Features and News

(April 9, 2019) At the end of last month, I had the privilege of presenting to more than 100 treatment providers and clinicians gathered at Gaudenzia Inc.’s 26th Annual Women and Children’s conference in Harrisburg, Pennsylvania, Gaudenzia Inc. is an organization that primarily operates drug and alcohol treatment programs at facilities for men and women in the mid-Atlantic region, but also offers programs for people suffering from severe mental illness and co-occurring mental illness and substance use disorders.

My presentation focused on how women with serious mental illness are disproportionately impacted by the disorders compared to men, and highlighted new research and insights into appropriate treatment considerations for women with co-occurring mental illness and substance-use disorders.

As research shows, there are noticeable differences between men and women with severe mental illness. For example, the onset of severe mental illness tends to occur at a later age for women than for men. On average, women develop symptoms for bipolar disorder or schizophrenia in their late 20s, while men tend to develop symptoms years sooner, in their early 20s. In addition, women with bipolar disorder are more likely to experience rapid cycling – quick alternations between episodes of mania and depression – than men with the same disorder.

There are also unique challenges associated with lack of treatment of women with severe mental illness who also have a co-occurring substance use disorder. Untreated serious mental illness and substance use disorders in mothers who are pregnant is associated with poor maternal and perinatal health, maladaptive fetal growth and poor cognitive development of the child. Therefore, appropriate mental health and substance use disorder treatment is essential for women living with these conditions. And in 2017, only 12% of individuals received such specialized treatment, according to the Substance Abuse and Mental Health Services Administration.

In 2016, the Treatment Advocacy Center’s background paper identified 10 ways women with serious mental illness — typically untreated mental illness — suffer more than the general population or men with the same psychiatric conditions.

1. MORE LIKELY TO BE INMATES Women with serious mental illness are twice as prevalent as men in state prison populations.

2. MORE LIKELY TO BE VICTIMIZED Adults with serious mental illness are up to 23 times as likely to be victimized, and women are more likely to be victimized than men.

3. MORE AT RISK FOR SUICIDAL BEHAVIORS More than 40,000 Americans take their lives annually. All of them have mental health conditions. Women make up more than half the at-risk adults in nearly every category of suicide risk.

4. LESS LIKELY TO RECEIVE NEEDED HOSPITAL SERVICES Women with serious mental illness are hospitalized for shorter periods than men, even when sicker.

5. MORE LIKELY TO BE RE-INCARCERATED Women with serious mental illness have much higher recidivism rates than men with the same conditions.

6. MORE AT RISK FOR SELF-HARM BEHIND BARS Women inmates with serious mental illness are more dangerous to themselves and more likely to be disciplined.

7. MORE LIKELY TO LOSE CUSTODY OF THEIR CHILDREN Women with serious mental illness are on a "fast track" for termination of parental custody.

8. MORE LIKELY TO HAVE A CO-OCCURRING DISORDER Women with serious mental illness are more likely to have a co-occurring substance-use disorder as compared with men. With co-occurring serious mental illness and substance abuse, women are at greater risk for arrest and incarceration.

9. MORE VULNERABLE TO NON-PSYCHIATRIC HEALTH RISKS Women with serious mental illness have higher risks for serious physical health conditions than men.

10. MORE LIKELY TO EXPERIENCE EMOTIONAL BURDENS Women with serious mental illness feel more internalized stigma and guilt than men.

For the full paper on these disparities, click here. To see a copy of the slide presentation from my talk at the Gaudenzia Inc. conference, click here.