More Than 140 Countries Pledge to Improve Mental Health of Women

Monday, July 26 2010

More than 140 countries have pledged to improve the mental health of women, thanks to our own Dr. Donna Stewart.

An international consensus statement written by Dr. Stewart was passed at the XIII World Congress of Psychiatry in Cairo at the end of September, much to her surprise. Signing on were not only countries that have already made leaps forward in promoting women's mental health, but also nations where harassment of women is routine, where lack of opportunity for women is endemic and even where violence against women is a religious right of men.

"I thought it wouldn't pass, but it passed. It is now policy. I was delighted," Dr. Stewart told the Medical Post. "I hope it leads to women having better lives."

The International Women's Mental Health Consensus Statement recommends women's mental health become a priority when groups such as health-care organizations, providers, governments, the UN, WHO and NGOs set policy. This cannot be achieved without women having access to basic human rights such as education, safety, legal rights, employment and health care, not to mention food, water and shelter.

One of the recommendations is that organizations support sexual and reproductive choices for women, a clause that may be impossible to implement in cultures where men are in charge of women's choices.

"I hear from my friends in Pakistan that women still get stoned in the provinces for seeing a guy without a chaperone," said Dr. Stewart, citing just one example of the obstacles that stand between women and good mental health.

The statement also calls for better research, eradication of gender harassment, women's choices in treatment, and safe and appropriate mental health care.

"In countries where fundamentalist philosophies prevail, there were greater hurdles to ratification," said Dr. Stewart. "Violence against women plays a huge role in these countries. Women can be killed as sacrificial victims."

In many places around the world, access to mental health care is either non-existent or so unpleasant that women won't seek it out. For instance, "the stigma of illness means a woman will never get married."

Dr. Stewart is pragmatic about how binding the recommendations are. "Like the UN, you do get countries signing on and doing nothing. But these countries are now obligated to try to implement them." Besides, the world is now watching. "You can't go and say, 'You're not doing this, this and this.' But you can say, 'This is policy; what are you doing about it, and how can we help you?' "

Even in Canada, the U.S., Israel and some European countries, Dr. Stewart faced "a lot of foot dragging" when preparing to get the consensus statement passed. "Psychiatry is dominated by men," she said.

Dr. Stewart, chairwoman of the women's health program at the University Health Network in Toronto, was in Cairo acting on behalf of the International Association of Women's Mental Health (IAWMH), of which she is president. In preparing for the vote, she linked the forces of the World Psychiatric Association (she is past chairwoman of the women's mental health section of the WPA) with the IAWMH, realizing "we have to get the guys on board as well."

On the day of the vote, luck was on Dr. Stewart's side. The mental health statement was on the agenda very late in the day, when delegates had little fight left in them. Not only that, but a rash of diarrhea and vomiting swept the meeting, owing to water problems, which meant there was a fair amount of traffic to and from bathrooms. Dr. Stewart will say only this: "The ease of passage reflected its lateness on the agenda."
 

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