase women’s problems, as they may be separated from their children and social networks, and they may be victimised. Women in prison experience higher rates of mental disorder than women in the community or men in prison, and rates are higher still for remand prisoners. Rates of self-harm and suicide are high among women in prison. [72]
Women in secure psychiatric hospitals are in a minority, but women are proportionately more likely than men to be sent to such hospitals for criminal behaviour, or transferred from another hospital because of a behavioural disorder. They have had similar adverse experiences growing up to women in prison generally, though fewer are mothers. Self-harm and substance abuse are common among this group. [73]
Being a refugee or asylum seeker can be traumatic for both men and women, but particular experiences such as rape are more common among women. Women who are refugees or asylum seekers may arrive from traumatic situations to find themselves detained, which has been described as ‘retraumatisation’. They are physically examined, but are rarely asked if they are victims of torture; even if they are asked and the response is ‘yes’, often nothing is done.
Women in detention centres are almost inevitably depressed, having fled from their home countries, and having often been persecuted, tortured or raped, and are in fear of being deported back to the countries they have fled. [74]
Women from BME groups in the UK may experience the dual impact of gender inequality within their family or community setting, and alienation from mental health services. The high levels of suicide and self-harm among young south Asian women are indications of this. [75]
Specific groups of BME women are heavily represented in psychiatric diagnoses and service use; Pakistani and Bangladeshi women have higher rates of depression than both their male counterparts and White British women. Higher rates of psychosis (including bipolar disorder and schizophrenia) are diagnosed among Black Caribbean women than among women from other groups. It is argued that this may be partly because racism within society is reflected by racial stereotyping within mental health services. Many mental health service users from BME groups are also living in poverty, which is an important social factor in mental distress. [76]
Lesbian and bisexual women tend to have higher rates of suicide, attempted suicide and suicidal thoughts, depression, anxiety and substance use disorders than heterosexual women. [77] Such mental health issue may of course be unconnected with their sexuality, but there is evidence that social hostility, stigma and discrimination are contributing factors.
Women are encouraged to become competent at relationships, and as a result are better than men at seeking help and dealing with the causes of their distress. They also tend to be better able to give and receive help from each other. [78] Women who have strong family support, autonomy, and access to material resources that allow choice are better protected against developing mental health problems. [79]
Physical and mental ill-health are linked in both men and women. People with chronic physical illnesses are at greater risk of developing mental health problems, particularly depression, while those with mental health problems are also more likely to have physical illnesses, such as heart or respiratory problems. [80]
A range of physical problems are considered by doctors to be the physical manifestation of mental health problems, otherwise known as ‘conversion symptoms’ or ‘somatisation’. These include irritable bowel syndrome, fibromyalgia, and chronic pelvic pain. Studies show that medically unexplained symptoms such as these are two to three times more likely in women than in men. [81] Research shows that a high proportion of people with such problems have experienced trauma, abuse or violence. [82]
An equally serious problem for women in mental distress is the lack of recognition for physical illnesses, because symptoms of physical illness may be wrongly seen as ‘imagined’ or psychosomatic. Research suggests that women with mental health problems are more likely than other groups to have physical complaints disregarded, and requests for services denied. Studies have found that women with mental health problems have significantly more undetected medical problems than men, and that women with bipolar disorder (manic depression) are three times more likely than men to have undiagnosed medical problems. [83]
Department of Health guidance on mainstreaming women’s mental health has pointed out that women ultimately want services to adopt a ‘whole person’ approach to their care, treatment and rehabilitation, to value their strengths and abilities, and to recognise their potential for recovery, in the context of holistic assessment and care planning. [84] Many areas of women’s mental health are now also covered by guidance from the National Institute for Health and Clinical Excellence (NICE).
Too often, a diagnosis of anxiety or depression leads to medication as the first or only treatment option. Women with these issues have repeatedly asked for better access to talking therapies, and for opportunities to learn new skills and coping strategies. [85] These preferences are reflected in current NICE guidelines for the treatment of both anxiety and depression, which state that talking therapies are the most likely treatment to produce lasting benefits, especially when combined with other forms of social support and self-help. [86], [87] Government investment in the Improving Access To Psychological Therapies programme has increased the availability of short-term therapies such as cognitive behaviour therapy (CBT) via primary care. [88] Pilot programmes show that over 60 per cent of those accessing this CBT are women, and that the intervention shows some positive results in reducing levels of depression and anxiety. [89]
Talking treatments, including family therapy and CBT, are widely advised for women with eating disorders. NICE guidance on treatment for anorexia advises structured and symptom-focused inpatient admission as a last resort, with psychological treatment rather than behaviour modification. [90], [91] However, a lack of specialist eating disorder services across large areas of England and Wales means that local services often fall short of national standards.
For women who self-harm, NICE recommends full assessment of physical, psychological and social needs, by a professional with suitable training and in an atmosphere of respect and understanding. Treatment choices should include counselling and therapy. Women who have self-harmed severely should be referred to psychiatric services for further assessment, treatment and support, or taken into hospital in an emergency.[92]
A study by an Asian Women’s group reported that a wide range of services is now on offer for young people across the UK, but there is still a need to evaluate which approaches really work, so that they can be widely adopted. Young women want a variety of options, including support for self-help techniques such as distraction – which includes a wide range of activities, from watching TV to gardening or flying a kite. [93]
For women diagnosed with BPD, NICE recommends that a clearly structured, comprehensive multidisciplinary care plan that includes short- and long-term goals is agreed with the client. The care plan should include psychological treatments of at least three months’ duration, and plans to manage crises. No medications are specifically recommended for BPD. [94] NICE and other agencies recommend a range of treatment options, including structured talking treatments, and medication for specific symptoms, such as transient psychotic episodes. [95]
Women clearly benefit from support before and after childbirth. One study shows that counselling for women who are depressed when pregnant may help to prevent problems for the family after the baby is born. [96] Other studies show that health visitors can provide valued listening and support to new mothers, and that individual, group and family support and counselling can help mothers to cope with postnatal depression and parenting problems. [97]
NICE has produced guidance on perinatal (ante- and postnatal) mental health, which recommends that health professionals look out for those most at risk of developing a mental disorder, and ask questions to detect problems, such as depression, as early as possible. This ensures that psychological treatment can begin as early as possible if needed, within one month of initial assessment, and no longer than three months afterwards.
NICE guidance recommends that clinical networks are developed in each region to ensure that services for mothers and infants are better coordinated, and that help is available quickly when needed. [98]
Experts have argued that gender-aware treatment for women with diagnoses such as schizophrenia should mean doctors taking more account of women’s practical and emotional needs and their social roles as partners, mothers, and professionals or employees. Women may need therapy and support focused on maintaining or re-establishing their roles, and perhaps will do better if they can receive help that does not separate them from their children, but helps them to cope better with parenting. [99]
Guidance has been developed to help health professionals work with women who may be experiencing mental disorders as a result of abuse, violence or trauma. The first step is to ask questions to find out about these experiences. [100] Some studies show that, despite guidance, many staff do not do this well, perhaps because of a lack of training and experience. [101]
The World Psychiatric Association recommends that women who have been sexually abused and those who have strong preferences for female healthcare staff should be accommodated whenever possible, and emphasises that the evaluation of mental health problems in women must consider the full context of their lives, as distress often has social origins. Diagnoses should not be stigmatising, and the role of violence and discrimination in the genesis of mental health problems in women requires special consideration. [102]
Women in prison who have mental disorders are rarely transferred to a hospital, but are treated by the NHS within the prison. Substance abuse is treated separately by Counselling, Assessment, Referral, Advice and Throughcare (CARAT). Offending behaviour is treated with CBT.
Treatment for women in secure psychiatric hospitals has been reformed by bringing all women in high secure units to Rampton, which provides a more specialised service. A new service development, Women’s Enhanced Medium Secure Services (WEMSS) aims to provide more local services, offering skilled nursing and psychological therapies, not just incarceration. [103]
Side effects of psychiatric medication that women in particular may find distressing include weight gain and hair loss. In addition, medications can interact with each other in problematic ways, for instance, some medications interact with the oral contraceptive pill.
While medication for antenatal and postnatal depression is an option, NICE guidance [104] says that the risks of anti-depressant medication to the unborn child, or the infant through breast milk, should be explained, and talking treatments and self-help options should be explored.
The issue of medication is particularly important for women with schizophrenia or bipolar disorder who are mothers or who want to become mothers. Healthcare professionals need to work sensitively with women who are already on medication about whether or not it is safe and advisable to take a break from medication, taking into account the additional stresses of pregnancy and parenting, and the amount of support available. If this is considered possible, then experts advise tapering off the dose of medication in order to avoid the risk of damage to the developing foetus. [105], [106]
Sexual safety includes freedom from sexual harassment, exploitation, aggression and violence. Women are entitled to feel safe from physical harm or sexual harassment when in a mental health unit; there can be particular issues for women who have experienced sexual abuse or rape.
Separate sleeping, toilets and bathing accommodation for women in mental health units has been policy since 2000, and, according to the National Patient Safety Agency (NPSA), mental health units should be reconfigured to provide either a self-contained, women-only ward or solely single sex wards. Many, though not all, have done this. However, physical and sexual safety for women in mental health units is an ongoing issue, and the NPSA recommends better use of existing guidance and more training for staff to recognise and report incidents such as sexual harassment, taking into account the physical and psychological harm caused. [107]
Since the Department of HealthHealth’s report on women’s mental health, [108] policies to improve treatment of women have become part of mainstream work. A number of NHS trusts have developed mental health strategies for women, [109] and, in the light of gender equality duty, [110] many are now further updating and reviewing their policies.
Current priority areas for improvement according to a recent national report [111] are:
Many of the initiatives to improve services for women still have a long way to go, however. Women have been calling for more support for self-help and alternatives to medicalised treatments for many years, but in most cases these alternatives are not well supported financially, and are usually left to the voluntary sector to provide, and therefore not universally available.
The voluntary sector provides many support services for women beyond what is available through statutory services, including information, advice and support and/or counselling, as well as drop-in facilities, befriending and advocacy. For further information, visit Mind’s website or see ‘Useful organisations’.
Some groups and organisations operating at local and national levels across the UK focus on the needs of women from particular BME groups. Many of these organisations are staffed by women who share the culture of their service users. Such groups can be useful for social opportunities or for specific services such as information, advice or counselling.
A range of organisations focusing on the needs of lesbians and bisexual women also operate locally and nationally. Most are run by lesbian, gay or bisexual people, and can provide social opportunities or specific services, such as information, advice and counselling. Counsellors or therapists who identify as lesbian or bisexual, or who work for organisations that are positive about LGB issues, can also be found via these organisations. For more details, see ‘Useful organisations’.
The following booklets can be ordered from Mind Publications: telephone 0844 448 4448, email publications@mind.org.uk or visit the Mind shop
Afiya Trust
tel: 020 7582 0400
web: www.afiyatrust.org.uk
The Afiya Trust, led by BME groups, aims to reduce inequality in health and social care provision for racialised groups.
Age UK
tel: 0800 169 8787
web: www.ageuk.org.uk
Provides information and advice on issues around old age, including finance, health, law and leisure activities. Delivers services through local centres across the country and campaigns on issues that affect the lives of older people.
Association for Post-Natal Illness (APNI)
helpline: 020 7386 0868 (Mon-Fri 10am–2pm)
web: www.apni.org
Provides a telephone helpline and information leaflets for those affected by postnatal illness and for health professionals. Coordinates a network of volunteers (telephone and postal) who have experienced postnatal illness and aims to increase awareness of the illness and encourage research into its cause and nature.
Battle Against Tranquillisers (BAT)
helpline: 0117 966 3629
web: www.bataid.org
Helps those who are addicted to tranquillisers or sleeping pills through information and practical support, including a helpline and support groups. Also provides education to health professionals.
b-eat (Beating Eating Disorders)
tel: 0870 770 3256
helpline: 0845 634 1414 (Mon–Fri 10.30am–8.30pm, Sat 1pm–4.30pm)
web: www.b-eat.co.uk
Information, advice and support to anyone affected by eating disorders. Services include publications, helpline, email and text support and self-help groups.
Black Mental Health UK (BMH UK)
tel: 07852 182 750
web: www.blackmentalhealth.org.uk
BMH UK aims to reduce inequalities in the treatment and care of people from African-Caribbean communities who use mental health services, and to inform these communities on how to influence the strategic development, policy design and implementation of services.
Bristol Crisis Service for Women
helpline: 0117 925 1119 (Fri, Sat 9pm-12.30am, Sun 6pm-9pm)
web: www.selfinjurysupport.org.uk
Supports girls and women in emotional distress, in particular those who self-harm, through a national helpline, publications, support groups and training for professionals.
British Association for Counselling and Psychotherapy (BACP)
tel: 01455 883300
web: www.bacp.co.uk
The leading professional organisation for counsellors and psychotherapists and reference point for anyone seeking a counsellor or therapist in the UK. Provides information about individual practitioners including, gender, areas of special interest, theoretical approach and languages spoken.
Depression Alliance
tel: 0845 123 23 20
web: www.depressionalliance.org
Works to relieve and prevent depression by providing information, training and services such as support groups and a pen-friend scheme.
Equality and Human Rights Commission (EHRC)
helplines: 0845 604 6610 (England); 0845 604 8810 (Wales)
web: www.equalityhumanrights.com
The aim of the EHRC is to promote equality and human rights, and to create a fairer Britain, by providing advice and guidance, working to implement an effective legislative framework and raising awareness of individuals’ rights. Contact details for regional offices can be found on the website.
The Gender Trust
tel: 01273 234 024
helpline: 0845 231 0505 (Mon–Fri 10am–10pm, Sat–Sun 1pm–10pm)
web: www.gendertrust.org.uk
Provides information and support services for all people with experience of transgender or transsexual issues or gender dysphoria.
National Institute for Health and Clinical Excellence (NICE)
tel: 0845 003 7780
web: www.nice.org.uk
Independent organisation responsible for providing national guidelines for the treatment of illnesses and chronic health conditions. NICE guidelines are available for depression, anxiety, eating disorders and self-harm. All guidelines can be read online free of charge.
National Mental Health Development Unit (NMHDU)
web: www.nmhdu.org.uk
The NMHDU was launched in April 2009, replacing the National Institute for Mental Health in England (NIMHE). It provides national support for implementing mental health policy by advising on national and international best practice to improve mental health and mental health services.
Prison Reform Trust
tel: 020 7251 5070
web: www.prisonreformtrust.org.uk
Campaigns for change in policy and practice and provides information on issues such as conditions in prisons, alternatives to custodial sentences, support to prisoners and their families and the needs of different groups in the prison population.
Queery.org.uk
web: www.queery.org.uk
Gives information on local lesbian, gay, bisexual and transsexual helplines across the UK.
Refuge
tel: 020 7395 7700
helpline: 0808 2000 247 (24-hour, run by Refuge and Women’s Aid)
web: www.refuge.org.uk
Gives support and practical help to women who experience domestic violence, including a helpline, outreach services and a network of refuges across the UK. Runs specialist refuges for African, African Caribbean and South Asian women.
Refugee Action
tel: 020 7654 7700
web: www.refugee-action.org.uk
Independent national charity working with refugees to help them build new lives in the UK.
Safra Project
web: www.safraproject.org
Organisation for lesbian, bisexual or transsexual women who identify as Muslim religiously or culturally. Aims to empower women in these groups, raise awareness of their needs and eliminate the interrelated discrimination such women may face.
Social Perspectives Network (SPN)
tel: 020 33971678
web: www.spn.org.uk
Coalition of mental health service users, carers, policy makers, health professionals and others who aim to influence mental health policy from a social perspective. Priorities include ‘Women, Children and Families’, ‘BME and Culture’ and ‘LGBT Issues.’
Stonewall
tel: 08000 502020
web: www.stonewall.org.uk
Campaigning and lobbying organisation aimed at achieving equality for lesbians, gay men and bisexuals. Provides information on equalities and other LGB issues and works with other organisations to address the needs of LGB people in society.
Welsh Women’s Aid
tel: 029 2039 0874
helpline: 0808 80 10 800 (24-hour, Wales Domestic Abuse Helpline)
web: www.welshwomensaid.org
Works to end domestic violence against women and children through campaigning, telephone and email helplines, and a network of refuges across Wales.
Women’s Aid (England)
tel: 0117 944 4411
helpline: 0808 2000 247 (24-hour, run by Refuge and Women’s Aid)
web: www.womensaid.org.uk
Works to end domestic violence against women and children through campaigning, telephone and email helplines, and a network of refuges across England.
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[4] Home Office, 2007, A report by Baroness Jean Corston of a review of women with particular vulnerabilities in the criminal justice system, www.homeoffice.gov.uk/documents/corstonreport/
[5] Prison Reform Trust, 2009, Bromley Briefings: Prison Factfile.
[6] Women’s Aid, 2009, Domestic violence FAQs, www.womensaid.org.uk
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[28] NICE, 2005, Post-traumatic stress disorder, National Clinical Practice Guideline Number 26, London, NICE.
[29] Mind, 2007, Understanding eating distress.
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[32] Newham Asian Women’s Project, 2007, ‘Everybody hurts’ conference report www.nawp.org/consulAndResearch.htm
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[34] Mind, 2010, Understanding borderline personality disorder.
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[36] Mind, 2008, Understanding premenstrual syndrome.
[37] Mind, 2008, Understanding postnatal depression.
[38] Evans, J. et al 2001, Cohort study of depressed mood during pregnancy and after childbirth, BMJ vol 323 August 4, pp 257-260.
[39] Brooks, P. (2009) Can antenatal counselling prevent postnatal depression? HCPJ July, pp 29-32
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[41] Turjanski, N., 2010, ‘Postnatal depression’, in: in: Kohen, D (ed) Oxford textbook of women and mental health. Oxford University Press, Oxford, pp.169-178
[42] Lewin, J., 2010, ‘Perinatal psychiatric disorders’, in: in: Kohen, D (ed) Oxford textbook of women and mental health. Oxford University Press, Oxford, pp.161-168
[43] Turjanski, N., 2010, ‘Postnatal depression’, in: in: Kohen, D (ed) Oxford textbook of women and mental health. Oxford University Press, Oxford, pp.169-178.
[44] Royal College of Psychiatrists www.rcpsych.ac.uk/mentalhealthinfoforall/problems/postnatalmentalhealth.aspx
[45] Barnes C and Mitchell P., 2005, ’Considerations in the management of bipolar disorder in women’, Australian and New Zealand Journal of Psychiatry, vol. 39, issue 8, pp. 662–7.
[46] Riecher-Rossler, A., Pfluger, M., et al., 2010, ‘Schizophrenia in women’, in: in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 102–114
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[48] Mind, 2005, Men’s mental health
[49] Day, E. and Turner E., 2010, ‘Women and drugs’, in: in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 208–215
[50] Roche J., Gilvarry E., et al., 2010, ‘Women and alcohol’ in: in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 201–207
[51] Department of Health, 2002, Women’s mental health: into the mainstream, DH, London
[52] Mind, 2005, Men’s mental health.
[53] WHO, 2004, Gender in Mental Health Research, Geneva, World Health Organisation
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[55] WHO, 2002, Gender and Mental Health, Geneva, World Health Organisation
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[57] Cawson, P. et al, 2000, Child maltreatment in the United Kingdom: a study of the prevalence of abuse and neglect, NSPCC www.nspcc.org.uk/inform
[58]Women’s Aid, 2009, Domestic Violence FAQs www.womensaid.org.uk
[59] Women’s Aid, 2009, Domestic Violence FAQs www.womensaid.org.uk
[60] Women’s Aid, 2009, Domestic Violence FAQs www.womensaid.org.uk
[61] Chowdhary N. and Patel V., 2010, ‘Gender-based violence and mental health’, in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 7–16
[62] Chowdhary N. and Patel V., 2010, ‘Gender-based violence and mental health’, in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 7–16
[63] Plumb, S., 2005, ‘The social/trauma model: mapping the mental health consequences of childhood sexual abuse and similar experiences’, in: J Tew, Social perspectives in mental health: developing social models to understand and work with mental distress. London, Jessica Kingsley Publishers
[64] Perrons, D., 2009,Women and gender equity in employment, Institute for Employment Studies.
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[67] Perrons, D., 2009, Women and gender equity in employment, Institute for Employment Studies.
[68] Mind Health Foundation, 2004, Lifetime Impacts: Childhood and adolescent mental health, understanding lifetime impacts, Mind Health Foundation, London
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[70] Office of National Statistics, 2003, Mental health of older people, The Stationery Office, London
[71] Department of Health, 2002, Women’s Mental Health: Into the mainstream, DH, London
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[73] Wootton L. and Maden A., 2010, ‘Women in forensic institutions’ in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp.139-146
[74] Social Perspectives Network, 2006, Paper 10 Meeting the Mental Health Needs of Refugees, Asylum Seekers and Immigration Detainees SPN
[75] Gill, A., 2004, ‘A lethal code of honour’, Community Care, 28 October
[76] Mind, 2010, Statistics 3: Race, culture and mental health.
[77] National Institute for Mental Health in England, 2007, Mental disorders, suicide, and deliberate self-harm in lesbian, gay and bisexual people: a systematic review, Care Services Improvement Partnership, London
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[81] Department of Health, 2002, Women’s mental health: into the mainstream, Department of Health, London.
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[83] Franciosi, L., 2005, ‘Women’s mental health and wellbeing: a global perspective’, Community Practitioner, vol. 78, issue 11, pp. 387–388
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[88] Royal College of Psychiatrists and Royal College of GPs, 2008, Psychological therapies in psychiatry and primary care, RCP/RCGP, London
[89] National Mental Health Development Unit, 2010,Realising the benefits, Department of Health.
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[91] NICE, 2004, Eating disorders: core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders, www.nice.org.uk/cg9
[92] NICE, 2004, Self harm: the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care, www.nice.org.uk/cg 16
[93] Newham Asian Women’s Project, 2007, Everybody Hurts conference report www.nawp.org/consulAndResearch.htm
[94] NICE, 2009, Borderline personality disorder: treatment and management, www.nice.org.uk/cg78
[95] Majid, S., 2010, ‘Borderline personality disorder in women: treatment approaches’ in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 127–138
[96] Brooks, P., 2009, Can antenatal counselling prevent postnatal depression? Healthcare Counselling and Psychotherapy Journal 9(3): pp 29-32.
[97] Morell, C.J. et al, 2009, ‘Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomised trial in primary care’ BMJ 2009;338:a3045
[98] NICE, 2007, Antenatal and postnatal mental health: clinical management and service guidance, www.nice.org.uk/cg45
[99] Riecher-Rossler, A., Pfluger M., et al., 2010, ‘Schizophrenia in women’, in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 102–114
[100] Chowdhary, N. and Patel, V., 2010, ‘Gender-based violence and mental health’, in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 7–16
[101] Bengtsson-Tops A., Saveman B.-I., et al., 2009, ’Staff experience and understanding of working with abused women suffering from mental illness’. Health & Social Care in the Community vol. 17, issue 5, pp. 459–465
[102] Stuart D.E., 2006, The International Consensus Statement on Women's Mental Health and the WPA Consensus Statement on Interpersonal Violence against Women, World Psychiatry, vol. 5, issue 1: pp. 61–64 http://ukpmc.ac.uk/classic/articlerender.cgi?artid=607401#__secid228516
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[104] NICE, 2007, Antenatal and postnatal mental health: clinical management and service guidance, www.nice.org.uk/cg45
[105] Riecher-Rossler A., Pfluger, M., et al., 2010, ‘Schizophrenia in women‘ in: Kohen, D (ed) Oxford Textbook of Women and Mental Health. Oxford University Press, Oxford, pp. 102–114
[106] Barnes C and Mitchell P., 2005, ’Considerations in the management of bipolar disorder in women’, Australian and New Zealand Journal of Psychiatry, vol. 39, issue 8, pp. 662–667
[107] National Patient Safety Agency, 2006, With safety in mind: mental health services and patient safety. Patient Observatory Safety Report 2, 2006-07-v1
[108] Department of Health, 2002, Women’s mental health: into the mainstream, DH, London
[109] National Mental Health Development Unit, 2010, Working towards women’s well-being: unfinished business, NMHDU, London
[110] Equality and Human Rights Commission: www.equalityhumanrights.com/advice-and-guidance/public-sector-duties/what-are-the-public-sector-duties/gender-equality-duty/
[111] National Mental Health Development Unit, 2010, Working towards Women’s Well-being: Unfinished Business, London, NMHDU.
This factsheet was written by Rachael Twomey, November 2006 and updated by Jan Wallcraft in June 2010.