1999: “Planning Gender Sensitive Community Interventions – Women and Mental health”

“Planning Gender Sensitive Community Interventions- Women and Mental health” was the theme of a workshop held from 17-18 September 1999 at YMCA, Pune, India.

The motivation for the workshop was the fact that mental health professionals in India are not sensitive to gender issues in their approach to interventions. For NGOs who see mental health problems frequently in their community work, there have been many issues needing discussion, especially in addressing women’s mental health needs.

The workshop aimed broadly
To introduce women’s mental health as an agenda for action to local organisations;
To give a socio-political perspective to mental health interventions for women;
To highlight policy, service, ethical and legal issues concerning women with a psychiatric diagnosis;
To provide a platform for deliberations between the medical professionals, NGOs and women’s organisations in Pune
And to integrate our work on women’s mental health with local movements in health and feminist activism.

Over 40 participants from health and mental health NGOs, community-based organisations, counselling centres, shelters and other women’s organisations from Pune and Bombay attended the workshop. The resource persons included feminist activists, activists in mental health, a disability and human rights advocate, psychiatrists and feminist counsellors. The workshop was funded partially by the Sir Dorabji Tata Trust of Bombay. The workshop introduced the theme of women’s issues in mental health by reviewing feminist work in mental health in India in the last decade.

For many of us in the women’s movement in India, the movement itself has provided us with many social spaces for personal change and healing. Social change has also brought about individual change. We are averse to psychiatric labelling, and see “mental disorder” as a way by which women resist patriarchy. However, the disabling aspects of emotional suffering also need to be addressed and slowly, in India, we see the growth of feminist alternatives in mental health, addressing the diversity of women’s needs.

The workshop contents included:
The social aetiology of women’s mental illhealth – that is, the mental health impact of a hierarchical social life, powerlessness, domestic / reproductive violence, and the socio-cultural violence in a globalizing society.
The relevance of discussing “common mental disorders” and NGO opportunities for addressing these in community based work with women.
The national policy on mental health and its limitations from a gender as well as NGO perspective. The policy propaganda was on “community mental health” and NGO involvement but the policy did not envisage a creative role for NGOs. They were seen as somewhat inferior conduits for making an informed referral to mainstream psychiatric services. The policy did not address social inequality issues.
Bias and prejudices within the mental health service system- The many ways in which the sciences had labelled and “treated” women’s ways of self-expression and dissent as mental illness. Professionals needed to respond sensitively and professionally to victimisation and create standardised clinical protocols for diagnosis and treatment.
Alternatives from a feminist psychological perspective- The need for feminist counselling and for women to assert their own spaces and legitimate experience within therapeutic transactions.
The overwhelming disempowerment of persons with mental illness, particularly women, by present mental health laws- The workshop emphasised the need for legal reform from the women’s perspective, the need for legal literacy and vigilance about judgements.
The problems of institutionalised women and the need to struggle for a realm of positive rights and a life of dignity for these women.
A brief history of legal activism in mental health in India was given, where the interests of different stake holders was emphasised.
The recent Equal Opportunities Act for persons with disabilities from the mental health perspective.
Brief panel discussions on the ethics and good practices in community mental health and the role of self-help groups in mental health work.
Our recommendations included:
Change in community mental health perspective from the medical model of mental disorder to a more social psychological model
Recognition of the mental health impact of social powerlessness of women
Change in sexist attitudes and paternalistic practices towards women who are receiving mental health care
Minimal use of and professional regulation of ECT (Electro-convulsive therapy)
Change in professional attitudes and practices towards women who are facing violence in the domestic or political sphere
Changes in community mental health policy from a top-down approach to a more participatory approach
Standardised clinical assessments, instead of subjective and incompetent professional assessments
Women-sensitive law reform to address the human rights violations of institutionalised women
Networking among NGOs and user groups and creation of feminist as well as self help alternatives at the community level

The specific outcome of the workshop was creation of a local platform for discussion on women and mental health, which has since strengthened networks and activities locally. The workshop created a local demand for Bapu Trust to get into an active support giving and resource-building role with NGOs, women’s organisations, carer groups, health organisations and with individual users of mental health services.

What was unique about this workshop was the emphasis given to the policy, ethical, social and gender aspects of mental health, aspects that are rarely addressed in other mental health forums in India. With this, important linkages between mental health, development and human rights have been forged.

As follow up, our Center has cultivated local networks with many women’s organizations and conducted similar awareness and sensitisation workshops for them.

Funding support: Funding for this program was given by Sir Dorabji Tata Trust, Mumbai.

 


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