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Putting Women's Mental Health on the Agenda

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The Government commissioned Mental Health Taskforce has reported, painting a bleak picture of the high levels of mental ill health in England and revealing the fact that three quarters of people with a mental health condition aren't getting any support. But encouragingly the report also recognises that there is increased public understanding and awareness around mental ill-health and political will to do more to tackle it.

Whilst the needs of a number of specific groups are recognised, one thing the report doesn't really highlight is the differences between men and women's mental health. Women's mental health is mentioned only with regards to perinatal mental health care, yet women tend to experience more common mental health disorders than men across their lives: more depression, more anxiety, more eating disorders, more PTSD. Men and women both need mental health support, but we've got to start talking about why women are more likely to develop certain conditions than men.

Agenda research shows that the difference between men's and women's rates of mental ill-health is closely linked to the fact that women experience much more abuse, both physical and sexual, than men. 84% of those who experience the most extensive physical and sexual abuse are women and of those, over half have a common mental disorder.

The women and girls Agenda campaigns for are particularly vulnerable to mental ill-health. Our members work with the most excluded women and girls: those who have experienced extensive abuse, and whose lives have spiralled off course. They are often traumatised, have low self-esteem, and struggle with serious mental health problems. Many turn to drugs and alcohol to cope.

These are the women who end up in prostitution, in prison, or on the streets. Their traumatic experiences make it hard for them to rebuild their lives and vulnerable to further abuse. Their needs are complex, and getting the right support can mean the difference between independent and fulfilling lives, or disability, disadvantage, and early death.

These are women for whom trauma and abuse often starts in childhood. The Mental Health Taskforce reported that half of all mental health problems are established by the time a child is 14, rising to 75% by the age of 24. So the report's focus on providing help early is key. But it is important to recognise the gendered nature of boys' and girls' mental ill health, and the differing experiences, societal pressures and expectations that impact on these.

The same is true for adult women, yet too little provision recognises this. For anyone with complex needs, it can be hard to access mental health support. But for women, this can be compounded by the sometimes overly clinical response from mental health services which fails to recognise the wider pressures and realities of women's lives. Not recognising that women with mental health problems are very likely to have experienced trauma and abuse. Insisting that women go through mixed-gender services where they may not feel safe. Refusing mental health treatment to women with addictions, and addiction treatment to women with mental health problems. Giving women no option but to move from crisis to expensive crisis, derailing their families, their communities, and their own lives.

Perinatal mental health support for women is vital. But by the time the most excluded women get there, they will have suffered from mental ill health for significant periods with opportunities for support missed. So while Agenda welcomes the vital extra funds for these services, we urge the government to commit to catching women and girls' mental health needs earlier.

Women and girls who have suffered the most extensive abuse and violence need the choice of specialist support when they experience mental ill-health. This cannot be purely clinical but must link to wider holistic support. There are projects run by voluntary organisations across the country providing the kind of care that works for these women. Dedicated, women-only, trauma-informed services which provide a safe space for women to open up about their experiences in a way they may not be comfortable doing around men. Services which help women rebuild self-esteem, and provide hope that life can get better. That provide support around domestic and sexual violence, parenting, housing, debt, employment and a whole range of other services.

This model, when provided alongside mental health treatment and addiction support, can help women in the most difficult circumstances get back on their feet. But these services are few and far between and often struggle for funding. A big frustration expressed by many is their difficulties in getting the women they work with proper mental health support.

Health services need to be attuned to women's mental health. From the head of the CCG making decisions about what services should look like, to GPs, to those working in A & E, everyone in the NHS needs to know that women's mental health, trauma and abuse are strongly linked, and to implement a trauma-informed response and put in place the right services that take account of this.

Bringing mental health up to parity with physical health will be one of the most significant advances in healthcare within the lifetime of the NHS. Let's do it with due regard to the differences between men and women, and particularly for those who most need a good quality mental health care system.

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