Mental Health Services for ‘Difficult’ women: Reflections on Some Recent Developments

The provision of mental health services to women has come sharply into focus for providers of secure psychiatric services in the UK. Women's services are being developed in response to the known risks of mixed-sex provision, and a growing appreciation of the ways that women in secure services can be further disadvantaged by their minority status. Our intention here is to present evidence and reflections to help inform this development. The evidence is drawn from our recent work in this field, which includes carrying out a review of local mental health services for ‘difficult’ women, and developing and piloting a national training programme for staff working with women in secure services. The reflections we offer are informed by the conviction that taking social inequalities into account is central to making sense of women's mental health difficulties, and improving service responses to women's needs. While there are signs that many mental health workers in secure services are beginning to share these convictions, the challenge now is to provide the necessary authorization, training and support that will enable them to translate these understandings into empowerment practice with women.     

Slovenia’s socialist superwoman: feeding the family,nourishing the nation

In this article we critically reflect on ‘feminist research methods’ and ‘methodology’, from the perspective of a feminist research unit at a South African university, that explicitly aims to improve gender-based violence service provision and policy through evidence-based advocacy. Despite working within a complex and inequitable developing country context, where our feminist praxis is frequently pitted against seemingly intractable structural realities, it is a praxis that remains grounded in documenting the stories of vulnerable individuals and within a broader political project of working towards improving the systems that these individuals must navigate under challenging social and structural conditions. We primarily do this by working with non-governmental organisations (NGOs) providing gender-based violence services in research conceptualisation, design and implementation. This raises unique and complex questions for feminist participatory research, which we illustrate through a case study of collaborative, participatory research with NGOs to improve health and criminal justice outcomes for survivors of sexual violence. Issues include the possibility of good intentions/good research designs failing; the suitability of participatory research in sensitive service provision contexts; the degree(s) of engagement between researchers, service providers (collaborators/participants) and research participants; as well as our ethical duties to do no harm and to promote positive, progressive change through personal narratives and other forms of evidence. Given the demands of our context and these core issues, we not only argue that there are no ‘feminist methods’, but also caution against the notion of a universal ‘feminist methodology’. Whilst we may all be in agreement about the centrality of gender to our research and analysis, the fundamental aims and assumptions of mainstream (Western) feminist approaches do not hold true in all contexts, nor are they without variance in mode, ideal degrees of participation and importance to social context.     

Green Grabbing: a new appropriation of nature?

Across the world, ‘green grabbing’ – the appropriation of land and resources for environmental ends – is an emerging process of deep and growing significance. The vigorous debate on ‘land grabbing’ already highlights instances where ‘green’ credentials are called upon to justify appropriations of land for food or fuel – as where large tracts of land are acquired not just for ‘more efficient farming’ or ‘food security’, but also to ‘alleviate pressure on forests’. In other cases, however, environmental green agendas are the core drivers and goals of grabs – whether linked to biodiversity conservation, biocarbon sequestration, biofuels, ecosystem services, ecotourism or ‘offsets’ related to any and all of these. In some cases these involve the wholesale alienation of land, and in others the restructuring of rules and authority in the access, use and management of resources that may have profoundly alienating effects. Green grabbing builds on well-known histories of colonial and neo-colonial resource alienation in the name of the environment – whether for parks, forest reserves or to halt assumed destructive local practices. Yet it involves novel forms of valuation, commodification and markets for pieces and aspects of nature, and an extraordinary new range of actors and alliances – as pension funds and venture capitalists, commodity traders and consultants, GIS service providers and business entrepreneurs, ecotourism companies and the military, green activists and anxious consumers among others find once-unlikely common interests. This collection draws new theorisation together with cases from African, Asian and Latin American settings, and links critical studies of nature with critical agrarian studies, to ask: To what extent and in what ways do ‘green grabs’ constitute new forms of appropriation of nature? How and when do circulations of green capital become manifest in actual appropriations on the ground – through what political and discursive dynamics? What are the implications for ecologies, landscapes and livelihoods? And who is gaining and who is losing – how are agrarian social relations, rights and authority being restructured, and in whose interests?     

Litigating Discrimination on Grounds of Family Status

Against the background of a deeply uneven package of work–family reconciliation measures and an increasing focus on engaging men in unpaid care work, in this article I discuss the extension of the Irish discrimination law framework to provide protection against family status discrimination to workers who are engaged in certain care relationships. While this development of the law to recognize a relational understanding of inequality is welcome, its confined definition of family status fails to capture the range of workers’ caring relationships and networks. Adopting a contextualized assessment of 12 years of litigation generated under the ‘family status’ ground, with reference to complainants’ gender and work status, the study considers the types of experiences being litigated as ‘family status’ discrimination. The study show how much of the nature and forms of inequality presented before the tribunals are beyond the conceptual boundaries of the principle of equal treatment that depends upon a sameness of treatment model with the (gendered) ‘care-less’ comparator. Despite its potential to question the neutrality of workplace structures predicated upon the division between paid work and unpaid care, the principle of indirect family status discrimination has been under utilised as a litigation strategy. The most successful dimension of family status discrimination protection has been in respect of its ability to capture the negative stereotyping of worker–carers who continue to perform as ideal workers. I suggest that this extension of a limited negative rights framework, when considered alongside the state’s extremely poor support for workcare reconciliation more broadly, places negligible obligations on employers, and that the gender neutrality implicit in its provisions have yet to impact on gender equality as regards work–care reconciliation.     

Gender differences in personality and cancer-related pain among older cancer patients

Indicators explaining gender differences in personality and pain among older cancer patients have not been adequately addressed. This study examined gender differences in cancer-related pain severity, the Five Factor Model of personality, and affect among older cancer patients (86 women, 64 men). No significant differences were found in pain severity between the gender groups. Analyses indicated that women scored significantly higher for the personality trait of neuroticism than men (p < .05). Further analyses showed that different demographic, health, and personality variables predicted pain severity in women and men. Gender was found to be a significant moderator in the association between the personality trait of neuroticism and average pain. These findings suggest that both gender and different personality types may influence reported pain severity. Specifically, the results suggest that how patients experience and report pain severity may be gender-specific, and that it may be inappropriate to assume that women and men experience, report, and manage their pain in similar ways. Future studies focusing on the influence of personality and gender on health outcomes are needed to assist healthcare providers in tailoring treatment, thereby promoting optimal symptom management.     

Does it pay to break male gender stereotypes in advertising? A comparison of advertisement effectiveness between the United Kingdom,Poland and South Africa

Advertisers shy away from using non-traditional (vs. traditional) male gender portrayals even though theory suggests they may be more effective cross-nationally. Two main hypotheses were tested cross-nationally for the first time. H1: ‘paternalistic’ male stereotypes (e.g. Househusband) would be more effective than ‘envious’ male stereotypes (e.g. Businessman) across countries confirming the stereotype content model (SCM). H2: the match between initial male gender role attitudes and advertisement type would increase advertisement effectiveness only in countries with relatively low egalitarian norms (i.e. Poland and South Africa). A cross-national study was conducted through the use of student samples following a 3(country: United Kingdom, Poland and South Africa) × 2(advertisement type) × (gender attitude) mixed design (N = 373). A three-way multivariate analysis of variance showed support for H1 and partial support for H2 (i.e. the second hypothesis held on purchase intent and for South Africa). The study provides evidence for the cross-national applicability of the SCM to advertising and the limited predictive value of gender attitudes for purchase intent depending on country. Thus, contrary to mainstream advertising practices, breaking male gender stereotypes does appear to pay cross-nationally. Theoretical and practical implications alongside the potential for change in practices are discussed.     

Women and Mental Health A Feminist Review

This article contextualizes some of the more specifically focused articles in this Special Issue of ‘Women and Mental Health’ by reviewing general historical and political currents structuring contemporary discussions around questions of models, treatment and provision for women within British mental health services. We highlight some particularities of the current British context (in relation to other national scenes) in terms of the forms and expressions of feminist activity around mental or emotional distress. While not absolute mirrors of each other, resonances between general trends in feminist debates and organizational forms within feminist mental health work give rise to a wide spectrum of sites of intervention. We discuss some of the conditions that gave rise to these forms of (visible) feminist intervention within mental health service provision, focusing particularly on women's counselling and therapy services, and we offer an analysis of the range and conceptual tensions within which such interventions may be situated, including contested perspectives on power and empowerment. We also consider ways in which women's political activity around mental health issues is likely not to be noticed as such, given women's prototypical positions as patients and practitioners. We end by identifying what we see as current challenges for feminist activism around distress and its links with the conditions of women's lives and oppression more generally, not only as instances of more general tensions and challenges within contemporary feminisms, but also as offering an arena of opportunity for broader alliance and coalition-building.     

Attitudes toward mental health services among homeless and matched housed youth

Homeless youth experience high rates of mental health problems yet they under-utilize mental health services. The present study surveyed 56 homeless youth and 97 matched at-risk housed youth on their attitudes toward mental health services, and investigated the link between social support and attitudes. Results showed groups shared similar neutral to positive attitudes. Higher levels of social support were associated with increased positive attitudes toward services. Further analyses found that lesbian/gay/bisexual/questioning youth held more positive attitudes compared to heterosexual youth. Implications of the current study can assist service providers with eliminating barriers and increasing mental health service use.     

Contesting ‘sex’ and ‘gender’ difference in emotions through music use in the UK

This article builds on social psychological critiques of ‘hardwired’ gender difference in emotions, looking at the topic through the emotional use of music. Starting from the premise that gender differences in emotion are socially and discursively constructed rather than innate, it moves on to challenge existing work in which masculinity and femininity are treated as singular, oppositional concepts, that are ‘normally’ attached to ideas of existing sex differences. Drawing on data, generated from a UK-based online survey of 914 respondents (male = 361; female = 553), this article highlights that whilst gender plays a significant part in shaping the emotional experience of music, this is often mediated heavily by age and personal experience. It suggests that music is a practical means of moving beyond ideas of differences in gender or sex differences in emotional display, towards ideas of diversity, especially given that existing face-to-face research has often found men to be ‘unable’ to communicate emotional experience in particular ways. Both inductive quantitative trends and open-ended fragments from people's emotional experiences of music are included in order to demonstrate how emotions and gender intersect discursively.     

Regendering modernism: the woman artist in Irish women’s fiction

The period between 1922 and 1960 is often characterized as one of social and cultural stagnation in Ireland. Irish fiction was dominated by an avant-garde writing in exile and the local dominance of the short story. Attention to the non-canonical fiction of women during the period, however, reveals a literature that exceeds this paradigm. Meaney focuses on two novels, The Troubled House by Rosamond Jacob and As Music and Splendour by Kate O’Brien, which both feature women as artists. This figure provides in both cases a mode of combining a commitment to narrative realism with a self-reflexive exploration of the role of art, thus evading the fictional polarities of the period. The woman artist as fictional character also offers an opportunity to explore the relationship between gender, sexuality, politics and art. The linkage between sexual dissidence and aesthetic freedom is a persistent trope of modernism in the Irish context, even if it is often critically submerged under the figure of exile. Both The Troubled House and As Music and Splendour might be considered to be supplements to Irish modernism in the Derridean sense, ‘an originary necessity and an essential accident’. Through the figure of the woman artist, both of these marginal novels transgress the configurations of gender at the heart of that modernism’s aesthetic project. Both link transgressive sexuality with artistic production. In doing so they posit a very different relationship between sexuality, aesthetics and politics.     

Parental Control of the Time Preadolescents Spend on Social Media: Links with Preadolescents’ Social Media Appearance Comparisons and Mental Health

Time spent on social media and making online comparisons with others may influence users’ mental health. This study examined links between parental control over the time their child spends on social media, preadolescents’ time spent browsing social media, preadolescents’ appearance comparisons on social media, and preadolescents’ appearance satisfaction, depressive symptoms, and life satisfaction. Preadolescent social media users (N?=?284, 49.1% female; aged 10–12) and one of their parents completed online surveys. Preadolescents, whose parents reported greater control over their child’s time on social media, reported better mental health. This relationship was mediated by preadolescents spending less time browsing and making fewer appearance comparisons on social media. Parental control over time spent on social media may be associated with benefits for mental health among preadolescents.     

Linking Family Economic Pressure and Supportive Parenting to Adolescent Health Behaviors: Two Developmental Pathways Leading to Health Promoting and Health Risk Behaviors

Adolescent health behaviors, especially health risk behaviors, have previously been linked to distal (i.e., family economic pressure) and proximal (i.e., parental support) contributors. However, few studies have examined both types of contributors along with considering health promoting and health risk behaviors separately. The present study investigated the influences of family economic hardship, supportive parenting as conceptualized by self-determination theory, and individual psychosocial and behavioral characteristics (i.e., mastery and delinquency, respectively) on adolescents’ health promoting and health risk behaviors. We used structural equation modeling to analyze longitudinal data from a sample of Caucasian adolescent children and their mothers and fathers (N = 407, 54 % female) to examine direct and indirect effects, as well as gender symmetry and asymmetry. Findings suggest that family economic pressure contributed to adolescent mastery and delinquency through supportive parenting. Further, supportive parenting indirectly affected adolescent health risk behaviors only through delinquency, whereas supportive parenting indirectly influenced health promoting behaviors only through mastery, suggesting different developmental pathways for adolescent health risk and health promoting behaviors. Testing for gender symmetry of the full model showed that maternal and paternal parenting contributed to females’ health risk behaviors directly, while maternal and paternal parenting contributed to males’ health risk behaviors through delinquency. Gender symmetry was largely unsupported. The study highlights key direct and indirect pathways to adolescent health risk and health promoting behaviors within a family stress model and self-determination theory framework, and also highlights important gender differences in these developmental pathways.     

Positive Daily Family Interactions Eliminate Gender Differences in Internalizing Symptoms Among Adolescents

By the age of 18, girls are more than twice as likely as boys to experience internalizing symptoms. Focusing upon the family, a significant factor for adolescent mental health, we examined how positive and negative daily family interactions relate to gender differences in internalizing symptoms. 681 12th grade students (54 % female) completed diary checklists each night for 2 weeks in which they indicated whether they got along with their family (positive family interactions) and argued with their family (negative family interactions). Results indicate that negative daily family interactions explain, in part, why females experience heightened internalizing symptoms. Yet, even in the face of negative family interactions, positive daily family interactions have salutatory effects, reducing females’ emotional distress and eliminating gender differences in internalizing symptoms at high levels of positive interactions. These findings underscore the importance of positive family interactions for adolescent girls’ mental health.     

Gender,ethnicity and feminism: an intersectional analysis of the lived experiences feminist academic women in UK higher education

Studies have begun to explore how those women academics committed to social justice, namely feminist academics, are navigating the increasingly managerial Academy. To understand how these multiple social identities, including gender and ethnicity, interact and intersect, this paper adopts an intersectional approach to understanding the heterogeneity of women’s experiences in academia. Five focus groups with feminist academics (n = 6–10 in each focus group) reveal concerns of hampered career progression as a consequence of being female and openly feminist. Some ethnic minority academics felt that they were forced to choose between a feminist identity or that of their ethnic background. For some women, their feminist identity provided opportunities for challenging dominant practices. The paper concludes that the heterogeneity of feminist academics’ experiences within academia is under-researched and that the lens of intersectionality helps to illuminate this. This paper advances understanding of multiple identities at work, though demonstrating that intersectionality can lead to the accumulation of advantage as well as disadvantage in relation to social identities such as gender and ethnicity, and a political identity such as feminist.     

Youth Pathways to Placement: The Influence of Gender, Mental Health Need and Trauma on Confinement in the Juvenile Justice System

Although the juvenile crime rate has generally declined, the involvement of girls in the juvenile justice system has been increasing. Possible explanations for this gender difference include the impact of exposure to trauma and mental health needs on developmental pathways and the resulting influence of youth’s involvement in the justice system. This study examined the influence of gender, mental health needs and trauma on the risk of out-of-home placement for juvenile offenders. The sample included youth referred to three urban juvenile probation departments in Texas between January 1, 2007 and December 31, 2008 and who received state-mandated mental health screening (N = 34,222; 30.1 % female). The analysis revealed that, for both genders, elevated scores on the seven factor-analytically derived subscales of a mental health screening instrument (Alcohol and Drug Use, Depressed-Anxious, Somatic Complaints, Suicidal Ideation, Thought Disturbance, and Traumatic Experiences), especially related to past traumatic experiences, influenced how deeply juveniles penetrated the system. The findings suggest that additional research is needed to determine the effectiveness of trauma interventions and the implementation of trauma informed systems for youth involved with the juvenile justice system.     

Being women in a male preserve: an ethnography of female football ultras

This article looks at the characteristics of contemporary sports audiences from the perspective of gender, focusing on the phenomenon of female ultras or ‘professional’ football fans. Drawing on ethnographic research conducted in an Italian football ultras group composed of male and female fans, this paper offers an analysis of female participation in communities of organized supporters. In examining the role and position of women inside the considered group, the paper pays attention to their perception of the existing gender differences showing how female ultras explain inequalities on the basis of ‘natural’ and ‘innate’ differences and capacities between men and women. Existing patterns of male dominance are supported by female fans’ own discourses and performance of their gender identity in the ‘male preserve’. Rather than questioning male dominance and gender hierarchies, female supporters’ efforts appear aimed at being recognized as ultras ‘despite being women’.     

independence,dependency and interdependence: struggles and resistances of minoritized women within and on leaving violent relationships

This paper draws on research conducted in Manchester, UK, examining service responses to African, African-Caribbean, Irish, Jewish and South Asian women experiencing domestic violence (Batsleer et al., 2002). Popular discourses of domestic violence, which also feature in services, are underpinned by ‘victim-blaming’ together with an assumption that women only show agency and control when they leave violent relationships, and/or what are constructed as oppressive minority cultures. Contrary to these perceptions, firstly, I note competing notions ascribed to ‘independence’. Secondly, I highlight the strategies of resistance used by minoritized women whether they stay, or leave, abusive relationships, and examine the inter-relationships between gender, class and culture. Thirdly, I outline the level and type of support on offer, including key barriers and dilemmas to accessing sensitive and relevant services that respond to women's positions of minoritization, focusing particularly on refuge or shelter provision as they offer one of the key points of transition for women using domestic violence services. Lastly, I indicate some positive steps that can be taken by helping agencies to respond more appropriately to minoritized women facing domestic violence.     

GENDERED AND CLASS RELATIONS OF OBESITY

Rising attention to the ‘social determinants of health’ puts questions of gender and class squarely on the public health agenda. Most health outcomes and health risk factors are inversely correlated with social class: people with better education, better jobs and higher incomes typically enjoy better health. By comparison, gender differences in health are quite variable, depending on the health outcome or risk of interest. Furthermore, the distribution of any given risk factor tends to vary from society to society, from time to time, and between specific sub-populations. Public health research rarely considers class and gender together. In this paper we summarise and problematise the interplay between gender and class in empirical research on the ‘problem’ of obesity. We suggest that some of the difficulties in explaining research findings arise from limitations in the evidence base used to measure obesity, conceptual ‘slippage’ between key terms like gender and sex, and an erasure of social class from academic language. It is via an examination of these issues that underpin current obesity research that we offer more innovative and effective ways to approach the underlying theoretical and health promotion problems. Nevertheless, we acknowledge the considerable practical and intellectual challenges of analysing and reporting social determinants like gender and class in an environment that demands certain kinds of scientific evidence.     

The ‘Wrongs’ of Women: Sex and Sexuality in Irish American Women's Writing

A key trait distinguishing the writing of Irish American women from that of their male counterparts is a strong feminist bent often expressed in stories featuring sex and sexuality. In ignoring these characteristics, Irish studies scholars have disregarded a trait established by Irish women writers in oral traditions as early as 600 and in written English since 1685. Much of this material was categorized as the ‘Wrongs of Woman’, a phrase used to describe stories about physical and sexual abuse. These same themes can be traced in the writing of Irish American women since the late nineteenth century. By focusing on these ‘wrongs’, Irish American women have not only carried on the tradition begun by their foremothers; they have also battled patriarchal bonds on three fronts: religion, which created such bonds; society, which reinforced them; and politics, which tries to recreate and re-impose them. A complete understanding of Irish American writing therefore depends on recognizing and adding the contributions of these women to the definition of the literature. This essay defines that cohort, then provides a historically contextualized examination of their literary attempts to address the ‘wrongs’ of women inflicted by religion, society and politics from 1899 to the present. In so doing, this discussion demonstrates the role played by Irish American women writers in promoting, protecting and perpetuating the rights of women in the United States and around the world.