April 11, 2020

Article at Times of India Blog

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What Covid-19 teaches us about women’s mental health

Swarnima Bhattacharya

Swarnima Bhattacharya is a public health professional and the founder of TheaCare, a women's health companion. She has previously published with TOI about FemTech in India.

Covid-19 has clearly shown that our Public Health infrastructure must be fortified, and this time, women’s mental health urgently needs to be a priority. Covid-19 has affected women much more profoundly, even though the Chinese Centre for Disease Control and Prevention (CCDC) found that the fatality rate for men at 2.8% was higher than women’s at 1.7%.

So, why must we especially focus on women’s mental health during this global pandemic? Due to various social, cultural and economic factors, women are facing a sharp increase in caregiving responsibilities, with even less freedom, space, or economic security.

In 2000, the World Health Organisation (WHO) declared Gender to be a critical determinant of mental health and mental illness. They said that “gender determines the differential power and control men and women have over the socioeconomic determinants of their mental health and lives”. Following the coronavirus outbreak, the Inter-agency Standing Committee (IASC) has also called for “gender-sensitive” deployment of healthcare, especially mental health.

Therefore, here are some aspects to keep in mind to reinforce the necessity of keeping women in the front and centre of mental health policy.

Re-orienting the Domestic Space, to unburden women

Lockdowns and self-quarantine measures across the world have increased women’s workload as more people are home-bound for a continued period of time and caregiving tasks have increased. Data from the Organisation for Economic Cooperation and Development (OECD) shows that Indian women do nearly six hours or unpaid care work each day. Indian men, on the other hand, spend less than an hour on an average doing the same. Globally, women perform 76.2% of total hours of unpaid care work. According to UNESCO, 300 million children are missing school globally due to the current virus outbreak, increasing the responsibilities of women. According to “Time To Care”, a report by Oxfam, women and girls spend 3.26 billion hours of unpaid care work each and every day, making a contribution to the Indian economy of Rupees 19 lakh crore per year, which is equivalent to 20 times the entire education budget of India.

This is not to say that women must not engage in caregiving work. In fact many women cherish and prefer caregiving activities when it comes to children and other close dependents. However, the fact is that a woman asking openly for rest or support with domestic chores, is viewed with disapproval at best, and faces emotional / physical abuse at worst. This becomes particularly distressing during certain phases of women’s lives like perimenopause / menopause, pregnancy or soon after childbirth, uncomfortable menstruation and more. Already vulnerable due to huge physical transitions, unexpected health issues and discomfort, a lack of domestic and emotional support can have long term consequences on their mental health.

To provide a solution to this, it might be helpful to turn to Jessica DeGroot, a quality of life theorist and founder of ThirdPath Institute. She introduced the concept of “shared care”, a radical unlearning of social conditioning, honest sharing of domestic work and emotional labour between partners so that both may thrive at home and work, and remain healthy and happy. It talks about removing gender as a determinant of who does more care work but allows couples to honestly chart out goals, equally share responsibility and increase gratitude.

Overhauling value systems at the workplace to include women

Due to the Covid-19 lockdown many women are working at home and also working from home. The virus outbreak has brought women’s economic insecurity to the forefront. According to a survey by the Kaiser Family Foundation a much larger proportion of women worry about loss of income due to disruption of work caused by Covid-19 as compared to men. Under “normal” circumstances women already face a significant wage gap. A 2016 study from Columbia University shows that women who have lower income than male counterparts (when matched across age, education, industry, marital status and other factors) are twice more likely to be depressed and six times more likely to suffer from anxiety.

Women in leadership positions are more likely to suffer from “depression, social tension and isolation” due to negative perceptions around women in power. This is significant again because people in leadership positions have better income control and better socio-economic status. Yet in case of women, these factors are more likely to make them more stressed.

Women entering the workplace enmasse is a relatively recent phenomenon and cultural attitudes are yet to square with this shift. For several women, workplaces can be a huge positive reinforcement for their intellect, independent identity, and economic self-sufficiency, but there remain some inexorable barriers to success along with difficult balancing acts. It should be a matter of some collective embarrassment that “mom guilt” is such a pervasive experience- this is the guilt that mothers feel for being inadequate or having to divide their time between child-rearing and other commitments.

According to sociologist Tetyana Pudrovska, “male leadership is accepted as normative and legitimate, while women face more stressors overcoming negative stereotypes and other resistance, presumably even pressure from home”. And therein lies the key. Covid-19 has taught us that work from home, flexiwork and other models of engagement with the workplace are not only possible but can also be productive. It is important to dismantle the male default at the workplace and incorporate systems and behaviors which are inclusive, empathetic and accommodating of equal lifestyles for all genders. In order to holistically address mental health women should not have to prove themselves as efficient and committed employees while also not getting much help with managing domestic responsibilities. And men should not be penalised at work for wanting to contribute extra hours at home.

The impact of sexual, emotional and physical abuse

Home is unfortunately not a safe space for everyone. One of the most heartbreaking adverse effects of self-quarantine has been that many women are isolated at home with abusive spouses. China, and several other countries, have reported a surge in domestic violence cases after the viral outbreak. In India as well, the National Commision for Women (NCW) has raised an alert about an increasing number of domestic violence cases since the national lockdown began.

Not just at home, a survey by “Stop Street Harassment” found that 81% of women surveyed had experienced some form of sexual harassment at the workplace. This has detrimental effects to the morale of other female coworkers as well, increasing a fear of lack of safety, affecting perceptions of women in offices and often even hiring decisions. The report also found that 66% of the women surveyed said that they have faced some form of harassment in the public place. It is noteworthy that the risk of Post Traumatic Stress Disorder (PTSD) following exposure to trauma is twice as high in women.

The impact of abuse therefore not limited to the women who go through it but also on women who are hearing this on the news so commonly. It is no wonder then that women have or are made to internalise so many self-blaming reasons for rape- because of the way it is reported on the news and the way in which people respond. Dealing with the problem of gender-based violence (GBV) is going to be a long-drawn process, but we must work towards it intentionally on a daily basis. In the short-term we must strengthen and support peer-support groups for survivors of violence in order to help women recover from the trauma of abuse, direct or vicarious, we must bring men into the conversation.

The media must report GBV in a responsible and sensitive manner. Matthew Baum, a researcher at Harvard’s Kennedy School of Government, recently conducted research which concluded that the manner in which rape is reported in the media, influences the local culture, mindset and norms around sexual assault. So when it comes to abuse, language matters.

The WHO states that “women’s health is inextricably linked to their status in society. It benefits from equality and suffers from discrimination. Today the status and wellbeing of countless millions of women worldwide remains tragically low”. The writing on the wall is clear- we have deprioritised women’s mental health for far too long. The pervasive issue of women’s mental health is not invisible but culturally invisibilized. The cost of blindsiding this reality is too high. Acknowledgement is the first step which will then lead to changes in policy.