Abuse and violence suffered by women and girls is the main reason they are much more likely than men and boys to develop mental ill health, Britain’s psychiatrists say.
Experiencing such behaviour can trigger very serious mental health problems in women and girls, including suicidal thoughts and psychosis, according to the Royal College of Psychiatrists.
Difficult relationships, especially those involving coercive behaviour, and dealing with home and family pressures, are also major drivers of poor mental health in women, it added.
A survey by the college found that psychiatrists across the UK believe that violence and abuse is a major cause of mental ill health among women and girls based on their experience of treating patients. When participants were asked to name the top three issues contributing to poor female mental health, almost six out of 10 (59%) identified violence and abuse – more than cited money worries, loneliness, hormonal health or work or exam pressures.
Almost half (49%) said relationship issues, often involving coercive behaviour, were another key underlying factor, while 48% cited home and family pressures.
“Tragically, it is not uncommon for female patients to experience long-term abuse that causes serious symptoms, including suicidal ideation or symptoms of psychosis,” said Dr Catherine Durkin, the college’s joint presidential lead for women and mental health. “I regularly see patients who are dependent on an abusive partner or family member due to emotional, family or financial reasons.
“Victims often feel unable to speak openly about such issues, meaning their problems go unnoticed, sometimes for years.
“Not all abuse is physical. Psychological abuse also causes extreme harm and casts a long shadow over victims.”
The findings potentially provide a key part of the explanation for the much higher incidence of a range of mental health conditions seen in women and girls compared with their male peers.
A recent report by 60 charities found that “women and girls are at significantly higher risk for multiple mental health problems, notably anxiety, major depression and eating disorders”.
The report, entitled A Mentally Healthier Nation, added: “This is due to both the physical and psychosocial experience of womanhood, with menarche, pregnancy and menopause being significantly associated with development of mental ill health.”
The document, collated by the Centre for Mental Health thinktank, also cited evidence showing that “experience of domestic abuse – including physical, sexual and emotional abuse and coercive control – is also gendered and is a significant risk factor for mental ill health in women and children”.
For example, women who have suffered domestic violence are more than six times more likely than other women to be treated for psychological problems.
Research in 2022 by academics led by Praveetha Patalay, a professor of population health and wellbeing at University College London, identified close links between sexual assault and mental illness. Victims were much more likely than others to suffer serious distress or self-harm.
The high levels of both forms of mental ill health in that age group would be far less common if they no longer suffered sexual assault or harassment, they found, in a study of 9,971 young people born during 2000-02 whose health was monitored by the Millennium Cohort Study.
“There is a large gender gap that emerges in adolescence where girls experience much greater depression, anxiety and self-harm than boys, but the drivers of this gap are poorly understood,” said Patalay, responding to the college’s findings.
“Sexual violence impacts on mental health in all genders. But these experiences are unfortunately much more common in girls and this plausibly contributes to higher rates of mental health difficulties in girls and women.”
Andrea Simon, the director of the End Violence Against Women Coalition, said: “These findings are not surprising given that women who experience intimate partner violence are three times more likely to have made a suicide attempt in the past year.”
But, she added: “Survivors of male violence against women often find their reports of abuse are dismissed or minimised when they seek help, including from health agencies.”
Victims can struggle to access the specialist help they need because rape crisis centres, domestic abuse refuges and advocacy services operate with “precarious funding”, Simon added.
More doctors should realise that abuse and violence can trigger mental ill health, said Dr Philippa Greenfield, the college’s other joint lead on women and mental health.
“Clinicians often do not realise that violence, abuse and coercive behaviour can have serious mental health implications. This lack of awareness can leave victims undetected and their mental health needs not appropriately addressed.” Many victims had poor access to practical and psychological support, she added.
All of the NHS’s 54 mental health trusts in England should employ independent domestic violence advocates to ensure women get better help, the college said.
In the UK, call the national domestic abuse helpline on 0808 2000 247, or visit Women’s Aid. In the US, the domestic violence hotline is 1-800-799-SAFE (7233). In Australia, the national family violence counselling service is on 1800 737 732. Other international helplines may be found via www.befrienders.org.
