Women as psychiatric casualties

Press, 15 November 1977, Page 16

Women as psychiatric casualties

Whenever the topic of the difficulty of being a woman in our society, particularly a young mar-< ried woman with children, is aired in talks or newspapers, a statement is either featured or glibly inserted to the effect that “everybody” is aware that more women than men by far make up our psychiatrically disturbed population. This is even intoned by certain senior people professionally involved in the field. When an apparent clearcut statement of this nature is repeated often enough it becomes an understood axiom and arguments are evolved from it. The claim is then made that, because there is this large casualty rate among women, it is due to a loosely defined phenomenon 'labelled “suburban neurosis.” This term has a number of emotional associations attached to it, namely that it involves living in a suburb of a large population city and giving an apparent veneer of adjustment while within the houses everybody is grossly disturbed; and also because it is neurosis that is caused entirely by circumstances which ■ a normal person cannot cope with. In fact what distinguishes neurosis from other forms of maiadjustment is the inability to learn from continual inadequate reactions, a grossly heightened degree of anxiety, and the repetitive nature of similar forms of inadequate reactions. Unless there is some sort of tighter classification it means that the whole population virtually will be classified to some degree as being neurotic and most of the population to a major extent. This makes the concept of maladjustment of this type pointless in telling us any-' thing about its causation, course or treatment. There is little doubt that certain groups of women in our society are under considerable stress of a different type than in years gone by. Also they

are more verbal and assertive in expressing their dissatisfaction, and this is all to the good. Whether the “suburban housewife” syndrome is anything new in the last few decades or simply the precipitation of a disturbance in women who had

By H. R. Unger, chief clinical psychologist, Sunnyside Hospital. prior maladjustment and who in other ages showed different symptoms, is still by no means a closed argument. What I wish to address myself to here is some figures that throw considerable doubt on the loosely verbalised and emotionalised numbers that are thrown up by the feminist movement. They have been obtained from the National Health Statistics Centre, which is a section of the Health Department in Wellington. I find that the number of males and females admitted for psychiatric in-patient care in New Zealand is approximately equal. For first admissions in 1974 there were 2428 males and 2564 females. Re-admissions were 4939 males and 4558 females. This was an actual drop from 1973 when there were 2499 males and 2730 females admitted for the first time but re-admis-sions at a similar pattern then with 4749 males being readmitted and 4380 females. A similar pattern was shown in 1972. The actual numbers within our psychiatric hospitals were in--1971, 5592 males and 4537 females. These numbers were on a particular day in that year. Factors contributing to this result are that many more males are admitted for alcoholism and patients with this diagnosis tend to remain in hospital for longer periods than those admitted with, say, depressive neurosis. There are two other smaller tendencies that cause the higher male intake, namely that mental retardation male patients are admitted at an earlier age than female and eld-

erly patients discharged to hostel care only are more inclined to be women. A different pattern emerges however when we look at psychiatric units attached to general hospitals which are included in the totals already given.Here we find that of first admissions, only 629 are male and 1138 are female. Re-admissions, 717 are male and 1309 are female. These are generally very short-term and include the milder disturbances referred by general pract i t i o n e r s for more specialised assessment and treatment. Further, breaking down age groups of women admitted, we find that in the 20 to 25 age bracket there are 115 males as against 82 females; in the 25 to 29. 114 males against 81 females; and in the 30 to 34 bracket, 143 males as against 66 females. It is not until age 63 that females start to exceed the number of males. In the diagnostic category of depressive neurosis, which is another term, I believe, for suburban neurosis in popular language, in 1973 there were indeed 42 per 100,000 females in the population and only 18 per 100,000 males, but the peak for the females appears to be between the ages of 15 and 20. Depressive psychosis, which is a very different illness coming from within and having very little connection with outside circumstances, showed 13 per 100,000 females and 7 per 100,000 males thus indicating the bundling together of all forms of depression to bolster an argument. Further, in the depressive neurosis category, 40 per cent of women stayed less than nine days in psychiatric care before returning to their presumably previously disturbing environment, thus indicating that this was very much crisis treatment rather than a careful gradual blossoming of helped self-understanding. Once these facts are accepted, the discussion can move to the number of visits made to G.P.

surgeries with' psy-< chological ills. Such statistics are virtually impossible to collect on a nationwide basis and cart only be done by sampling, and are then very much open to a variety of questions because of the different approaches to diagnosis by G.P.s. A social climate which therefore tends to classify women in a particular way will similarly be absorbed by the medical consultant in the case of the less severe disorders. There is no doubt at all that the problem of

women’s adjustment in our society is an important one and should be discussed and steps taken to ameliorate it. It is not helped however by the creation of a new mythology based on faulty reasoning to replace the old female mystique. Stress appears to fall on both sexes equally with women tending to avail themselves more readily of psychiatric facilities of a general medical hospital nature than men, who tend to favour other forms of alleviation of various medical or tranquillising types.