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Gender and Mental Health

A call to oust out-dated gender generalisations within mental health.

 By Will Sutherland

http://capmh.biomedcentral.com/articles/10.1186/s13034-015-0088-x

There’s an old story about Arthur Miller from the opening night of his play, Death of a Salesman. He watched from the back of the theatre as his play was brought to life publicly for the first time. Typically, it would be difficult to gauge the audience reaction to a drama during the play, but this one was different. Throughout the production Miller noticed a strange metronomic response to his play. The shoulders of the suited men in the audience started bobbing up and down, as they tried to subdue their tears. These men had seen themselves, their ambitions and their paternal relationships reflected to them, perhaps for the first time.

Last year, at a party, I met a family member’s partner for the first time. He asked me what I did. I told him I’m studying to be a psychologist and with the quick draw of a Wild West sharpshooter, he responded with- ‘Psychologists are the most messed up out of everyone’. This guy, who I’d met maybe 15 minutes earlier, was suggesting that all Psychologists were more mentally unstable than the normal population. At that point I realised, this guy could not find out I used to be a part of the other group in society, considered equally as ‘messed up’: comedians. Now, telling someone they’re most-likely ‘messed-up’ is obviously a great conversation starter, but in other contexts generalising predictors of mental health is drastically neglectful.

The first aim of this article is to oust out-dated gender generalisations within mental health. Secondly, to suggest we be a little more curious about the nuanced variables that moderate predictors of mental health. Otherwise stated, everyone is messed up’ but in their own way. I have especially noticed many reductive presumptions involving men’s mental health, that don’t align with my observations nor the research1, 2. The first presumption I notice is that men’s emotional distress could be eliminated or reduced if they simply talked more about their feelings. Perhaps this is extrapolated from how effective discussing emotional distress within social groups can be for women6, 7. The second presumption is that men experience mental health issues at greater rates than women. This may be a mis-attribution from the statistics indicating higher rates of substance abuse and suicide for men3, 8. Either way it’s important for us to continually assess our presumptions and reasoning. This will hopefully yield even more accurate and appropriate mental health assistance for those in need.

In 2018 it was reported that 1 in 5 Australians suffered from a mental or behavioural condition1. Women have higher rates of psychological disorders at almost every age group and with almost all disorder types. This disparity is as large as 25% in the 18-24 age group1. Although, these statistics should encourage a proportionate response to these rates, there are additional variables that complicate things. Firstly, although women are more likely to have a mental health disorder, they are also 30% more likely to seek treatment, when in need3. Secondly, men are over-all three times more likely to die by suicide 8. Finally, how men and women typically process emotional distress is shown to be literally backwards from one another5.

One study in particular supported this difference, showing that gender can moderate the benefits of social support in adolescents with depression5. The study found that a feeling of self-control mediated the relationship between social support and reduced depressive symptoms. However, both genders had a different order to this process. Boys benefited most from the ‘don’t talk about it approach’. This involves first engaging in unrelated physical and social activities without mentioning the distress. This can increase their feelings of self-control and autonomy over their circumstances, which gives them the confidence to discuss their distress. However, girls benefited most when they began by making their social group aware of their distress. Increasing the social group awareness led to restoring their feeling of self-confidence and agency over their life circumstances.

The study is a small example of how differently we can experience and process mental health issues. Since it was published, research has been extended to explore other gender identities including non-binary and transgender populations. Culture has also been explored as a moderating factor within the relationship between gender and distress. The risks of neglected mental health issues can be terrifying and generalisations can ease this with a feeling of certainty. Yet, it is vitally important that we continue to challenge our assumptions and consider the individual nuances in a person’s mental health.

By Will Sutherland

If you or someone you know needs support please consider contacting one of these helpful support lines:

Lifeline: 13 11 14

Beyond Blue: 1300 22 4636

1.  Australian Bureau of Statistics (December: 2018) Mental Health[https://www.abs.gov.au/statistics/health/mental-health/mental-health/2017-18], ABS Website, 24th May 2022.

2.  Australian Bureau of Statistics (December: 2021) First Insights from the National Study of Mental Health Wellbeing, 2020-21 [https://www.abs.gov.au/articles/first-insights-national-study-mental-health-and-wellbeing-2020-21] ABS Website, 24th May 2022.

3.  Australian Bureau of Statistics (October: 2008) National Survey of Mental Health and Wellbeing: Summary of Results. [https://www.abs.gov.au/statistics/health/mental-health/national-survey-mental-health-and-wellbeing-summary-results/latest-release] ABS Website, 24th May 2022.

4.  Sundberg, L., Agahi, N., Fritzell, J., & Fors, S. (2018). Why is the gender gap in life expectancy decreasing? The impact of age- and cause-specific mortality in Sweden 1997-2014. International journal of public health, 63(6), 673–681. https://doi.org/10.1007/s00038-018-1097-3

5.  Martínez-Hernáez, A., Carceller-Maicas, N., DiGiacomo, S.M. et al. Social support and gender differences in coping with depression among emerging adults: a mixed-methods study. Child Adolesc Psychiatry Ment Health 10, 2 (2016). https://doi.org/10.1186/s13034-015-0088-x

6.  Andrews, B., Brewin, C.R. & Rose, S. Gender, Social Support, and PTSD in Victims of Violent Crime. J Trauma Stress 16, 421–427 (2003). https://doi.org/10.1023/A:1024478305142

7.  María P. Aranda, PhD, LCSW, Irma Castaneda, PhD, LCSW, Pey-Jiuan Lee, MS, Eugene Sobel, PhD, Stress, social support, and coping as predictors of depressive symptoms: Gender differences among Mexican Americans, Social Work Research, Volume 25, Issue 1, March 2001, Pages 37–48,  https://doi.org/10.1093/swr/25.1.37

8.  Australian Bureau of Statistics (September: 2021) Causes of Death, Australia [https://www.abs.gov.au/statistics/health/mental-health/mental-health/2017-18] ABS Website, 24th May 2022.

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