She is the pivot around which the family revolves. Wife, mother, daughter, daughter-in-law, sister, cousin and friend – women play diverse and important roles. This is why with International Women’s Day falling on March 8, the need to focus on the mental wellbeing of women was underscored by many experts at a media briefing on [...]

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Experts stress importance of women’s mental wellbeing

Sri Lanka College of Psychiatrists in bid to make Lanka a pleasant place for women
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She is the pivot around which the family revolves. Wife, mother, daughter, daughter-in-law, sister, cousin and friend – women play diverse and important roles.

This is why with International Women’s Day falling on March 8, the need to focus on the mental wellbeing of women was underscored by many experts at a media briefing on Thursday at the Health Education Bureau (HEB).

A National Programme on the Mental Health of Women is in the pipeline, in the wake of the Sri Lanka College of Psychiatrists, under the stewardship of President Prof. Samudra Kathriarachchi, forming ‘a women’s mental health special interest group’. This group is set to collaborate actively with other partners including the HEB, the Mental Health Unit of the Health Ministry and professional organisations.

The National Programme, according to Prof. Kathriarachchi, will ensure women’s mental health to enhance family wellbeing; empower women to reach their potential while achieving a work-life balance; improving parenting skills which would include helping children to develop their personalities; detecting and treating women’s mental health issues including perinatal depression; and taking measures to combat gender-based violence.

Strongly urging all Sri Lankans to join hands with the Sri Lanka College of Psychiatrists to make this country “a pleasant place” for women, thus showing the way as a champion in the region, she said that even though 51% of the country’s population comprises women, recent research and anecdotal reports have repeatedly shown a gap in the delivery of mental healthcare services to them.

“This is why an intervention to improve the mental health of women is at the forefront of the objectives of the Sri Lanka College of Psychiatrists,” stressed Prof. Kathriarachchi.

Casting a closer look at Sri Lankan women, she said that they are involved in various spheres of employment, both in the national and international job markets. Women provide a major share of foreign remittances to the country and in turn contribute to the economic development of Sri Lanka. Modern women play diverse roles while balancing the functions of the family. “This is a daunting task for many Sri Lankan women.”

Lamenting that in spite of women entering institutions of higher education and the public service, women’s political representation at national level remains low (5%) and at provincial level lower, she said that anecdotal evidence indicates that women have shown little enthusiasm to enter politics.

“This has resulted in the lack of a voice in the issues and challenges faced by women in their personal and occupational lives as well as in society. As such there has also been a failure in addressing these issues through the drafting of necessary laws. This is why, while many accomplishments of Sri Lankan women need to be celebrated, there is a need not to get distracted from addressing the many challenges which remain,” she said.

According to Prof. Kathriarachchi rapidly changing society and supportive networks have resulted in making women vulnerable to modern-day stressors. Therefore, it is inevitable that most present-day women suffer major and minor psychiatric disorders and psycho-social setbacks. However, many Sri Lankans underestimate the importance of mental health and its impact on the overall health of the people. Though Sri Lanka boasts of high levels of literacy among women, the same cannot be said about mental health literacy and mental health issues.

“Gender based violence and discrimination of women, gender inequality in payments and employment opportunities are rampant in some strata. The victims of domestic violence experience high rates of depression, anxiety disorders and post-traumatic disorders, sleep disorders and poor general health. Children exposed to domestic violence experience high rates of abuse and neglect and are more likely to have health problems and be at risk of injury and even death. Thus, the improvement of women’s mental health to protect them and their families is of primary importance to the nation,” she said.

Prof. Kathriarachchi pointed out that despite psychiatry services being relatively well-established throughout the country, research and anecdotal evidence indicate a gap in the delivery of mental health services to women. Often women’s mental health problems are not addressed by the family, employers and wider society. The resultant mental health issues and illnesses are often unrecognised and untreated. This causes suffering not only to the women themselves but also to all those around them including their ailing parents, in-laws, children and employers.

Referring to the mental health issues to which women are more vulnerable than men, she said they included self-harm attempts and depression. The underlying risk factors such as lack of ‘confiding’ relationships in which they can open up their hearts to, unemployment, having three or more children below the age of 12 years, poverty, social disadvantages and physical and sexual abuse have been demonstrated, through research, as contributing to the development of various mental illnesses later.

The post-partum period in itself is associated with an increased risk of relapse of several major psychiatric disorders seriously affecting mother-child bonding, later contributing to mental illnesses of the offspring, she added.

This is why the College of Psychiatrists has come up with a National Programme to carry out coordinated public awareness programmes including in-service programmes for healthcare professionals and police officers at national and district levels. Being an urgent issue, the deadline does not stretch for long. The college hopes to achieve much in a year.

Those who addressed the media briefing also included the Health Ministry’s Deputy Director-General (Education, Training and Research), Dr. Sunil de Alwis; the Director of the HEB, Dr. Amal Harsha de Silva; HEB Deputy Director, Dr. R.F.D.C. Kanthi; the Lady Ridgeway Hospital’s Consultant Child Psychiatrist  Dr. Swarna Wijethunga on ‘Good parenting for child development – the role of women’;  Consultant Obstetrician and Gynaecologist  Dr. Harsha Atapatthu on ‘Solving psychological problems in pregnancy – to save mothers’; and Consultant Psychiatrist Dr. Pushpa Ranasingha on ‘Gender-based violence and women’s mental health’.

Thought-provoking reproductive health statistics

Thought-provoking were the reproductive health statistics portrayed by the Health Ministry’s Director, Mental Health, Dr. Chithramalee de Silva:

- 400,000 women get pregnant every year

- 180,000 female babies are born every year

- 125-140 pregnant mothers die every year

- 10 mothers die of abortions every year

- 24,000 teenage pregnancies occur annually

- 6% of youth have suicidal ideas

Underlining the ‘multiple’ roles of women, she said they were wives, mothers, breadwinners and carers. They also faced greater risks of experiencing mental problems.  Other factors that may exacerbate the situation are gender discrimination and gender-based violence, poverty, hunger and malnutrition, overwork and physiological changes.

Changes in the reproductive system such as menarche, pregnancy, lactation, menopause, fertility issues including sub-fertility, abortion, contraceptive use, gynaecological problems and illnesses could also cause psychological distress, it is learnt. Women could also be at serious risk of developing a psychiatric illness after childbirth and that is why there is a need for comprehensive care during pregnancy, proper planning of birth, a healthy environment and good family support for expectant mothers, added Dr. de Silva.

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