Promoting mental health in women and increasing access to treatment are
possible only through the close collaboration of dedicated health
professionals and advocates from multiple disciplines, according to APA
Such collaboration took place in Washington, D.C., last month as a cadre of
psychiatrists, mental health professionals, and patient advocates turned their
focus to women's mental health for a daylong meeting that culminated in a list
of recommendations for policymakers and mental health professionals.
Meeting attendees included APA leaders and representatives from the
American College Health Association, Substance Abuse and Mental Health
Services Administration, and Depression and Bipolar Support Alliance.
The Women's Mental Health Roundtable was sponsored by the American
Psychiatric Foundation (APF) through an unrestricted educational grant from
Women's Mental Health Leadership Summit moderator Altha Stewart, M.D.
(left), and co-presenter Annelle Primm, M.D., M.P.H., discuss the importance
of prevention and wellness as they encourage meeting participants to
brainstorm solutions to improving women's mental health.
"We need to come up with an action plan for developing mental health
services for women," declared outgoing APF President Altha Stewart,
M.D., and help women overcome major barriers to good mental health, which
include stigma, lack of awareness about mental health problems, and access to
culturally competent mental health care.
Stewart noted that a focus on wellness and preventive care is lacking from
many approaches to women's mental health but is badly needed.
Annelle Primm, M.D., M.P.H., director of the APA Office of Minority and
National Affairs, drew attention to "striking" differences in the
patterns of mental illness between men and women. For instance, depressive
disorders affect two to three times as many women as men, she noted, and women
with depression are more likely to develop alcohol problems as a result of
Women may also be at more risk for depression than are men, due to societal
norms in which women take on more than they may be capable of in regard to
balancing careers and family and taking care of others, she noted. 'This
behavior is not only culturally accepted, but expected and encouraged,
especially when it comes to women of color," Primm said.
In addition to causing problems at home, depression is a significant
workplace problem, Primm noted. Some 83 percent of women in a 2003 survey by
the National Mental Health Association cited depression as the number-one
barrier to success at work.
In terms of seeking treatment for mental disorders, women may feel as if
doing so indicates a personal failure or that they should be able to handle
emotional difficulties on their own, Primm stressed.
Meeting participants, including APA President Carolyn Robinowitz, M.D.
and president-elect Nada Stotland, M.D., M.P.H., vowed to work with national
mental health organizations and government officials to improve women's access
to mental health services.
Credit: Eve Bender
And when women do disclose mental health concerns, they are most likely to
do so to their primary care physician, while men are more likely to seek
specialty mental health care and are the principal users of inpatient care for
symptoms of mental illness, according to Primm.
She also reminded meeting participants that culture plays a significant
role in how women experience symptoms of mental illness, experience stigma
related to those symptoms, and seek help for them.
Racial and ethnic minorities have several risk factors for developing
mental health problems, including poverty, discrimination, and immigration
stressors, and are less likely to seek out a mental health specialist than are
whites. "We must continue to look for ways to develop more effective
interventions for depression and other mental health issues in low-income
communities of color," Primm said.
She also highlighted three factors that may help protect women against
development of mental health problems, especially depression. "It's
important that women have autonomy to exercise some form of control in
response to severe events" or adverse circumstances, she said. In
addition, having access to resources that enable them to make choices in the
face of these events is essential.
Finally, having support from family, friends, and health care providers is
a protective factor for women.
Given the barriers to and protective factors for good mental health in
women, meeting attendees were charged with creating a list of recommendations
for policymakers and mental health professionals working with women.
Meeting participants suggested that both communitywide and more specialized
mental health education initiatives for primary care providers would be
helpful, as would combining primary care and mental health services in a"
medical home" concept.
They also recommended establishing mentoring and peer-support programs for
adolescents in schools and communities and strengthening research findings by
including ethnically and racially diverse women in clinical studies.
Primm and Stewart acknowledged the complexity of tackling the issue of
improving women's mental health and emphasized the need for continued
"We must continue to reach out to other national organizations on
issues of women's mental health and wellness" in order to implement
these recommendations, Primm said. ▪