Women and Mental Health – Prevention, Screening and Management NHS - February 26, 2014

Depression & Stress?

Research evidence show that men and women have differential mental health risks Why Women? Environment ( Work, Home) Triple Burden Psycho-social(expectations, marriage, family, male-child, extended family etc.)

Women’s Triple Role Burden Reproductive: Childbirth and care Domestic: Food preparation, washing, cleaning, cooking etc. Productive: Wage earning and income-generating activities Women’s heavy workload is time-consuming Women’s heavy workload is time-consuming

Gender socialization theory in stress management: Women show high internalizing responses to stress Men show high externalizing responses to stress (Ostrov, offer & Howard 1989)

Social model of mental health explains the stressors faced by women beyond the reproductive such as: Low paid jobs Unemployment Emotional & sexual violence Psychological costs of home making and child rearing

Anxiety and depression Common during pregnancy in Pakistani women Rates are highest in women experiencing sexual/physical abuse Increased among women with unemployed spouses and those with lower household wealth. (Karmaliani & Asad,2008)

Women experiencing verbal and emotional abuse during pregnancy have higher rates of suicidal ideation and attempts (Asad &Karmaliani, 2010)

Risk of depression Married women than single women Increasing age, lower educational levels, the presence of in-laws, heavy household work and pregnancy symptoms (Kazi 2000) (Fikree, 1999; Khan, 1998)

Management Mental health services integrated within the primary health care Screening for mental health problems integrated within routine antenatal and post natal checkups

Socio-cultural Work-life balance Negotiating for sharing of responsibility Career counseling. Economic independence Better vocational and recreational opportunities for women

Woman’s Role Coping Resources