Psychologist explains domestic violence, caregiver stress impact women’s mental health: Here’s how to help them heal | Health – Hindustan Times

Report on Gender-Specific Stressors and Their Impact on Women’s Mental Health in Alignment with Sustainable Development Goals

Introduction: A Public Health Imperative

Violence against women and gender-specific stressors represent a significant global public health challenge, directly impeding progress toward Sustainable Development Goal 3 (Good Health and Well-being) and Sustainable Development Goal 5 (Gender Equality). According to the World Health Organization (WHO), approximately 30 percent of women globally have experienced physical or sexual violence. This report analyzes key psychiatric triggers affecting women, such as domestic violence and caregiver stress, and outlines recommendations for a healthcare response rooted in the principles of the SDGs.

Key Psychiatric Triggers and Their Consequences

Clinical observations indicate that women frequently present with psychiatric symptoms stemming from gender-specific stressors. Addressing these triggers is crucial for achieving SDG Target 5.2, which calls for the elimination of all forms of violence against women and girls.

Domestic Violence: A Major Contributor to Trauma

Domestic violence (DV), encompassing both physical and emotional abuse, is a primary cause of severe mental health conditions in women. This directly contravenes the objectives of SDG 5. The resulting psychiatric diagnoses often include:

• Complex Post-Traumatic Stress Disorder (PTSD)
• Dissociative Disorders
• Major Depressive Disorder (MDD)

Survivors may also present with non-specific physical complaints that mask underlying trauma, necessitating the use of trauma-informed assessment tools for accurate diagnosis.

Perinatal Psychiatric Conditions

The perinatal period presents unique mental health challenges for women, including postpartum depression, anxiety, and psychosis. Social and cultural stigmas often prevent women from seeking necessary care, undermining SDG Target 3.4 (promote mental health and well-being). Early identification through screening protocols like the Edinburgh Postnatal Depression Scale is essential.

Caregiver Stress and Burnout

Women, particularly those in the ‘sandwich generation’ caring for both children and elderly relatives, face a heightened risk of caregiver stress. This burden can lead to adjustment disorders, burnout, and Generalized Anxiety Disorder (GAD), compromising their overall health and well-being as outlined in SDG 3.

Recommendations for Women-Centric Psychiatric Care to Advance SDGs

To effectively address these challenges and support the achievement of the SDGs, psychiatric care must be specialized, safe, and holistic. Creating women-centric psychiatric wards is a clinical necessity and a social responsibility.

Essential Clinical Features

Specialized wards should incorporate key features to ensure safety, dignity, and recovery:

1. Gender-Sensitive Intake Protocols: Tailoring the admission process to the unique experiences of women.
2. Routine Trauma and Violence Screening: Proactively identifying histories of abuse to provide appropriate care.
3. Mother-Child Provisions: Allowing for maternal bonding in postpartum cases to support both maternal and infant well-being (SDG 3).
4. Multidisciplinary Teams: Integrating psychiatrists, psychologists, social workers, and legal advocates to provide comprehensive support.

Holistic Recovery Services

Beyond clinical treatment, holistic care is required to restore autonomy and empower women, aligning with the broader goals of SDG 5. Recommended services include:

• Evidence-based psychotherapies such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR).
• Group therapy sessions to provide peer validation and support.
• Access to legal aid, childcare services, and vocational rehabilitation programs.

The Imperative of Trauma-Informed Care

Staff must receive comprehensive training in trauma-informed care, de-escalation techniques, and cultural competence. This ensures that women are treated as individuals recovering from profound injuries, fostering an environment of healing and respect. Such an approach is fundamental to building the effective and inclusive institutions envisioned in SDG 16 (Peace, Justice and Strong Institutions).

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article extensively discusses the mental and physical health consequences for women facing domestic violence and caregiver stress. It mentions specific conditions like “complex PTSD, dissociative disorders, and major depressive disorder (MDD),” as well as physical complaints such as “migraines, gastrointestinal torture, or habitual pain.” The focus on perinatal psychiatric conditions like “postpartum depression, postpartum anxiety, and postpartum psychosis” further solidifies the connection to health and well-being. The article also emphasizes the role of the healthcare sector in providing “comprehensive care” and the need for “women-centric psychiatric wards.”
2. SDG 5: Gender Equality
   • This is a central theme of the article. It directly addresses violence against women, citing that “approximately 30 percent of women worldwide have experienced physical and/or sexual violence.” The discussion revolves around “gender-specific stressors” that disproportionately affect women, such as domestic violence and the “caregiving burden.” The article also touches upon the unequal burden of care, noting the stress on “‘sandwich generation’ women caring for both seniors and children,” which is a key aspect of gender inequality.
3. SDG 16: Peace, Justice and Strong Institutions
   • The article’s focus on eliminating violence and providing support systems for victims connects to SDG 16. It highlights the need for a robust institutional response to violence against women by advocating for “multidisciplinary brigades” that include “legal lawyers” and access to “legal aid conventions.” This points to the necessity of strong institutions that can provide justice and support to survivors of violence, thereby reducing violence in society.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • The article directly supports this target by focusing on the promotion of mental health for women. It details the severe mental health impacts of violence and stress, such as depression and anxiety, and advocates for specific interventions. The call for “women-centric psychiatric wards,” “trauma-informed care,” and access to “substantiation-grounded psychotherapies like CBT for trauma, DBT for emotion regulation, and EMDR for PTSD” are all measures aimed at treating mental health conditions and promoting well-being.
2. Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.
   • This target is explicitly addressed. The article opens by stating that “Violence against women, including intimate partner violence and sexual violence, is a pressing global health concern.” It discusses “domestic violence (DV)” as a primary trigger for psychiatric symptoms and cites WHO data on the prevalence of physical and sexual violence against women. The entire piece is framed around understanding and healing from the trauma caused by this violence.
3. Target 5.4: Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate.
   • The article highlights the negative impact of the unequal burden of unpaid care work on women’s mental health. It identifies “caregiver stress” as a major risk factor, particularly for “‘sandwich-generation’ women managing both senior and child care,” leading to “depression, burnout, and generalised anxiety disorder (GAD).” By identifying this as a “gender-specific stressor,” the article implicitly calls for recognition and support for women performing this unpaid work, aligning with the goal of Target 5.4.
4. Target 16.1: Significantly reduce all forms of violence and related death rates everywhere.
   • While the article focuses on the health consequences rather than death rates, its core subject is the reduction and prevention of violence. It states that “violence against women is preventable.” By advocating for comprehensive support systems, including legal aid and multidisciplinary teams, the article contributes to the broader goal of creating institutions and societal structures that reduce all forms of violence, particularly domestic and intimate partner violence.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Prevalence of Violence Against Women
   • The article explicitly mentions a key indicator used to measure Target 5.2. It cites a “World Health Organization (WHO) estimate” that “approximately 30 percent of women worldwide have experienced physical and/or sexual violence at the hands of an intimate partner or non-partner.” This statistic is a direct measure of the prevalence of violence against women, which is a primary indicator (like SDG Indicator 5.2.1) for tracking progress.
2. Use of Mental Health Screening and Assessment Tools
   • The article mentions several specific tools that serve as practical indicators for identifying and addressing mental health issues (Target 3.4) and trauma from violence (Target 5.2). These include:
     • Trauma-informed assessment tools: The article suggests using “the DAYS- 21, HTQ, or ACE scores to identify covert torture.” The use and results of these tools can be tracked to measure how effectively the healthcare system is identifying trauma.
     • Perinatal depression screening tools: It recommends “Screening with tools like the Edinburgh Postnatal Depression Scale (ENDS) is essential for early identification” of postpartum depression. The rate of screening among new mothers is a clear indicator of progress in perinatal mental healthcare.
3. Availability of and Access to Integrated Support Services
   • The article implies the need for indicators related to the availability of comprehensive services. It calls for “multidisciplinary brigades (psychiatrists, psychologists, social workers, legal lawyers)” and access to “legal aid conventions, childcare services, and vocational recuperation.” The number of women-centric facilities offering these integrated services and the number of women accessing them can serve as indicators of progress towards providing holistic support for victims of violence (Targets 5.2 and 16.1) and those with mental health conditions (Target 3.4).

4. Summary Table of SDGs, Targets, and Indicators

Source: hindustantimes.com