Chapter

Mind the gender gap: mental health in a post-feminist context

David Pilgrim

in Oxford Textbook of Women and Mental Health

Published on behalf of Oxford University Press

ISBN: 9780199214365
Published online July 2011 | e-ISBN: 9780199640454 | DOI: http://dx.doi.org/10.1093/med/9780199214365.003.0003

Series: Oxford Textbooks

Mind the gender gap: mental health in a post-feminist context

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Differences in mental health status (if any) between men and women remain an important matter of debate for two main reasons. First, methodological questions abound about measuring mental health and which inclusion criteria to utilize in empirical studies. Second, the gendered picture has been shaped, in part, by pre-empirical or non-empirical forces, which reflect interest in the academy (first in relation to masculine assumptions in psychiatry and second in relation to the response of feminist scholars). Thus an exploration of the gender gap is a window into both the general challenges of doing mental health research and in understanding our current post-feminist discourse. This chapter will address both of these areas of understanding.

A couple more points can be made by way of introduction. The first is that the ambiguity of gender as a social variable, in predicting mental health status, is also shared by others (such as age and race) (Rogers and Pilgrim 2005). The least ambiguous predictor is social class—generally the poorer the person, the poorer their mental health, as with physical health. Basically, the poor are sicker in all respects and they die younger than richer citizens. They are consequently over-represented in psychiatric populations. But even in the case of class as a predictor of mental health status, a clear gradient in diagnosis does not apply to a few categories (such as bipolar disorder and obsessive–compulsive personality disorder).

A second contextualizing point is that the analysis of mental health in terms of single social variables is an academic convenience, in a highly complex world in flux. But, in the latter, people with or without mental health problems are not just old or young, black or white, men or women, etc. Social variables coexist in the open systems of real populations. This makes definitive deductions about single variable influences inherently open to challenge in relation to cohorts and when seeking to definitively formulate the genesis of a mental health problem or its maintenance in a particular patient. For example, women have lower incomes on average than men and are often employed more precariously. This being the case, if a gender gap is recorded in mental health status, it could be explained by the stressors associated with these labour market features or socioeconomic status (combined with domestic responsibilities, itself a form of division of labour).

Thus disaggregating the specific causal impact of single social variables (of in this case gender) is a risky task. A safer model is to posit multi-factorial formulations and talk in terms of risk and probability rather than in terms of certain causation. A fuller discussion of the mental health inequalities literature in relation to gender and other social variables can be found in Rogers and Pilgrim (2003, 2005). With these general points in mind, I now turn to the first main part of the chapter.

Chapter.  4429 words. 

Subjects: Psychiatry

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