Women living with mental health issues
Contents:Mental health is described by World Health Organisation as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. Good mental health is essential for the wellbeing of individuals, their families, and the community.
Mental, physical and social health is interdependent (WHO, 2005). People living with mental health problems may experience poorer health—placing individuals at an increased risk of chronic disease. People living with mental health issues will also often find it difficult to develop and maintain social relationships (Davidson et al., 2004). While the deinstitutionalisation of mental health facilities has been positive, the move to more community-based mental health service delivery has resulted in increasing social disconnectedness amongst mental health consumers (Riessman and Gartner, 1984).One in five Australians will experience mental illness this year, and nearly one in two Australians will experience some form of mental illness at some stage during their life. It is the largest cause of non-fatal disability of any disease in the country. It is a bigger barrier to workforce participation than any other illness in the country. People living with mental illness need access to a range of services from across government – health and clinical care services, but also stable accommodation, community support and education and training opportunities (Butler, 2011).
Both social isolation and mental illness are gendered phenomena. Women experience marginalisation due to social, political and economic factors impacting on their social role, resources and lifestyle. The mental health needs of women are also different from those of men, and women experience mental illness diagnosis, illness and recovery differently to men. Evidence shows that some mental illnesses are more prevalent in women, that women use mental health services more frequently than men do, and that women want a different range of treatment and support options than is currently available.
Women’s mental health needs also change across their life. They may experience mental health issues related to pregnancy and antenatal depression. Women of all ages can struggle with body image and eating disorders, and older women may have different mental health needs in relation to ageing because of their greater longevity. Women may have preferences, feel more comfortable with and gain greater benefit from access to women-specific peer support groups and alternative therapies.
Maslen (2008) reports that “people with mental health issues are amongst the most vulnerable in our society, and are subject to stigma and discrimination in many aspects of their lives”. Despite this, there is a significant shortage of statistical information available on the number of people who experience mental health issues, and an absence of information on the number of ACT women who experience mental health issues. In the Australian Capital Territory (ACT), it is estimated that 3000 women access ACT mental health services annually and approximately a third of these women have ongoing connections with the sector (AIHW, 2002).
While the ACT has a growing body of support services for people living with mental health issues, mental health and community services and supports services are not always gender sensitive. It is therefore vital to develop strategies to facilitate and support women to maintain their social connectivity and manage good mental health and wellbeing outside of traditional mental health services and facilities.
Gathering this information should be a priority as it has been suggested that women in the ACT experience a significantly higher amount of psychological distress than women in other Australian states and territories, 3.5 percent compared to 1.6 percent nationally (National Health Survey, 2001).
It is for these reasons that WCHM has remained mindful of the importance of the social determinants of health and of illness, and recognises in its work the significant adverse impact on health and wellbeing of social isolation and marginalisation. WCHM’s work in this area is focussed on developing strategies to enable women living with a mental health issue to connect/reconnect to their community and build networks.
By focussing on improving women’s access to women-sensitive health practitioners and services WCHM hopes to help develop increased knowledge about the factors that act as barriers to social inclusion and which impact adversely on women with mental health issues and to put specific policy proposals and advocacy initiatives in place to increase their social inclusion.
Current WCHM Projects
Peer Support Research Report
With the support of funding from an ACT Health Promotions grant, WCHM completed a two year peer support research project to document good practice peer support models and the needs for and experiences of peer support programs for women living with a mental health issue in the ACT. This research is a contribution to the growing body of research on the effectiveness of peer support and is unique in that it highlights the context of mental health, the ACT and the importance of gender sensitive practice.
This research found that peer support improves participant’s mental health and wellbeing, including examples of decreasing symptoms. Peer support increases self-esteem and confidence, increases social support networks and reduces isolation through building mutually supportive relationships with others and connecting with the broader community through new activities such as work and volunteering.It also emerged that for women, peer support provides improvements in mental health because it is an alternative to the medical model. The women involved described how being treated as “normal” and “as a person, not the symptoms” by peers is empowering. For many of the women a positive outcome of peer support was that it provides a sense of belonging, friendship and connection with others, and perhaps the only opportunity for social inclusion they have. Women in this study reported appreciating the time to socialise and “get out of the house” to relieve boredom, lethargy or loneliness. In addition, peer support provided a feeling that “you’re not alone, other people are having bad days as well”, and the sense that others care about you.
This project showed that it is important that peer support groups for women living with mental health issues in the ACT continue to grow. It also showed that peer support is a mechanism of health promotion as it positively influenced participant’s health and wellbeing by increasing participant’s confidence, building skills in advocacy and communication and empowering them to ‘take control’ over their health. Peer support also educates members about the causes and impacts of stigma and builds knowledge through sharing information about how to navigate the mental health system, treatment options and increased awareness about mental health symptoms. It is hoped that as a consequence of this research, peer support as a means of increasing social connectivity and managing mental health for women will become more widely understood in the ACT community.
Peer support for women living with mental health issues (1022 KB)
Peer Support Evaluation Framework (336 KB)
Peer Support Evaluation Framework (479 KB)
Working with the ACT mental health peaks
WCHM continues to work closely with the Mental Health Community Coalition (MHCC), the Mental Health Consumer Network (MHCN) and Carers ACT to influence them about the needs of women living with a mental illness, and assist them to better engage with women.
Past WCHM Projects
Research Report into the experiences of women with mental health issues and their access to the legal system
Throughout 2009-10 WCHM undertook research to document the experiences of women living with mental health issues accessing the legal system. The research was conducted via interviews with women in the ACT and then documented in a final research report Out of Reach - Women living with mental health issues in the ACT: What hinders their access to legal services in the ACT.
The findings indentified that women with a mental illness experience a collection of personal barriers that hinder their capacity to access legal support, which include:- Communication problems that can inhibit their ability to adequately communicate their legal needs to service providers and subsequently obstruct a lawyer’s ability to adequately assist them
- Financial and educational risk factors that can contribute to social isolation and limit women’s ability to access legal support, amplified for women as a result of socio-economic inequalities
- Stigmatisation and discrimination, which exacerbate fear and social exclusion and impede women’s capacity to access and participate within the legal system
- Social isolation
- Stress associated with participating in legal proceedings discourages contact with legal services, which can contribute to relapses in illness
- Cognitive impairment, which has been intrinsically linked to mental illness and can affect women’s ability to access and understand legal processes
- Lack of awareness among women living with mental health issues about available legal services and the issues that can be dealt with through legal processes
- An inability to access mental health care and treatment can affect women’s ability to maintain feelings of health and wellbeing, impacting on many of the personal barriers faced, and subsequently restricting their ability to access legal support and assistance
- As a result of systemic inadequacies with the mental health care system, the police are left to ‘crisis manage’ the affects of mental illness, often resulting in arrest and detention by default
- Those who have the authority to make legal decisions affecting the lives of these women are often unaware of the personal and systemic barriers that women with a mental illness face, therefore, the structures and facilities within the legal system are not considerate of the additional issues women face
Women with a mental illness are one of the most vulnerable and disadvantaged groups within our society and are more susceptible to socio-economic discrimination and reduced health and wellbeing. Subsequently, women with a mental illness experience additional difficulties when accessing legal support and representation that can impact on the personal and systemic barriers they encounter on a daily basis.
It goes with the Territory! The views of ACT Women who are mental health carers about health and wellbeing information
In April 2011 WCHM launch the companion report It goes with the Territory! The views of ACT Women who are mental health carers about health and wellbeing information.This report presents the findings and views of women mental health carers who participated in WCHM’s health and wellbeing information research in 2009, and identifies the major themes and the barriers facing them in accessing the health and wellbeing information they need.
The report identified that women mental health carers face a number of barriers to accessing the health and wellbeing information they need, which include but are not limited to: being shut off from information and knowledge by mental health professionals and workers; not being respected in their role by mental health professionals and workers; being denied information on the premise of confidentiality and privacy; not having a central source of ACT specific information on mental health treatments and services; and not being able to afford many of the options that do exist.
Mental health carers are also greatly affected by the level of discrimination and stigma that exists around mental illness in the community, which can be very isolating and curb their function as carers. Women who are mental health carers need access to up-to-date and relevant information from trusted sources. This means that local and trusted health and wellbeing information sources need to be promoted over time to be visible and accessible to them.
Survey of ACT Women Mental Health Carers
WCHM finalised a literature review of the needs and experiences of women mental health carers, and has conducted a survey of ACT women mental health carers. Data analysis of the results was completed, and the preliminary survey findings are available on the WCHM website. A final report will be completed in 2011-12.
Other Research and Reports
Unravelling Psychosocial Disability
The term ‘psychosocial disability’ is referenced in the National Disability Strategy 2010-2020, but it has not been widely used in the Australian community. It is a term preferred by mental health consumers and carers to describe living with a disability that is associated with a severe mental health condition. This Position Statement has been prepared by the National Mental Health Consumer & Carer Forum (NMHCCF) Steering Committee on Psychosocial Disability with funding from the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA). In 2010, the NMHCCF identified the need for the Position Statement as part of its consideration of the Productivity Commission Inquiry into Disability Care and Support.
http://www.nmhccf.org.au/documents/NMHCCF_Psychosocial%20disability_Booklet_Web%20version_27Oct11.pdf
People Living with Psychosis
A new report People Living with Psychotic Illness summarises the results of a study which was the largest ever carried out in Australia on the impact of conditions such as schizophrenia. The study was commissioned by the Australian Government, Department of Health and Ageing, and provides a comprehensive insight into the impact of psychotic illness on the lives of Australians today. SANE Australia was a partner in this project, and has produced People Living with Psychotic Illness: A SANE Response which summarises the key findings and outlines the action needed in response to them.
http://www.sane.org/sane-information/informationresearch/1042-people-living-with-psychosis-a-sane-response
Adversity to Advocacy: Australia's first survey of mental health carers
Adversity to Advocacy is Australia’s first ever national survey of mental health carers. The results, released in October 2009, give a unique insight into the difficulties and concerns of Australians caring for someone with a mental illness. Conducted by the Mental Health Council of Australia, the survey involved more than 1500 mental health carers from across the nation. This report reveals the 15 key issues identified by mental health carers, which are all based directly on stories, experiences and ideas from the carers who contributed to the survey. These key issues relate to carers and their role alongside priorities that relate directly to the mental health system and the care of the consumer. This reflects the fact that in many situations the needs of carers and those they care for are intrinsically entwined. http://www.mhca.org.au/documents/publications/MHCA%20CEP%20webLR.pdf
Building a Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014
The ACT Action Plan for Mental Health Promotion, Prevention and Early Intervention 2006–2008 (the 2006–2008 Plan) was developed in recognition of the need to accompany clinical treatment for mental illness with actions that promote mental health and resilience across the whole of the community. The 2006–2008 Plan was launched by the Minister for Health in 2006. The Mental Health Promotion, Prevention and Early Intervention Working Group (the Working Group) guided the implementation and evaluation of the 2006–2008 Plan and was tasked with developing priorities for and guiding the development of the 2009–2014 Framework. Building A Strong Foundation: A Framework for Promoting Mental Health and Wellbeing in the ACT 2009–2014 (Building A Strong Foundation) provides a framework to guide a coordinated approach to the implementation and development of activities that promote mental health and wellbeing, prevent mental illness, and provide timely early intervention for those experiencing mental illness in the ACT. Building A Strong Foundation builds on the work and learning of its predecessor and provides a collaborative and co-operative whole of community approach to mental health promotion, prevention and early intervention (PPEI) in the ACT.Building A Strong Foundation sets out the ACT Government’s commitment to:
- Promoting mental health and wellbeing
- Preventing mental illness
- Intervening early in the course of an episode of mental illness
- Providing timely early intervention for those experiencing mental illness http://www.health.act.gov.au/c/health?a=sendfile&ft=p&fid=1266807854&sid=
Mental health services - in brief 2011
The Australian Institute of Health and Welfare report Mental health services - in brief 2011 provides an overview of the characteristics and activity of Australia's mental health services, the availability of mental health resources, and the changes that have occurred in these over time. It is designed to accompany the more comprehensive data on Australia's mental health services available online at http://mhsa.aihw.gov.au. http://www.aihw.gov.au/publication-detail/?id=10737420189
Useful Links
ACT Mental Health Consumer Network (http://www.actmhcn.org.au/) The ACT Mental Health Consumer Network is an organisation that is run by consumers for consumers. Their aim is to bring about a higher standard of health care in the mental health sector, through representation, lobbying and active involvement in new developments in the mental health sector.
Mental Health Community Coalition of the ACT (MHCCACT) (http://www.mhccact.org.au/cms/index.php) The MHCCACT is the peak body representing the not-for-profit Community Mental Health sector in the Australian Capital Territory. Founded in 2004 the organisation promotes a diverse range of community agencies and local consumer and carer groups that support people recovering from a mental illness in the community.
Mental Health Council of Australia (http://www.mhca.org.au/fact-sheets)The Mental Health Council of Australia (MHCA) is the peak, national non-government organisation representing and promoting the interests of the Australian mental health sector, committed to achieving better mental health for all Australians. Their site includes a range of useful fact sheets and publications.
Mental Health Foundation ACT (http://www.mhf.org.au/mhf/)
The Mental Health Foundation is a leading service provider and information resource for mental health in the ACT. They deliver programs that are designed to positively enrich and to improve the lives of people living with a mental illness and their family, friends and colleagues. They also provide direct assistance to individuals living with any mental illness.
Mental Health ACT (http://health.act.gov.au/c/health?a=sp&did=10050411)
Mental Health ACT provides a comprehensive range of flexible and accessible mental health services and provides specialist treatment and rehabilitation services for people experiencing mental health issues. Mental Health ACT works in partnership with consumers, carers, general practitioners, service providers, the community and other health care professionals to reduce the impact of mental disorders and ensure the best possible consumer outcomes in a respectful manner.
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