PSYCHIATRIC CARE FOR WOMEN

Psychiatric Care for Women

Psychiatric Care for Women

Introduction

In any given year, approximately 13% of women will have a diagnosable depressive disorder. About one in five women will experience an episode of major depression during her lifetime, twice the rate seen in men. Anxiety disorders are also more common in women than in men. Although they often receive less attention than depressive disorders, anxiety disorders are the most common psychiatric disorders in the United States (U.S. Department of Justice, 2001). Slightly more than one third of women will experience an anxiety disorder in their lifetime; in any given year, almost a quarter of American women will be affected with an anxiety disorder. Anxiety disorders include such diagnoses as specific phobia, social phobia, agoraphobia, panic orders, and generalized anxiety disorder (Reed, 2003). Psychiatric disorders often go undetected and treated in women, and it is estimated that only 30% of patients with anxiety disorders actually receive treatment for their conditions.

In this context, psychiatric treatment was used to punish rather than care for women. The use of psychiatry for political ends remains a concern within Russia and elsewhere (Bassuk, 1997).

Psychiatric Care and Gender Issues

An issue related to psychiatric abuse within prisons is the over prescription of antipsychotic or mood-modifying medication. For example, a survey of U.S. state public and private adult correctional facilities in 2000 reported that approximately 10% of women received psychotropic medication (U.S. Department of Justice, 2001). Although this survey did not provide a gender breakdown, other research indicates that women are more likely to receive psychotropic medication than men (Barrow, 1999). This may reflect the fact that women are more likely to be diagnosed with and treated for a mental disorder. A similar trend is apparent in the general population.

However, the degree to which this represents “real” gender differences or is a product of sexist diagnosis and treatment is a matter of much debate. It is also important to recognize that sexist and sexually abusive practices within prisons may contribute to mental health problems among women. Similarly, racism within the prison regime, including psychiatry, may contribute to mental health problems and inadequate psychiatric care (Barrow, 1987).

Age is related to a woman's family status, but it also has other implications for how women experience homelessness. In the 1996 Urban Institute survey, 15 percent of unaccompanied women were fifty-five or older. Some older women approximate the “shopping bag lady” stereotype: isolated, reluctant to accept contact or help except on her own terms, ensconced in an alternative reality structured by mental illness. And research has found high rates of psychiatric problems in this group: In a New York study of older women, 42 percent showed evidence of psychotic symptoms and 27 percent reported past psychiatric hospitalizations; a study in Virginia found that 48 percent of women over fifty had received mental health or substance abuse services, and 40 percent were receiving Supplementary Security Income (SSI) or Social Security Disability (SSD) benefits. However, older women with indicators of psychiatric disorders are a minority; ...