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HLTC02H3 (51)
Chapter 13&14

HLTC02 CHAPTER 13 & 14 NOTES.docx

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University of Toronto Scarborough
Health Studies
Joseph Bryant

Chapter 13-Women’s Voices Matter: Creating Women Centered Mental Health Policy (Marina Morrow) Intro  In Canada there is still stigma associated with mental illness and the enduring belief that people with mental illness cannot make sound decisions Women and Health  Mental health is a ‘gendered concept’ –meaning the very notions of madness, mental illness and so forth have positioned women as more vulnerable  Gender differences do exist in the rates of specific mental health problems o Eg women are twice as likely than men to be diagnosed with depression and anxiety, eating disorders, phobias, panic disorders, and more women even attempt suicide compared to men  Possible explanation: women are MORE likely to seek out health care services than men  Research demonstrates that differences between and among women and men is the result of an interaction between biological and psychosocial factors o Treatment focuses more on biological factors...leading to biomedically biased mental health system  PYSCHOSOCIAL explanations examine the ways in which women are more vulnerable to poor mental health  Poverty and social inequality are also key factors in mental health ---which as we know disportionaltely affects women  Other possible social explanations of poor mental health in women include: adverse effects of inferior status, sexual abuse, economic inequalities, discrimination, family burden etc. Citizen Engagement, the Mental Health System and Women  Citizenship is not just about having citizenship rights ( eg legal, political, civil rights) but it’s also about the capacity to ‘practice as citizens’(eg contribute to the creation of public services)  Historically women have been excluded from rights and responsibilities of citizenship  Women with mental illness struggle to have their voice heard due to discrimination and stigma against them  Therefore citizenship for people w/mental illness would allow for their participation in decision making, policies, practices that affects their lives  Mental health in Canada fall under PROVINCIAL jurisdiction  The degree to which a mental health system is responsive to women depends on 2 things: o The degree to which governments have made explicit commitments to improve women’s mental health and o The degree to which women who are or have been recipients of mental health care are active in their citizenship (ie. pushing, lobbying, involved) Women and Mental Health Policy in Ontario, Quebec and British Columbia  Each province has different history when it comes to women’s mental health  Ontario o Strong and radical movement of survivors to impact direction of policy o Although many activists were women, most refused to ally themselves with feminist organizations o Ontario has the widest range of hospital based specialized programs for women o Ontario, esp Toronto, has well developed women’s movement and community based women’s service sector (women’s centers, shelters, rape crisis centers etc)  Quebec o The role of the women’s movement in Quebec is very complex o Heavily fractured and politicized  British Columbia o Unlike Ontario and Quebec, psychiatric survivors in BC have historically not had a political voice o Movement has brought some initiatives but not successful in bringing women’s concerns to forefront of provincial poverty o Used to work under 52 regions, switched to 6 o Movement is not as organized as that of Quebec or Ont. Discussion  We can see how diverse things are when it comes to women’s mental health  Mental health policy must be guided by a gender-neutral framework and the must take into account class, race, age, sexual orientation etc.  One thing that is clear from all three provinces—there is lacking government incentive to this issue Women Centered Mental Health care: Fostering Meaningful participation for women  The adoption of women-centered care principles might facilitate both a better understanding of women’s health issues and develop mechanisms that actively engage women in decision making  Also crucial: to address the complexities of women’s lives , be inclusive to diversity (social and educational)  Best tool to recognize diversity amongst women is gender based analysis Chapter 14 Between Visibility and Vulnerability: Women and HIV/AIDSWomen’s health activists have been sending conflicting messages by demanding the same kind of treatment and research for all people with HIV/AIDS, while at the same time vehemently critiquing gender neutral procedures (excluding gynaecological symptoms in women). Globally, women comprise around half of the people living with HIV, the vast majority of cases being in developing countries. Women represent a quarter of those who have tested positive for HIV but they are only a fraction (16.5%) of cumulative AIDS diagnosis. Assumptions such as “AIDS is everywhere” and “everyone can get AIDS” fail to recognize the vulnerability associated with gender and other axes of difference
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