More than two in five Australians experience a mental health issue in their lifetime. In 2020–21 more than 3.4 million Australians sought help from a health care professional for their mental health. These statistics are from the Australian Bureau of Statistics’ National Study of Mental Health and Wellbeing (NSMHW) (Australian Bureau of Statistics , 2022). It was also reported:

  • Almost half (46.6%) of females aged 16-24 years and almost one third (31.2%) of males aged 16-24 years had a 12-month mental disorder.
  • Females were more likely than males to have had a 12-month anxiety disorder (21.0% compared to 12.4%)
  • Females experienced higher rates of post-traumatic stress disorder (7.6% compared with 3.6%) than males.
  • 5.3% of females experienced a depressive episode in 2020-21, compared with 3.8% of males.

The Royal Commission into Victoria’s Mental Health System also frames a set of important contextual markers for health promotion and primary prevention work for women and their mental health.

The final report (RCVMHS, 2021) recognises the role of social determinants that contribute to mental health and the evidence to date of their contribution to wellbeing and mental health.

The report also recognises specific factors impacting on women and their mental health, dedicating a specific section on the role that gender and inequality can play on influencing mental health outcomes. Further, it noted the impact of gender and age on mental health, highlighting how women’s mental health can change over her life stages.

This also is reflected in the Federal Government’s (2018) National Women’s Health Strategy 2020-2030 which noted that:

There are a number of critical life points experienced by women and girls, such as puberty, pregnancy, motherhood and menopause that can result in poor mental health.

​(Department of Health, 2018, p. 35)

In keeping with the Australian Longitudinal Study on Women’s Health (ALSWH), the strategy also noted that:

… A variety of situations typically associated with women can lead to anxiety and depression. These include; infertility and perinatal loss, being a primary care giver, relationship breakdowns, violence or abuse, discrimination, unemployment or under-employment, isolation and socioeconomic disadvantage.

​(Department of Health, 2018, p. 35)​

The study found that mental health is a major issue for Australian women with anxiety symptoms being more prevalent than depressive symptoms (Department of Health, 2018).

ALSWH’s own policy briefs on mental health characterises the intersection of gender and life stage on mental health further. Specifically, their study draws upon the cohorts of women, advising that in 2013 (the most recent collection in the study):

  • Women aged 85-97 reported the best mental health followed by women aged 65-70, then women aged 37-42 and then women aged 22-27
  • Women aged 18 to 23 had the worst mental health of the cohorts (including higher levels of psychological distress)(Mishra, et al., 2019)

While drawing on earlier data, the federal strategy also recognises the prevalence of anxiety and depression, and also notes that women experience post-traumatic stress and eating disorders at higher rates than men (Department of Health, 2018).

In the Victorian context, the Royal Commission’s (2019) interim report noted that “a greater proportion of girls aged 0-17 years are being diagnosed with more eating, personality, mood and anxiety disorders” (p.45).

It is worth noting that even though a 2017-2018 survey on national health found that mental illness and behavioural problems were more prevalent in Victorian women (23.7%; State of Victoria, 2019), research has also found that, for instance, men report higher rates of loneliness and young males aged 4 to 17 report a higher prevalence of mental illness than young females (RCVMHS, 2021; Lawrence, et al., 2015).

The role of intersectionality on mental health is recognised in the Royal Commission’s (2021) report emphasising the need for safe, inclusive and valued support that is culturally appropriate.

Work undertaken by the Women’s Health Services across Victoria on mental health is reflected in submissions provided by Women’s Health Victoria (2019) to the Royal Commission into the Victorian Mental Health System and submission to the Productivity Commission Inquiry (2020). The submissions identify a need “for an intersectional gender-sensitive approach to be applied to all areas of mental health policy, health promotion and service provision” (Women's Health Victoria, 2019, p.2).

Gender-sensitive approaches to mental health for women and girls should, among other things:

  • Prioritise understanding mental distress in the context of women’s lives
  • Be co-designed with women and enable women to be involved in initiatives intended to promote good mental health and to make choices about mental health care and treatment
  • Address reproductive and life stage elements of mental health and wellbeing
  • Address the mental health impacts of gendered experiences including sexual abuse, family violence and poor body image
  • Be responsive to the diversity of women’s needs, experiences and backgrounds including race, sexuality and disability. (Women's Health Victoria, 2019, p.3)

Role of health promotion and primary prevention on women’s mental health

Primary prevention and health promotion have been implemented to address mental health, and specifically women’s mental health, for some time.

The National Women’s Health Strategy has five priority areas for action relating to mental health. The first key priority areas is, “Enhance gender-specific mental health education, awareness and primary prevention” (Department of Health, 2018, p.35). The specifics of this action area include:

  • Collaborating with existing early learning institutions and schools to strengthen early education and promote opportunities to screen young girls and adolescents who may be at high-risk
  • Equip primary and secondary school educators, as well as physical and mental healthcare staff in these environments, to recognise the factors, such as sexual and family violence, discrimination or distorted body image, that influence mental health in young girls and adolescents
  • Increase awareness of the impact of sex and gender on mental health for women and girls
  • Identify and address the longer-term systemic forms of discrimination in information provision, service delivery and other social determinants that impact on mental health
  • Support the development of media and community awareness materials covering a range of mental health conditions affecting women and girls across the priority populations
  • Develop and deliver ‘protective’ mental health strategies to reduce the onset of mental ill-health

(Department of Health, 2018, pp. 36-37

In the interim summary report, the Royal Commission (2019) noted an emerging theme of prevention in its consultations stating that:

…prevention of mental illness is closely linked to broader social and economic factors such as those that help build individual and community resilience. The notion of taking a systems approach to building good mental health, rather than just responding to mental illness, emerged frequently in the evidence the Commission has received. Many social determinants shape mental health (p.11).

In the final summary report, the Royal Commission (2021) has noted that there will be a place for primary prevention and health promotion going forward:

There will be appropriate and continuing investment in the leadership, coordination and delivery of a state-wide approach to prevention and promotion activities, and these activities will concentrate on human rights and on reducing imbalances in mental health and wellbeing outcomes (p. 28).

For women’s health services, it is vital to take an intersectional gender approach to mental health from primary prevention to early intervention, treatment and recovery (Women's Health Victoria, 2019)

Women’s Health Victoria (2019) eloquently summarise the approach to implementing health promotion and primary prevention in women’s mental health while considering the intersectional factors which impact on women:

...Investing in and strengthening gender equity ... can address the social determinants that lead to unequal mental health outcomes for young women... investing in gender equity is key to preventing violence against women and can also improve the health and wellbeing of men and boys and gender diverse people. Applying an intersectional lens will ensure interventions are sensitive, appropriate and effective, and that they support equity among girls and women (pp. 3, 21).