Journal of Women's Health Care
Open Access

Are Women more Susceptible to Mental Health Issues?

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Introduction

The world is facing a pandemic creating a health crisis and affecting people's life in unimaginable ways. COVID-19 has increased the depth of our preexisting differences and exposed the faults in our systems, thereby amplifying the effects of pandemic. The layered effects of Covid-19 have created a plethora of problems for women and girls.

Physical distancing and stay at homes orders which are problematic for everyone had larger implications for women in every aspect of their lives. Majority 70% of women work in the informal economy; they hold less secure jobs, earn less and save less. With the global economy undergoing recession creating unemployment in every sector of the economy, women have the limited capacity to absorb the economic shocks and are more likely of falling into poverty. Adding to this, there has been an exponential increase in unpaid care work with closure of schools and heightened care needs of family members at home [1]. Women are spreading themselves thin as they bear the brunt of household responsibilities. This ever increasing competition between home and work demands place their jobs at further risk with cuts (inability to avail paid sick leave) and layoffs. Single parent or female headed households are facing more difficulties in supporting themselves and their families.

Loss of financial independence along with controlled finances keeps women sticking to their relationship and makes them more vulnerable to exploitation and abuse. In addition to this limitation of movement, limited decision making capacity further threaten their safety and autonomy at home. Family members may indulge in neglectful tactics to exert power, including continuous badgering upon them, belittling their efforts, refusing access to jointly owned money and threatening to cause harm. Neglectful strategies include withholding interaction, invalidating their feelings and inferring to woman that she is inferior [1].

Psychological abuse often precedes physical and sexual violence in relationships; depriving them of basic necessities, causing harm, using coercion, manipulation or guilt to have sex and making derogatory remarks about one's sexuality or body. Covid 19 has presented a scenario of increased incidence of family abuse, intimate power violence and more complications in reporting and seeking help. With minimal community support, disconnections from social networks and inability to take temporary refuge from 'outside spaces' or have access to 'private spaces', women are facing chronic distress [2].

Women trapped in this vicious cycle of tension, power and control are vulnerable to facing varied mental health concerns, including depression, anxiety ant trauma. Social stigma and lack of social support often lead to non-reporting of abuse and directing the anger, humiliation and fear towards themselves, leading to feeling of worthlessness and helplessness. This may also result in trauma bonding. If women experiences abuses as well love from his partner, they learn to associate love with abuse. This leads to rationalization and justification of abuse and such cases are less likely to be reported [2].

For those already facing these grim situations, it may further deteriorate their experience of mental health conditions. Symptoms may include(but are not limited to)the following: negative self-perception, persistent low/anxious/empty/erratic mood, inability to sense pleasure, difficulty paying attention, disturbed memory, changes in eating and sleeping habits, fatigue, bodily pains and thoughts of self-harm and suicide [1,2].

During the health crisis, as regular healthcare facilities are often diverted to emergency services, women do not have access to sexual, reproductive and maternal health services. Challenges in getting contraception, safe abortion and medication further leads to isolation, violence and feeling of shame and worthlessness and increases the risk to women's health and wellbeing. Visible and invisible scars of harassment and violence remain with women throughout their lives [2,3].

As we stand in the middle of this historic inflection point, our collective response must be equally historic and urgent. Through the ages, women have proved to be the backbone of recovery in communities, as they serve their families, households and communities during difficult times. They need to be considered equally in economic planning, policy designing, decision making and emergency response planning [3].

Individuals and communities must be sensitized about Covid-19's effect on mental health of women, and work towards addressing long standing differences. Governments should take immediate measures and coordinate efforts between local governing bodies, civil society organizations and mental health organizations to ensure women's safety. This is not only about combating the inequalities but building a better world, one in which interests of everyone is taken care off.

Strategies may include to:

• Designating domestic violence shelters as essential services and increasing resources to them and groups on the front line of response.

• Designating safe spaces to report abuse with the benefit of anonymity.

• Availability of online services and creating social networks for survivors.

• Working towards increasing awareness and advocacy campaigns.

• Provide and increase social protection for caregivers to mitigate the effects of the overload of unpaid care work (for example providing family and paid sick leave, flexibility in work timings etc.).

• Prioritize sexual and reproductive healthcare services and legal help.

References

1. Leung CC, Lam TH, Chengc KK. Mass masking in the COVID-19 epidemic: people need guidance. Lancet. 2020;395(10228):945.
2. https://www.who.int/emergencies/diseases/novel-coronavirus- 2019/advice-for-public