Gender in mental health: Gender-based violence, suffering, recovery, and the greater responsibility of society during the COVID-19 pandemic

Trauma including gender-based violence (GBV) requires us to bear witness to the human capacity to bring about social suffering to another in the context of a seemingly orderly society (Herman, 2015). Although GBV is widely experienced by women and people of diverse sexualities and genders in all countries and social groups (Dlamini, 2021, Morgan and Bhugra, 2010), it is often overlooked, under-recognized, and under-addressed (Herman, 2015). GBV can include any physical, psychological, and sexual violence that is directed against a person based on their sex or gender (Dlamini, 2021). While others may do well after an experience of GBV, some may manifest severe traumatic symptoms. These can manifest as an individual’s call to deflect the traumatic experience from consciousness or to bring about their unspeakable secret through alternating between feeling numb and reliving the event (Herman, 2015). These outcomes varied based on both individual and social vulnerabilities. Nonetheless, these traumatic experiences can aggravate mental health conditions (Morgan and Bhugra, 2010, Sadock et al., 2015). Notably, more than 50% of individuals who become victims of GBV develop Post-traumatic Stress Disorder (Morgan and Bhugra, 2010).

When away from the eye of public order, the human capacity for these atrocities can be magnified (Herman, 2015). This may be the case during the COVID-19 pandemic and lockdowns. During the lockdown in 2020, at least 243 million women and girls had been victims of sexual and physical violence perpetrated by an intimate partner (Dlamini, 2021). Both developing and developed countries have witnessed these atrocities. In particular, there was an increase in domestic violence and/or helpline calls by about 25–30% in France, Singapore, Cyprus, and Argentina during the lockdowns. Women rights groups and civil society organizations in Canada, China, Germany, Spain, the UK, and the USA had similarly observed the increased incidence of trauma-related GBV during the pandemic (Dlamini, 2021).

These higher rates of GBV can further magnify the waves of mental health adversities and disparities brought upon by the COVID-19 pandemic. These waves have been construed as long-term problems that may persist beyond the pandemic, itself. Previous discussions of the mental health wave have focused on the ability of the pandemic to magnify mortality and worsen morbidity among people with mental health conditions such as psychosis, depression, and anxiety (O’Connor et al., 2021, Tandon, 2020, Tandon, 2021a). Given the heightened GBV during the pandemic and the ability of GBV to aggravate these conditions (Dlamini, 2021, Morgan and Bhugra, 2010), GBV and its consequences on mental health must be addressed.

While it is imperative to alleviate the mental suffering of victims of GBV, addressing the consequences of trauma is not usually easy. It entails clinicians, advocates, and other observers to be witnesses of the evil in human nature and the human vulnerability in the physical world (Herman, 2015). It is also difficult for victims to find the language to convey their adversities and vulnerabilities. Thus, GBV requires individuals to listen to often unspeakable events borne from the capacity of humans to inflict mental and social suffering (Herman, 2015, Morgan and Bhugra, 2010, Sadock et al., 2015).

Nevertheless, recovery from trauma must be addressed. It requires security, remembrance, and reconnection while the victims come face-to-face with their vulnerability and the capacity for evil in the physical world (Herman, 2015). Particularly, it necessitates promoting the victim’s security in a situation that seemed unsafe. It also entails the remembrance and re-telling of often unspeakable stories of extreme personal adversity. Moreover, it is necessary to restore the connection between the victim and society after lapses in societal protection (Herman, 2015). Thus, security, remembrance, and reconnection may be necessary for the restoration of victims and societal order, however, it is often challenging for the already vulnerable and victimized (Herman, 2015, Morgan and Bhugra, 2010, Sadock et al., 2015).

Recovering from trauma may be further difficult during the COVID-19 pandemic and lockdowns as it has magnified the weaknesses in social and healthcare systems (Alibudbud, 2021, Dlamini, 2021, Morgan and Bhugra, 2010, Tandon, 2021b). Securing safety during the pandemic can entail facing the additional threat of COVID-19 among institutional settings for GBV victims. The intermittent COVID-19 related quarantine and lockdown can also delay and interrupt the conversation between clinicians and victims slowing the process of remembrance. Likewise, restrictions and quarantines can disrupt the reconnection of victims to their families, loved ones, and in general, societal protection (Dlamini, 2021, Morgan and Bhugra, 2010, Sadock et al., 2015). Thus, the distance of victims from societal protection and restoration may be further pushed by lockdowns and quarantines resulting in the prolonged mental suffering of victims.

Given these societal needs for lockdowns and quarantines due to COVID-19, the lapses in societal protections, and the difficulty of victims conveying their needs, society must bear the greater responsibility than the victims in upholding their security and welfare. Thus, it may be a societal responsibility to expand current platforms for victims to safely speak, remember, and re-tell their adversities. It may also be the greater responsibility of clinicians, loved ones, advocates, and in general, society to reach disconnected victims to provide their protection and capacity for restoration. Hence, society must be ever-cognizant of those who may be silent, marginalized, and disempowered including GBV victims, as it finds solutions to the social and health inequities and disparities magnified by the pandemic (Tandon, 2020, Tandon, 2021b). In doing so, no victims may be left behind as the world recovers from the pandemic.

Declaration of Competing Interest

No conflict of interest exists in the submission of this manuscript. The author declare that the has no conflict of interest.