IWD 2023 #Embrace Equity in mental health care

By Dr Margaret Nakhid-Chatoor

Psychologist/Educator

email: mncpsych17@gmail.com

This year 2023, the campaign theme for International Women’s Day, #EmbraceEquity, seeks “to get the world talking about why ‘equal opportunities are no longer enough’ – and can in fact be exclusionary, rather than inclusive”.

It brings to the forefront the difference between equality and equity, as for many persons these words are interchangeable or carry the same meaning. They are not.

‘Equality’ is when everyone gets the same opportunities and while this can be considered as an improvement in some sectors, we all know that one size does not fit all and that some persons, due to ACEs – adverse childhood experiences – and/or disabilities, will need extra benefits and resources if they are to succeed in life.

But where do we start? How do we close the gaps? The focus for this year on DEI – diversity, equity, and inclusion – begs the question, especially in proper mental health care.

Very rarely do we embrace equity with persons who are mentally ill. Mental health affects everyone and more so, women who are victims of domestic violence every day, and who continue to endure the mental and emotional, traumatic effects of adverse circumstances.

According to Moreno and Chhatwal (2020) on equity in public health, they posit that “women have higher rates of mental disorders, such as depression, anxiety disorders, eating disorders, and trauma-associated conditions, compared with men. They are also more likely to be victims of trauma or abuse in the form of domestic violence, sexual assault, and human trafficking. Women from ethnic and racial minority groups are also less likely to access care, even when it is available”.

When these traumatic experiences affect their mental health, women tend to be marginalised by family members, friends and co-workers, and this social exclusion can decrease mental well-being.

Many women are therefore reluctant to seek help and counselling for fear of stigma or discrimination.

What if?

What if we had a world free of bias, stereotypes, and discrimination against women with mental illness – a world where they are valued and celebrated and their mental health seen as crucial to the survival of family life and economic growth in any society?

How can we break down the barriers that currently exist to equitable care in mental health for persons? Which politician or equal opportunities advocate is ready to examine the policies and systems that have un/intentionally widened the gap, preventing equitable distribution of resources to underprivileged individuals and groups, especially women and children affected by mental illness?

Collective activism – from all sectors of society, business, the pulpit, stakeholders in education, law enforcement, politics—will drive change.

Moreno and Chhatwal further stress that “leaders of mental health agencies and individual providers must make health equity an important part of their mission and contribute toward it according to their capacity”.

Whilst those affected by mental illness and their families await these much-needed changes to happen in public health care and if research on these inequitable factors is to be seriously considered and understood, the gaps to equity need to close sooner than later for women with mental illness. Collectively and across all sectors, we must #Embrace Equity by:

• Working proactively with diverse families who have experienced serious mental illnesses and emotional disturbances
• Helping women with mental illness to examine the implicit biases and factors – fear of discrimination; past failures; added social stressors – which prevent them from moving towards improvements in their own mental health
• Providing training for social workers and mental care physicians and nurses who interact with these groups to reduce the biases and poor cultural understandings of mental health in families; for example, the differences between somatic symptoms versus mental health symptoms. It is necessary to understand the background, race, culture, and belief system and the ecological context in which such people live – to ask them what impacts their mental health and to consider, rather than disregard, their own lived experiences which have shaped their outlook on life.

International Women’s Day #EmbraceEquity, allows us to critically examine all of these varied factors and to lobby for additional assistance for women and children who are unable to access mental health services.

Let us #EmbraceEquity for mental health, regardless of race, ethnicity, sexual orientation, or socioeconomic status.

Let us educate women with mental illness, especially those who are disadvantaged and dispossessed, on how to successfully navigate health care systems in this country for proper care for themselves and for their families.

Together, we can forge women’s equality as we all #embrace equity.