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Dear Girls Inc. » Women's Courage

Dear Girls Inc.

March 3rd, 2011 by bisi Leave a reply »

TO: Girls Incorporated

FROM: Bisi Ibrahim, Class of 2011, Stanford University

DATE:  March 3, 2011

SUBJECT: Initiating Mental Health Programs For Young Women

As evidenced by thorough quantitative and qualitative research, the current state of mental health and healthcare services for young women in the US and internationally has been exposed, revealing a gaping, wanting void. Nevertheless, interventions and initiatives leading to successful outcomes are under-researched and underfunded, while in our societies we continue to adhere staunchly to our belief that it is not a cause for concern.

As a leading, non-profit organization invested in the empowerment of young women, Girls Incorporated has not only created programs for girls’ issues, but also in an extraordinary display of astuteness, Girls Incorporated has established its own Girls’ Bill of Rights. In this document Girls Incorporated has declared and vowed amongst many rights, two very pertinent rights: Girls have the right to be themselves and to resist gender stereotypes; Girls have the right to accept and appreciate their bodies. Both of these rights are directly related to mental health as often gender stereotypes are the root of mental disturbances and they often lead to an inability for girls to accept and appreciate their bodies. Therein Girls Incorporated inherently needs to address, create and maintain newer mental health-focused programs for an oft-stigmatized issue. Girls Incorporated should not continue to foster the silence that shrouds mental health and that endangers the lives of many young women globally, as it goes against Girls Incorporated’s mission.

The Basics

In the US, researchers have noted and repeatedly concluded that young girls, often beginning during puberty, are experiencing internalized mental disorders at a rate alarmingly greater in proportion than their male peers. For Caucasian girls evidence shows that gender stereotypes and societal standards of beauty in concordance with the traumatizing events of puberty are promoting an increase in depression and anxiety disorders in young women. Cross-cultural studies in the US have also revealed mental health discrepancies for minority women (African American, Asian America, & Latinas), as well as for young women emigrating from developing countries (including refugees of war-torn countries who are coping with Post-Traumatic Stress Disorder), but it is unclear whether it relates with the traumatizing effects of puberty.

The latter studies also showed that minority and immigrant women often experience lower incidences of internalized mental disorders, but evidence suggests that the numbers may be unreliable due to the manifestation of these disorders resulting in a different manner than that of Caucasian young women. It has been hypothesized that minority young women are often affected by stereotype threat. For immigrant young women it has been hypothesized that while they are initially afforded economic advantages and general health advantages not conferred by staying in their impoverished, war-torn, or economically unsound country, they arrive in developed countries like the US only to still face barriers in access to mental healthcare—the barrier often being stigmatization and anxiety over the need for assimilation. Therein on top of potential, preexisting mental disorders such as PTSD, they acquire adjustment-related mental health disorders that compound and lead to severe mental health disturbances.

What’s really going on?

With such a wealth of information repeatedly uncovering the same outcomes, one would think that there would be relative success in initiatives and interventions to counteract these findings. This, however, is far from the current state of initiatives and interventions. In fact as a whole, youth mental health is in shambles. The rate at which mental-health care services fail to meet the needs of youth patients is nearly 100%, this figure including developed nations. (Patel, 1303; Hickie, 63) This is a result of many mental healthcare services being adapted from adult mental health models, and assumed that with slight variations would have similar success for young adults and adolescents. Decades later, it is plainly just not working. (Hicke, 63).

For young women, the mental healthcare system fails them twice. Not only are intervention models faulty, but also diagnoses are often occurring decades after the onset of a mental disorder. Young women are not often diagnosed with mental disturbances until they are well into adulthood, and by then their mental disturbances have influenced other health and development discrepancies, including lower educational achievement, substance abuse, violence, and poor reproductive and sexual health. [Note: Girls Incorporated already has programs with many of these aforementioned co-occurrences, so why not deal with the root of the problem?]

What can be done?

Successful interventions are rare but are possible by incorporating several key components. For the few interventions that do exist, many are still being tested and their results are still in infancy; they also often need financial support. Nonetheless, addressing financial allocations and resources should not be the first step in creating successful interventions and initiatives for mental health and wellness for young women.

We must first begin with the minute details such as awareness and education. First, it is important that we begin to see mental health as an issue equal in magnitude to physical health. As a society we cannot continue to put mental health off as something that happens to the “others”—whomever we assume those “others” might be, we often fail to realize are those closest to us. Furthermore, health and wellness as a whole include the body and mind. In fact, it should be noted that mental illnesses are often correlated with the spread of communicable diseases, increased rate of acquiring non-communicable diseases and increased injury.

Secondly, on the cusp of education we must make it very clear that early intervention is key. 75% of adult mental disorders start before age 25, of which 50% have an onset before age 15; either way by adulthood the effects of a mental illness are less reversible and more challenging to care for. (Hickie, 64) One in four young people will experience a mental health disturbance in their lifetime that will significantly influence their adolescence and/or early adult life. However, in spite of this statistic early intervention has been associated with significant improvements in at least the first two years after presentation of a mental disorder. It would be a travesty to not take advantage of an answer sitting right in front of our faces.

Finally, we must work on the development of youth oriented mental health models. Current approaches are ineffectual and we must be open to newer models such as those incorporating the use of online systems, electronics, and computer interactions. We could get bogged down in arguments over whether technology alienates us from each other, but research has repeatedly shown that youth and young adults are less inhibited when interacting with computers and are more willing to share their conflicts and emotions leading to earlier diagnoses. (Coyle, 2007) It still requires that ethical and privacy considerations are hashed out, but it shows significant improvements in comparison to traditional interventions.

By focusing on mental health, Girls Incorporated will come full circle in maintaining its mission to inspire strong, smart and bold girls. If Girls Incorporated were to have a mental health program it could function much like the already existing pregnancy prevention program. The program would be divided along distinction age groups, and in the age groups most affected by mental health disorders (i.e. 12-14, 15-18), there needs to be extra emphasis placed on not just on awareness and education, but the removal of stigmatization in seeking mental health. Further ties should be made with the already existing PEERsuasion Program to make sure that peers do not feel that it is on them to keep mental health issues in secrecy, but instead have peer appropriate interventions (i.e. having peers realize that they are often the first resource for their friends suffering from a mental illness and having them remind their friend that seeking further help is not only an option, but the best option.)

I truly believe Girls Incorporated has the willpower, means and inherent motivation to create such a program that will hopefully become the model for future successful, intervention models for mental health in young women.

Coyle, D., Doherty, G., Matthews, M., Sharry, J. (2007). Computes in talk-based mental health interventions. Interacting with Computers 19, 545-562.

Hickie, I.B. (2011). Youth mental health: we know where we are and we can now say where we need to go next. Early Intervention in Psychiatry 5(1): 63-69.

Patel, V., Flisher, AJ., Hetrick, S., McGorry, P. (2007). Mental health of young people: a global public-health challenge. Lancet 269, 1302-1313.

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3 comments

  1. kaking says:

    Hi Bisi!

    Really great policy memo! I think you do a really great job at laying out the issue and addressing the shortcomings with the current approaches to dealing with teen mental health issues. As you stated, I think one of the huge issues with mental health problems is how much these types of problems are oftentimes written off and not seen as legitimate issues affecting the well-being of young people. I think it’s really important, as you said, to really address these mental health problems when they first arise, and not years later after they’ve already potentially had a detrimental effect on someone’s life. I really liked your suggestion that Girls Inc focus on mental health issues as well. However, I wonder what type of additional resources Girls Inc would need in order to adequately do this. Learning about various mental health issues and how to deal with them takes a lot of time, education, and training. Thus, I really liked your suggestion that perhaps these mental health programs could have some sort of online component, where people could express their feelings/receive feedback online. This might be more feasible, and some people might feel more comfortable expressing their issues secretly. Overall, great post!

  2. Elise says:

    Thanks for the post, Bisi. I came across “Girls Inc” for the first time a week ago, when I was looking into resources to offer adolescent girls, as they learn about their changing bodies. I think it’s a terrific organization, and a very appropriate audience for your work on women’s mental health. I think you capture the facts beautifully – when girls hit puberty, they are at a much higher risk of developing depression and other mental health disorders. I am so glad that you’ve focused on mental health disorders, because it’s often a topic we feel uncomfortable discussing (along with eating disorders, death, body image, money) openly. But we cannot promote women’s health without considering their minds and spirits, in addition to their bodies.

    Without education, prevention, and intervention programs, girls may feel completely alone, abnormal, hopeless, unloved, confused, and even suicidal. This can be debilitating, and certainly does not help advance the women’s rights movement, which requires all hands on deck. Girls need to be celebrated and supported for their unique energy. As Eve Ensler promotes in her newest book, “I am an Emotional Creature,” we need to stop telling girls that they’re “too intense,” or that they need to “reign it in, settle down, and be rational.” Instead, we should be urging them to HOLD ON to their vivacious “girl cells” that represent passion, compassion, and creative energy. I think that if Girls Inc teamed up with V-Girls, Ensler’s spin-off of “V-day.org” meant for adolescent girl advocates and activists, we would see phenomenal prevention efforts around the world.

  3. labrian says:

    Fabulous post. You’ve clearly done a substantial amount of research on this subject. Job well done. It is interesting how mental health is often stereotyped as a “weak” illness, just because the brain is something that we’re supposed to have a degree of control over. Our rational thoughts should just be able to “power through” any mental health issues we have and “fix them ourselves.” In recent years, there has been a growing awareness of mental health disorders and psychological issues becomes more mainstream and normalized, but the stigma is still there. Perhaps it is a very first-world problem, but even so, that does not make the pain of any person suffering from mental illness less than the pain of someone suffering from another health problem. Just by giving greater recognition to these issues and providing education (just as we do for other more traditional health issues) we can hopefully decrease their prevalence and increase the recovery rate. Especially for young women.

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