HOW TO CONSIDER MENTAL HEALTH FROM AN INTERSECTIONAL APPROACH
In the field of psychology, mental health diagnoses such as “depression” or “bipolar disorder” are defined by a series of symptoms. One of the most common diagnostic manuals is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), created by the American Psychiatric Association. If we take a look at the “depression” diagnosis, the DSM-5 includes symptoms such as “Depressed mood most of the day, nearly every day.” or “Feelings of worthlessness or excessive or inappropriate guilt nearly every day”. When referring to the person receiving the diagnosis, the DSM-5 uses the gender-neutral term “the individual”.
Diagnostic labels and symptoms are neutral and do not specifically take into account factors such as gender identity, race, ethnicity, class, or sexual orientation. However, all of these factors play a very important role in mental health detection, prognosis, and likelihood. Here are some important considerations when looking at mental health from an intersectional perspective:
Men are socialized to repress feelings and emotions
The negative male gender role of being unemotional, and also aggressive, is what has been described as "toxic masculinity". This stems from very early experience and socialization- While girls generally learn to identify and communicate emotions from a young age, boys are taught the opposite- to hide and repress emotions. When boys show sadness or emotional vulnerability, they are encouraged to “tough it out” and not “act like a girl”. It is no surprise that later on, in adulthood, women are more prone to identifying and articulating mood fluctuations, while men may repress them and also be perceived to be emotionally resistant. It is common for men to cover up their mental health disorders through substance use, violent behavior, or recklessness. Toxic masculinity causes severe psychological damage to men and leads to multiple arrays of social threats including sexual assault, partner violence, hate crimes, and domestic terrorism.
Men suffering from mental illness are less likely to get professional treatment
According to the World Health Organization, depression is twice as likely to be diagnosed in women as compared to men. However, this data does not necessarily mean that women are more likely to feel depressed moods, it just tells us that women are the ones that end up being diagnosed. Psychological distress is socially considered a sign of weakness, which affects the likelihood of men seeking and receiving professional help. The American Foundation for Suicide Prevention reports that men are three times as likely to commit suicide than women, and experts point out that this is directly connected to the failure to adequately detect psychological distress in men.
Women are typically overrepresented in mental health populations
It is more likely for a woman to see a mental health practitioner, and it is more likely for practitioners to consider that women have mental health disorders. The result is that mental health populations are largely composed of women. This has been consistent throughout the relatively brief history of psychology as a scientific discipline. In the wake of experimental psychiatry in the late 18th century Europe, male doctors were primarily treating upper-class women diagnosed with the exclusively female label of “hysteria”. Women “trouble-makers” that defied patriarchal systems where pathologized, and even punished or confined. Although we have evolved significantly, the tendency to over-medicate and over-represent women in mental health populations remains.
Women and non-male populations experience certain social injustices more often than men
Social injustices including sexual assault or domestic abuse are more often experienced by women and non-binary people. The higher likelihood of these traumatic experiences that impact women and non-binary psychology in a very unique way. Exposure to sexual violence is highly correlated to the severity of mental health issues, as is the likelihood of attempting suicide. Also, women are subject to certain social expectations in terms of physical appearance and beauty standards. The pressure to reach unrealistic beauty standards can severely damage women’s confidence, leading to self-esteem problems and eating disorders. In addition to this, taking charge of the emotional health of a family or a social group is a traditionally female task - also known as the term “emotional labor”- and this may also result in increased mental distress.
People of color are particularly vulnerable to mental health-related inequities
Many diagnostic labels and symptoms have been built through years of racially-biased research. Another import factor is that for decades, most of the clinicians leading the research were white men. As a consequence, what was considered normal versus pathological was often based on Caucasian or western codes of conduct. Today, this continues to be an issue in psychiatry, especially because there are still not enough practitioners that are sensitive to racial and cultural differences. The lack of culturally-competent providers means that people from communities of color are at risk for not receiving adequate treatment. Mental Health America reports that African-American women are typically overrepresented in severe psychiatric disorders, such as schizophrenia. They also point out that distrust of authority, in the context of a country that has historically targeted and marginalized them, leads communities to not seek professional treatment. Low-income people of color with mental health issues are at very high risk of falling victims of mass incarceration.
Trans people and gender minorities are often excluded in binary mental health research and are at high risk to experience psychological distress
The fact that non-binary people are often not included in mental health research makes it difficult to assess the prevalence of mental illness and its manifestations. Mental health research specific to queer populations shows that they present higher depression and anxiety scores than non-gender minority individuals. This is often aggravated by the social stigma and abuse they endure, particularly during their childhood and adolescence years. The American Academy of Pediatrics reports harrowing statistics of suicide attempt rates among trans youth- more than 41% have attempted suicide at some point in their lives.
WHAT CAN WE DO TO PROMOTE MENTAL HEALTH FOR ALL?
Mental health is not a stand-alone factor. Human rights - such as safety, fair work conditions, housing, healthcare, education, ecology, freedom of expression, social and cultural rights- are fundamental in guaranteeing a well-balanced and psychologically healthy society. At these times in which human rights are being increasingly threatened, we must put as much effort as we can in defending free access to quality mental health and counseling programs. It is important for us to advocate for this as individuals, and also to demand our elected officials to provide free resources in our communities, schools, and hospitals.
It is helpful for us to be supportive of people that are struggling with mental health problems. We should make efforts to not stigmatize them, offer them company, talk to them, and to show compassion towards them. There are several low-cost and/or free resources that are specific to gender or gendered issues: such as women’s advocacy groups, men’s groups, sexual assault survivor support groups, and LGBTQI counseling services among others. Some mental health associations offer free or low cost individual therapy. It is also important to keep in mind that everyone needs to take care of their mental health, even if a diagnosis or illness is absent. Working to create and maintain an open and free social environments - such as reading groups, community associations, advocacy groups- is an excellent way to have fun and take care of each otherr
In the field of psychology, mental health diagnoses such as “depression” or “bipolar disorder” are defined by a series of symptoms. One of the most common diagnostic manuals is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), created by the American Psychiatric Association. If we take a look at the “depression” diagnosis, the DSM-5 includes symptoms such as “Depressed mood most of the day, nearly every day.” or “Feelings of worthlessness or excessive or inappropriate guilt nearly every day”. When referring to the person receiving the diagnosis, the DSM-5 uses the gender-neutral term “the individual”.
Diagnostic labels and symptoms are neutral and do not specifically take into account factors such as gender identity, race, ethnicity, class, or sexual orientation. However, all of these factors play a very important role in mental health detection, prognosis, and likelihood. Here are some important considerations when looking at mental health from an intersectional perspective:
Men are socialized to repress feelings and emotions
The negative male gender role of being unemotional, and also aggressive, is what has been described as "toxic masculinity". This stems from very early experience and socialization- While girls generally learn to identify and communicate emotions from a young age, boys are taught the opposite- to hide and repress emotions. When boys show sadness or emotional vulnerability, they are encouraged to “tough it out” and not “act like a girl”. It is no surprise that later on, in adulthood, women are more prone to identifying and articulating mood fluctuations, while men may repress them and also be perceived to be emotionally resistant. It is common for men to cover up their mental health disorders through substance use, violent behavior, or recklessness. Toxic masculinity causes severe psychological damage to men and leads to multiple arrays of social threats including sexual assault, partner violence, hate crimes, and domestic terrorism.
Men suffering from mental illness are less likely to get professional treatment
According to the World Health Organization, depression is twice as likely to be diagnosed in women as compared to men. However, this data does not necessarily mean that women are more likely to feel depressed moods, it just tells us that women are the ones that end up being diagnosed. Psychological distress is socially considered a sign of weakness, which affects the likelihood of men seeking and receiving professional help. The American Foundation for Suicide Prevention reports that men are three times as likely to commit suicide than women, and experts point out that this is directly connected to the failure to adequately detect psychological distress in men.
Women are typically overrepresented in mental health populations
It is more likely for a woman to see a mental health practitioner, and it is more likely for practitioners to consider that women have mental health disorders. The result is that mental health populations are largely composed of women. This has been consistent throughout the relatively brief history of psychology as a scientific discipline. In the wake of experimental psychiatry in the late 18th century Europe, male doctors were primarily treating upper-class women diagnosed with the exclusively female label of “hysteria”. Women “trouble-makers” that defied patriarchal systems where pathologized, and even punished or confined. Although we have evolved significantly, the tendency to over-medicate and over-represent women in mental health populations remains.
Women and non-male populations experience certain social injustices more often than men
Social injustices including sexual assault or domestic abuse are more often experienced by women and non-binary people. The higher likelihood of these traumatic experiences that impact women and non-binary psychology in a very unique way. Exposure to sexual violence is highly correlated to the severity of mental health issues, as is the likelihood of attempting suicide. Also, women are subject to certain social expectations in terms of physical appearance and beauty standards. The pressure to reach unrealistic beauty standards can severely damage women’s confidence, leading to self-esteem problems and eating disorders. In addition to this, taking charge of the emotional health of a family or a social group is a traditionally female task - also known as the term “emotional labor”- and this may also result in increased mental distress.
People of color are particularly vulnerable to mental health-related inequities
Many diagnostic labels and symptoms have been built through years of racially-biased research. Another import factor is that for decades, most of the clinicians leading the research were white men. As a consequence, what was considered normal versus pathological was often based on Caucasian or western codes of conduct. Today, this continues to be an issue in psychiatry, especially because there are still not enough practitioners that are sensitive to racial and cultural differences. The lack of culturally-competent providers means that people from communities of color are at risk for not receiving adequate treatment. Mental Health America reports that African-American women are typically overrepresented in severe psychiatric disorders, such as schizophrenia. They also point out that distrust of authority, in the context of a country that has historically targeted and marginalized them, leads communities to not seek professional treatment. Low-income people of color with mental health issues are at very high risk of falling victims of mass incarceration.
Trans people and gender minorities are often excluded in binary mental health research and are at high risk to experience psychological distress
The fact that non-binary people are often not included in mental health research makes it difficult to assess the prevalence of mental illness and its manifestations. Mental health research specific to queer populations shows that they present higher depression and anxiety scores than non-gender minority individuals. This is often aggravated by the social stigma and abuse they endure, particularly during their childhood and adolescence years. The American Academy of Pediatrics reports harrowing statistics of suicide attempt rates among trans youth- more than 41% have attempted suicide at some point in their lives.
WHAT CAN WE DO TO PROMOTE MENTAL HEALTH FOR ALL?
Mental health is not a stand-alone factor. Human rights - such as safety, fair work conditions, housing, healthcare, education, ecology, freedom of expression, social and cultural rights- are fundamental in guaranteeing a well-balanced and psychologically healthy society. At these times in which human rights are being increasingly threatened, we must put as much effort as we can in defending free access to quality mental health and counseling programs. It is important for us to advocate for this as individuals, and also to demand our elected officials to provide free resources in our communities, schools, and hospitals.
It is helpful for us to be supportive of people that are struggling with mental health problems. We should make efforts to not stigmatize them, offer them company, talk to them, and to show compassion towards them. There are several low-cost and/or free resources that are specific to gender or gendered issues: such as women’s advocacy groups, men’s groups, sexual assault survivor support groups, and LGBTQI counseling services among others. Some mental health associations offer free or low cost individual therapy. It is also important to keep in mind that everyone needs to take care of their mental health, even if a diagnosis or illness is absent. Working to create and maintain an open and free social environments - such as reading groups, community associations, advocacy groups- is an excellent way to have fun and take care of each otherr