Toxic Cultures & Women’s Mental Health—Time To Act!

The allegations of the past month have reignited wider questions about Australian political culture, including long-held debates about sexism and misogyny. The debates about sexism and misogyny have spread to our schools, hospitals and other workplaces. Tens of thousands of people turned out to marches across Australia, in the ‘March 4 Justice’ protesting against the sexual abuse and harassment of women in our country.
What does all this mean for women’s mental health? As Mental Health experts, we are very familiar with the huge role of trauma, loss and abuse in the development of mental ill health—particularly in women. Early life emotional invalidation, physical abuse and worst of all sexual assault, all play a big role in the subsequent development of lifelong depression, anxiety disorders, complex PTSD and other mental illnesses. When we take a developmental history from our patients, we look for recollections of such events and then attempt to understand the woman’s mental ill health trajectory springing from emotional neglect, invalidation and other types of early stress. Our understanding in Psychiatry of the impact of trauma is of an intrapersonal one. But what happens in the situation of repeated emotional invalidation in the external environment? As Brittany Higgins, the woman who reported her rape, said when she spoke to the thousands of protesters outside Parliament House at the March 4 Justice: ‘There is a horrible societal acceptance of sexual violence experienced by women in Australia.’ External invalidation of the horrors experienced by a rape victim by systematic blaming of the woman or denial of the assault completely is all too common and the impacts on that individual woman are catastrophic for her mental health. Then there is the ripple effect, where other women have remained silent about their own experiences after seeing the impact that disclosure has had on the initial ‘whistle blower’. And an even more insidious ripple effect is when young girls and women absorb the general concept that ‘nice women are passive’ or ‘to get on, you just have to accept it’. Their subsequent development of depression, eating disorders and other mental illnesses may well be seen, at least in part, a response to inaction by authorities. A kind of pervasive ‘learned helplessness’ that enables sexism and misogyny to thrive.
Psychiatrists and other Mental Health practitioners can righteously deplore sexism and the denials of sexual assaults because we know about the impact of trauma on mental health. However, an uncomfortable parallel between Parliamentary misogyny and insensitive Psychiatric treatment can be drawn. These parallels loosely include Mental Health systems that still question the validity of a sexual assault within psychiatric wards, community care units or the use of the label ‘Borderline Personality Disorder’ to describe a victim’s behavioural responses to traumatic events past or present. There are lessons to be learned from the anger expressed across the nation at the treatment of women. Misogyny and sexism do exist in the healthcare systems we work in and just as sweeping change is being strongly, clearly and loudly advocated for in our National Parliament, we need to advocate just as strongly for open discussion and change in the way women will be treated in our mental healthcare systems. Strong advocacy is needed for those women receiving care and those women giving care. The recent report by the Royal Commission into Mental Health in Victoria may assist some of the needs of women with mental ill health but a great deal more is needed.
It is high time that the toxic culture existing in our Nation’s peak governing and law-making workplace be exposed and change dramatically. The ripples of such change should extend to our own workplaces to ensure that women do not experience trauma that erodes their mental health, by direct assaults or the damaging downstream effect of active and passive sexism and misogyny.


Prof Jayashri Kulkarni FRANZCP
Director Monash Alfred Psychiatry research centre (MAPrc)





 MAPrc Monash Alfred Psychiatry Research Centre, Level 4, 607 St Kilda Road, Melbourne 3004

 © MAPrc 2013. Designed and hosted by Infoxchange Australia