For four days (22–25 March), Tokyo is hosting the 6th World Conference on Women’s Mental Health. Focusing on trauma, depression and resilience, the event is organised by the International Association for Women’s Mental Health, a non-profit organisation established in 2001 to improve the mental health of women throughout the world.
While mental health problems have a profound impact on men and women, research shows some conditions affect them differently. On the whole, the toll of mental illness weighs more heavily on women.
Worldwide, depression is the most common mental illness. By 2020, it is expected to be the second-greatest cause of disability. In Japan—as in many developed countries—mental health problems continue to be on the rise.
The Global Burden of Disease Study 2010, conducted by the Institute for Health Metrics and Evaluation, reported that mental illness accounted for 7.6% of the global burden of disease, ranking as the fifth leading cause of disability and loss of life.
As a result of a 37% increase in the rate of disability between 1990 and 2010, the lifetime prevalence of depression is roughly double for women compared with that for men. Moreover, in 2010, the rate of healthy years lost as a result of depression was reported to be 1.7 times higher in women than in men.
The study examined various factors contributing to women’s mental health problems, particularly the role of sexual assault and intimate-partner violence in the development of post-traumatic stress disorder (PTSD) and depression.
Rates of depression in women were found to be three to four times higher in those who were exposed to sexual trauma during childhood, and physical abuse or intimate-partner violence in adulthood.
Research shows that following rape, one in three women will develop PTSD. The high prevalence of sexual violence to which women are subjected, and the correspondingly high rate of PTSD experienced following such violence, renders women the largest single group affected by this disorder.
The report also found that women are vulnerable to mental health problems during pregnancy and the postnatal period. Studies suggest that one in 10 women will experience depression at some point during their pregnancy, increasing to one in five during the first year after giving birth.
Moreover, research indicates that mental health issues of mothers have a significant impact on social life as a whole, including child-rearing and the overall mental and physical health of families. A study in the UK’s Confidential Enquiry into Maternal Deaths states that suicide, while rare, remains one of the leading causes of maternal death in the country.
Research has also found that work-life balance plays an important role in the mental health of men and women.
A 2011 cross-cultural study examined women’s socioeconomic inequalities and their mental health in the UK, Finland and Japan. It found that Japanese women reported the greatest levels of conflict in their work–life balance and had the poorest mental health status.
Meanwhile, Finnish women reported the lowest conflict levels and best mental health. Key factors in this positive result were greater family-friendly work policies, good pay and job opportunities, as well as less gender stereotypes.
In the Global Gender Gap Report 2014, compiled by the World Economic Forum, Japan ranked 104th out of 142 countries. The report shows that gender inequality, lower wages and difficulty in obtaining full-time employment after giving birth affect Japanese women’s work-life balance.
Further, economic dependence resulting from these issues limits women’s ability to divorce or escape an abusive relationship.
Mental health problems carry significant stigma worldwide. A 2013 study in this area by Shuntaro Ando, Sosei Yamaguchi, Yuta Aoki and Graham Thornicroft shows that greater levels of stigma were found in Japan compared with Taiwan and Australia.
Japanese are more likely to believe recovery from mental illness is not possible, and that it is the result of personal weakness or character flaws rather than due to any biological cause.
If we are to improve women’s mental health, equality in society—including the workplace—needs to be achieved and effective mental health treatment needs to be available.
National campaigns addressing mental health issues and educational programmes at the community level are desperately required in Japan. The benefits would be felt not only by women, but also by their families and, ultimately, the country as a whole.