A LEADING psychiatrist has criticised Scottish mental health policies for failing to recognise the difficulties experienced by women.
Orkney-based Dr Linda Gask said women in Scotland are twice as likely to suffer from anxiety and depression but are not getting the help they need because data on men and women is too often lumped together.
As a result, women too often “become the problem”, Dr Gask, who has had a distinguished career in psychiatry, told the Sunday National.
The issues women of all ages face are outlined in her new book Out Of Her Mind – How We Are Failing Women’s Mental Health and What Must Change.
“I know from my experience and research that the large majority of young people on the waiting list for mental health services in Scotland will be young women and a large number of the people waiting for psychological therapies for depression and anxiety will be women – but this gendered lens is never looked through,” she said.
“You can’t get a gender-informed perspective about what is going on with mental health care at all.”
The only mention of women in the Scottish Government’s policy for mental health is around maternity and perinatal issues, something that the charity Engender pointed out in a review in 2022.
“It is just not looked at from the perspective that in Scotland women are poorer than men, they are in more precarious jobs, they are more likely to be single parents and carers and that women of colour, or who are disabled or LGBTQ+ are all experiencing much more difficulty in accessing adequate mental health care,” Dr Gask said.
“Women are more likely to be sexually abused and are twice as likely to get Post Traumatic Stress Disorder but nothing ever gets connected up.”
She said the fact that women were experiencing mental health problems as a result of what was happening in their lives was not acknowledged, with the result that “women themselves become the problem and are more likely to be diagnosed with personality disorders if they don’t recover”.
Dr Gask said that what was needed were services where women receive mental health care, together with advice and expertise from people who can help with their practical problems.
“It needs to be all in one place and it isn’t,” she said. These services just don’t connect with each other and that is a problem all over.
“Women do have mental health problems for which they need help but they also need real practical help with what is going on in their lives.”
While there are more psychiatric beds in Scotland, Dr Gask said there was still very poor access to psychological therapy services.
“Waiting times are very long and that is an issue for all the women out there who are suffering and need help because the majority of people on those waiting lists for psychological therapy are women,” she said.
“They are often told not to complain so they are getting on with things but they are struggling.
“I think it is a real issue for Scotland because I think women here do get on with things quietly.”
While men are three times more likely to take their own lives than women, the latter are more likely to self-harm. It is an issue that is becoming more prevalent and Dr Gask said there had to be faster access to therapy.
“I think we have also got to stop thinking it is just about women and their self-esteem as it is about attitudes in society as well,” she said.
“I am really concerned that we are avoiding talking about how easy it is now to get access to porn online and the attitudes of young men towards sex and relationships.
“Young women also feel under pressure about their appearance, pressure to stand out or to not stand out, pressure to look good, pressure to be in relationships. If I were growing up now as a young woman, I think I would find that very, very hard.
“It’s terrifying really and I think it is no wonder they are having problems but we are not getting them help fast enough.”
The mental health problems facing children and adolescents also need to be looked at through a gender lens, according to Dr Gask.
“We need to look at what is going on with young women and what is going on for young men,” she said.
The ”enormous” shortage of psychiatrists in Scotland is a problem with a “phenomenal” amount of money spent on locums to fill the gaps, Dr Gask said.
“We can’t carry on spending this amount of money on locums,” she said. “We have got to really work at making posts attractive to encourage people with mental health skills to work north of the central belt and I think we are really failing at that at the moment in Scotland.
“The situation in Orkney, for example, is that we have some care just being provided online but it is very hard to engage with people with severe mental health problems online and you don’t know anything about the culture or the place they are coming from.”
Dr Gask said she was “stunned” that Scotland still did not have any academic department in the north with a speciality in rural mental health.
“If you had someone who was willing to set that up, you would start to attract people instead of parachuting people in two days a week which is very disjointed and not very supportive,” she said.
A chapter at the end of her book concentrates on the needs of older women who she believes are often forgotten about.
“We are relying so much on women as carers but that carries a terrible burden.
“Supporting those carers is absolutely essential, especially if we are increasingly expecting people to be caring for others outside hospital,” Dr Gask said.
She pointed out that women are also twice as likely to be diagnosed with Alzheimer’s disease but this again was not looked at through the perspective of gender.
“The failure to think about women is there throughout our whole society,” said Dr Gask.
A Scottish Government spokesperson said they were aware of considerable differences and were pursuing more detailed statistics.
Out Of Her Mind – How We Are Failing Women’s Mental Health by Dr Linda Gask is published by Cambridge University Press and available now
