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Women's right to mental health scwsd       14 9-06
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Women's right to mental health scwsd 14 9-06


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Mental health issues of women are gaining ground in the social work discourse. Universalist ETIC approach is found limiting in dealing with mental health problems. EMIC approach that emphasises …

Mental health issues of women are gaining ground in the social work discourse. Universalist ETIC approach is found limiting in dealing with mental health problems. EMIC approach that emphasises cross-cultural psychiatry and evaluates mental health condition of women from within a culture is found more useful. Worsening socio-economic and political situation has enhanced the rates of common mental disorders and minor psychiatric morbidity. Trauma caused by violence against women should be tackled with the help of psychotherapy and psychoanalysis. The paper also discusses mental issues of adolescent girls, substance abusers, HIV-AIDS patients and women in reproductive age group. Media can play progressive role by providing empowering role models for women. Mental health of women in shelter homes, mental hospitals and police custody\ prison needs enlightened intervention by the state, non-government organisations and civil society. Self help groups provide democratic space for rebuilding broken lives. To make women’s material reality more secure, liberating and healthy, breakthrough counselling is need of an hour. Sensitization and training of general practitioners and other health personnel with this objective is a must. Ethics of valuing and respecting others must be observed by the counsellor. The counsellor should know that healing is a part of empowerment.

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    • Presented at
    • SCWSD, Sophia College, 14-9-2006
    • by
    • Dr. Vibhuti Patel
    • Director, PGSR
    • Professor and Head,
    • University Department of Economics
    • SNDT Wpomen’s University, New Marine Lines,
    • Smt. Nathibai Road, Mumbai-400020
    • Phone-022-26770227 Mobile-9321040048
  • 2. 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.
  • 3. 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.
  • 4. 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.
  • 5. 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.
  • 6. 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, …
  • 7. 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 .
  • 8. 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 .
  • 9. 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.
  • 10. 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.
  • 11. 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
  • 12. 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.
  • 13. 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.
  • 14. 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
  • 15. 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.
  • 16. 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.
  • 17. 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.
  • 18. 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.
  • 19. 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.
  • 20. 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
  • 21. 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.
  • 22. 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
  • 23. 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
  • 24. 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
  • 25. 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
  • 26. 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
  • 27. 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.
  • 28. Thank you