This International Women’s Day, it’s important to shed light on the disparities that exist between the sexes in mental health care. We’ll examine how women are underrepresented in mental health clinical trials and research, how referrals to treatment vary between the sexes from childhood into adulthood, and how the sexes are diagnosed and treated for mental health conditions differently based on gender.
Gender gaps have existed for centuries and still do today as it relates to the diagnosis and treatment of mental health disorders.
A man and woman could present with the exact same mental health symptoms, yet receive two completely different diagnoses and treatment options.
The prevalence rates for common mental health disorders, such as anxiety and depression, are nearly twice as high for women as they are for men.
Gender disparities in research studies
There are a variety of gender inequalities in society today, and mental health is one of the biggest areas where gender inequality in health care is apparent. In Europe, for example, even though women make up over half of the population, they are drastically underrepresented in biomedical research. Failing to have a sufficient population of women in research and clinical trials puts the health and lives of women at risk.
Mental health gender gaps begin in childhood
In the U.S. there is a disparity between genders in terms of traits and characteristics that are more visible in one gender than the other, leading to more boys being referred for mental health treatment than girls. This is because boys tend to externalize what they are going through, while girls internalize more. Teachers are also less likely to refer someone to treatment if their academic performance isn’t suffering, which is also a trait more common in females, as they tend to perform better in school in comparison to males. For example, ADHD often goes undiagnosed in females because of the different ways it presents in females as opposed to males. Females tend to do more daydreaming, while males tend to be more active, hyper, and external with their symptoms.
Gender differences as they relate to mental health continue into adolescence. Males are socialized to see therapy and opening up about their feelings and emotions as a weakness, while women are encouraged to do so. In their teen years, girls are more likely to talk with a trusted friend about any struggles they are facing than boys are. This feeds into the stigma surrounding mental health that’s been slowly challenged over the years. It also leads to men being more resistant toward therapy and mental health services into adulthood.
Inequalities in diagnosing and prevalence rates
When it comes to diagnosing mental health disorders and the overall prevalence rates, the most common mental health disorders, such as depression, are nearly twice as likely to be diagnosed in females than in males, even when the two present with identical symptoms. Furthermore, women are more likely to be prescribed medications, while men are more likely to be diagnosed with substance use disorders. The same can be said of anxiety, which is another common mental health disorder more commonly diagnosed in women.
Socioeconomic status has also been linked to greater gender gaps in mental health treatment and diagnosis. Women account for 70% of the world’s lowest paid workers, and these gender roles and pay gap inequalities still exist in society today.
Gender bias differences in mental health
Gender biases have contributed to the ways that males and females receive mental health treatment since the birth of psychology. Women were oftentimes diagnosed with hysteria, a disorder that was exclusive to females for centuries, with roots dating back to ancient Egypt. It wasn’t until recently that research solidified the fact that males can also have hysteria. These biases still continue today, especially when it comes to anxiety and depression prevalence rates in females vs. males. Males have a greater tendency to be diagnosed with behavioral disorders as opposed to mood or anxiety disorders.
How can we close the gender gap?
In order for mental health professionals to more accurately diagnose and treat patients, more education is needed surrounding gender equality so that men who have depression can get the help they need and women who have substance use disorders can as well. The fact that a man and a woman can show up with identical mental health symptoms and receive two completely different diagnoses and treatments is a call to action concerning the need for equality as it relates to both women’s and men's health.
It is alarming that women receive depression or anxiety diagnoses and are prescribed psychotropic medications more than men who experience the same symptoms. Men are told that they drink too much and may be sent to rehab or told to attend an outpatient treatment program or recovery meetings, but are they having their needs substantially addressed? And what about the women who may be struggling with substance use disorders and who are being wrongly diagnosed and treated for anxiety and depression? It’s an ongoing argument of what came first, the chicken or the egg, as symptoms of substance use can show up as anxiety and depression, and on the same token, those who are suffering from anxiety or depression may self-medicate with drugs or alcohol in place of medication.
It's important for pharmaceutical companies and mental health researchers to ensure that there is the equal representation between genders in research studies so that both men and women are able to have access to the most accurate, up-to-date information about their symptoms as well as the best treatment options available. Mental health is a bit trickier in terms of diagnosing than physical health, as it’s not always so cut and dry. Physical ailments can be found using diagnostic tools such as imaging and microscopic inspection, but when it comes to mental health, diagnoses can vary drastically from one professional to the next.
More awareness of this issue will bring to call these disparities and the need for mental health equality. This is something that can only happen through greater awareness, training, and education surrounding gender equality and how mental health disorders can present differently in males and females, along with the stigmas that go along with each of the sexes.
- Singapore Medical Journal. Gender Differences in Mental Health.
- Clinical Practice and Epidemoiology in Mental Health. Women and Hysteria in the History of Mental Health.
- Social Psychiatry and Psychiatric Epidemiology. The gender gap in mental health service use.
- Mental Health. Gender disparities in mental health.
- Journal of Adolescent Health. Stigma starts early: Gender differences in teen willingness to use mental health services.
- Journal of Emotional and Behavioral Disorders. Understanding Gender Differences in Referral of Children to Mental Health Services.