Can the Mental Health Bill truly transform women’s lives?
Will this long-awaited reform finally fix the mental health crisis for women – or will it leave us fighting the same battles?
A few years ago, a woman wrote to me to say she’d spent Christmas Day googling for ways to take her life without it looking like suicide. She’d written to me because she’d stumbled on my blog, 50Sense, and realised her despair was a symptom of her menopause.
Her story isn’t unique. My own mental health took a beating during menopause and I went to some dark places. That was one of the sparks that led to my campaigning with Pausitivity and raising awareness about how hormonal changes can affect emotional well-being. But as I’ve researched, I’ve discovered it’s not just a lack of education leading to women suffering; it’s systemic failures in our healthcare system.
For example, studies show that women are more than twice as likely as men to be diagnosed with anxiety and prescribed antidepressants, often without adequate support. Women also have their concerns dismissed or downplayed (“hysterical women” were being diagnosed in Ancient Greece), while the picture is even bleaker for black women, who have a greater likelihood of being detained under the Mental Health Act than any other group.
That’s why I’ve been watching the passing of the Mental Health Bill as it starts its way through the House of Lords. It promises to transform mental health care in England and Wales and is a rare opportunity to change women’s lives for the better. But will it really address the challenges women face? Or will it, like many initiatives before it, simply make a nod to progress without creating lasting change?
What’s in the Mental Health Bill?
It’s early days and amendments and changes could happen, but with promises to improve patient autonomy, address inequalities and create a more compassionate approach to care, here are the highlights of the bill and what they could mean for women:
- Patient autonomy and safeguards
Under the new bill, there will be a stronger focus on patient choice, involving them in the decisions being made about their healthcare. This will give women a greater say in their care and allow those from vulnerable groups or minority backgrounds to receive treatment plans focussed around their needs. There are also new safeguards planned to protect patients who do not wish for treatments such as electroconvulsive therapy (ECT) – women statistically face more coercive treatment pathways, so that’s good news indeed. - Tailored, gender-sensitive care
While the bill isn’t explicitly gender-focused, its emphasis on individualised care plans will be a step towards addressing the mental health challenges faced by women, which are very different to those facing men. Tailored care plans could be transformative for women with conditions linked to hormonal changes, such as postpartum depression, premenstrual dysphoric disorder (PMDD), or menopause-related mental health issues. - Advance Choice Documents
The proposed introduction of Advance Choice Documents, which would detail a patient’s preferred treatments in advance, would be an excellent step forward. This would really help ensure women’s wishes are respected, even when they cannot advocate for themselves, and that their concerns are taken seriously. It should also help women with histories of trauma, such as survivors of domestic violence, who would be able to say what treatments they are comfortable with and avoid the risk of them suffering further trauma. - Helping hands
Independent Mental Health Advocates (IMHAs) support people with issues relating to their mental health care and treatment, as well as help them to understand their rights under the Mental Health Act, so they won’t feel alone or lost. The bill proposes to expand this role, which could really help women from minority backgrounds or those facing systemic inequalities, who often struggle to have their voices heard. IMHAs could help women from a minority background receive culturally appropriate treatment, or help a domestic abuse survivor discuss her need for trauma-informed care.
I’m also pleased to see plans to let patients choose a nominated person to provide them with practical and emotional support. At present, this person must be a near relative, which completely ignores the reality of life for some women, for whom their nearest relative may be their biggest threat. Under the bill, they’d be able to choose someone they trust to help them, whether a partner, friend or community leader, which could make all the difference between being safe or facing further harm. - Community support and aftercare
The bill also aims to reduce hospital detentions and increase community-based care, which is especially significant for women, many of whom juggle caregiving responsibilities. Ensuring access to support closer to home could prevent their mental health challenges from spiralling.
How will this impact women’s health?
Women often feel dismissed or misunderstood in healthcare settings, particularly when their mental health is being discussed, so these reforms would be a step in the right direction. As it stands, patients will have greater autonomy and dignity, with tailored care, which should lead to more equitable and effective treatment.
But – and sadly, there’s always a but – there are still concerns over the practicalities, especially in today’s cash-strapped NHS. For instance, will mental health practitioners be given the right training to allow for patient autonomy? Also, the availability of mental health services varies widely, so how will rural and deprived areas access this vital help?
Systemic biases won’t vanish overnight. Gender inequities in mental health care have roots that stretch back centuries and while hysteria may no longer be a formal diagnosis, its shadow lingers and plays a role in how women with mental health concerns are perceived and treated today.
Thankfully, groups such as Labour Campaign for Mental Health are lobbying peers and MPs to highlight the areas of the bill they think could be improved. But ultimately, lasting change will depend on rigorous implementation and oversight, adequate funding and a cultural shift in women’s healthcare.
The way forward
Women deserve better. Too many of us have been dismissed, misdiagnosed or mistreated when we’ve sought help, leaving us less likely to go to the GP in the future. While this bill offers hope, it would just be one piece of the puzzle and there are many, many other pieces to go.
But that change won’t happen without you. We all need to share our stories, to contact our MPs and tell them enough is enough. And each and every one of us needs to advocate and lobby for the training, funding and accountability needed to ensure this bill – and every other healthcare bill that follows – delivers for every woman, no matter her age, social status, race or religion.
Let’s push for a system that truly meets our needs. Because we can’t afford to wait any longer.
Photo: Matthew Ball on Unsplash
