This blog is the second in a four-part series on women’s mental health. As the Royal Commission into Victoria’s Mental Health System continues its public hearings there is an opportunity to consider the social and economic factors that contribute to poor mental health using a gender lens. This piece by Sarah Squire (@SquireSarah) and Policy Whisperer Susan Maury (@SusanMaury) of @GoodAdvocacy explores how economic inequality contributes to poor mental health among women, drawing on reflections from practitioners in Good Shepherd services. Part 1 in this series, providing an overview, is available here. Part 3, on the role of financial hardship, is here, and part 4, looking at the impacts of violence, sexualisation and gender stereotyping, is here. You can read the full submission here.
There is a strong relationship between low socioeconomic status and poor mental health, which the World Health Organisation (WHO) notes can be observed in children as young as three. The links between income and mental health are incontrovertible according the WHO:
Economic policies that cause sudden, disruptive and severe changes to the income, employment and living conditions of large numbers of people who are powerless to resist them, pose overwhelming threats to mental health. Disruptive, negative life events that cannot be controlled or evaded are most strongly related to the onset of depressive symptoms.
A recently-published global analysis indicates that women experience depression at twice the rate of men, and that inequality – both fiscal and gender – is highly correlated. Women disproportionately carry the burden of poverty, including in Australia, and it is perpetuated through their experiences of employment, unpaid work and social security. Housing insecurity and homelessness also play a significant role. The connections between these elements of poverty and mental health are reflected in the lives of Good Shepherd clients. As one of our practitioners noted:
Ongoing housing insecurity is a significant issue—particularly housing support services for young people who cannot live at home due to family violence. An increase in medium-long term housing would have a significant impact on positive mental health outcomes.
Employment and unpaid work
Women’s workforce participation is often prescribed to allow for caring duties (AIFS, 2019). However, women are also more likely to experience reduced pay and career opportunities than their male counterparts even in the absence of children, and as demonstrated by a persistent pay gap which starts when young people first enter the workforce. The ‘motherhood penalty’ results in mothers being seen in a negative light in the workplace; effects include the withholding of opportunity, and underpayment due to a misconception that they are not productive workers.
Discrimination at work during pregnancy, parental leave or return to work affects a staggering one in two mothers in Australia, while 39 per cent of women report being sexually harassed at work in the preceding five years. Single mothers are more likely to experience discrimination during pregnancy compared to partnered mothers and experience greater financial impacts.
Two thirds (72 per cent) of women who have experienced discrimination during pregnancy, parental leave or return to work reported that the discrimination affected their mental health. Effects included stress and lowered self-esteem and confidence. Many of the women interviewed for that report said that their experiences of discrimination affected their mental health significantly:
Women said that they were diagnosed with depression and suffered from severe anxiety, despite no previous medical history of mental health issues, following their experiences of discrimination.
Due to their greater responsibility for child rearing women are more likely to be in precarious employment – employment that is marked by low income, few or no entitlements, short-term contracts, and holding little organisational power or status. These experiences can erode physical and mental health through increased anxiety over job security, lack of autonomy, low status, and few or no benefits such as personal leave, while also entrenching financial disadvantage. This can be seen in recent research that examines the gender gap in retirement incomes and the increasing cohort of older women who are experiencing housing precarity. It is therefore not surprising that depression is a significant issue for many women in mid-life with the peri-menopausal period bringing with it a 16 fold increase in diagnoses of depression.
As one of Good Shepherd’s practitioners observed:
There is a fundamental lack of understanding about the root causes of mental ill-health, including that it just ‘descends’ down from somewhere—rather than acknowledging the socio-cultural factors that impact on mental health outcomes. The system mirrors this rather than empowers people.
Women’s responsibility for child rearing and other unpaid household work results not only in financial disadvantage and a motherhood penalty, it also affects their mental health. A heavy load of unpaid work in addition to paid work results in women feeling significant time pressure. Time for sleep and leisure is particularly scarce for mothers of young children, and this experience is associated with outcomes such as poor health and reduced life satisfaction.
Of particular relevance to women’s mental health are the Welfare to Work policy reforms, which were introduced in 2006. Our research found that many women appeared to be referred to Welfare to Work when they were not in a position to participate in employment. This included experiences of poor mental health and past or ongoing experiences of intimate partner violence. Despite this, very few women received referrals or assistance from their program provider to access appropriate support.
Research participants also reported that face-to-face interactions with providers were experienced as stressful and undermining of self-worth. Several participants reported ‘microaggressions’ from providers and an adherence to negative stereotypes about single mothers. Women reported having been yelled at, and in one case sexually harassed, by providers. These experiences resulted in some women developing anxious behaviours such as hypervigilance.
The negative impacts of ParentsNext have been well documented. Heavy compliance activities and the threat of income sanctions do not advance the program’s aim of enhancing job readiness but instead add to participants’ stress and reduce their autonomy. This is particularly the case for people who are already experiencing poor mental health, as one of our practitioners observed:
Dependency on Centrelink as a system for basic financial assistance and meeting criteria for things like ParentsNext is compounding existing mental health issues. Essentially these systems require individuals to function beyond their capacity.
Single parent families have the highest poverty rate of all family types in Australia, while children in single parent families, with a poverty rate of 39 per cent, are more than 3 times as likely to live in poverty as children in couple families (13 per cent of whom are in poverty). Reduction in income support for single parents is directly correlated to a range of negative outcomes for children, including poor mental health, emotional difficulties, behavioural problems, increased anxiety, increased social isolation and relational support, and an increased sense of social stigma.
Conversely, the research on this topic is unequivocal in relation to sufficient income – which leads to reductions in child maltreatment; increases in positive child development markers, maternal health, and mental health; improves child test scores in reading and maths; and improves overall educational performance.
Ensuring the human right to an adequate standard of living would go some way to improving mental health outcomes for women and their children.
If this post has raised issues for you please contact Beyond Blue on 1300 22 4636 or Lifeline on 13 11 14.