Abstract
In this issue we address the sensitive issue of societal attitudes towards women, in particular violence, exploitation and oppression, and their consequences for women’s mental health. The subject of exploitation and abuse of women, by men, is rarely out of the headlines. Yet the prevalence of the problem does not seem to diminish, despite widespread publicity. In their fascinating review of the confluence of partner violence and substance misuse with mental health problems, Cari Jo Clark and Grace Wyshak estimate that up to two-thirds of women are subject to such violence, extrapolating from studies conducted in a wide variety of countries and cultures. They make the point that substance misuse and mental health disorders are both risk factors for such behaviour and outcomes of it.
Psychiatric interventions to mitigate the effects of violence upon women’s mental health must be sensitive to local cultural contexts, but there are formidable complexities.
Psychiatric interventions to mitigate the effects of violence upon women’s mental health must be sensitive to local cultural contexts, but there are formidable complexities. These are exemplified in the contribution from Drs Lari, Alaghehbandan and Joghataei, on the psychosocial and cultural motivations for self-inflicted burns among Iranian women. They provide an insight into aspects of a social phenomenon that is truly disturbing: the rising incidence of self-immolation among Iranian women, especially during the early years of marriage. There is a supposition that in many cases this course of action is taken to escape from a violent relationship, or one in which the woman is exploited by traditional male values, but the truth is we cannot be sure. In many cases the women concerned are killed by their actions; in others they deny intent and ascribe the burns to an accident.
Finally, Drs Medina-Mora and Lara have contributed a review of attitudes to women and their mental health in Mexico, a culture where the term ‘machismo’ still holds meaning. Mexican society has, by this account, clear divisions into what are regarded as appropriate male and female roles. Yet, as women in many countries in the Western world have found following their ‘liberation’ in the 1960s, all too often the freedom to join a male-dominated world of work means dual responsibilities and limited opportunities to advance along a parallel path to men outside the home. In Mexico, there is an additional twist to the differentiation of gender roles, in the sense that women are expected not to drink alcohol, because it is not compatible with their domestic responsibilities. And so we come back to the issue of domestic violence which was raised by Clark and Wyshak, with the misuse of alcohol by men being closely correlated with physical violence against female partners.
Psychiatrists around the world need to be alert to the continuing stresses on women, from family, partners, work and many other obligations; cultural influences on female mental health are rarely trivial.