The theme for Women’s Day 2025, ‘Accelerate Action’, aims to promote swift action to achieve gender equality. But are women falling through the cracks unnoticed? Are standalone laws and policies sufficient to prevent this?
Mental health is often treated as an individual struggle, but for women, it is deeply tied to systemic discrimination, gender-based violence and a lack of legal protections. It is affected by social norms, gender roles and economic and social dependence.
Mental healthcare is a fundamental right, a fact acknowledged by the Mental Healthcare Act 2017 (MHCA) and in the National Mental Health Policy 2014 (MHP). What they fail to highlight, however, are the unique challenges faced by women – challenges that shape the reality of women’s mental health.
Around 30% of women across the world face physical or sexual violence. WHO reports that 35% of women in India face gender-based violence. In the National Crime Records Bureau’s 2022 report, over 4,00,000 cases of crime against women were registered, of which over 30% were ‘Cruelty by Husband or His Relatives’, nearly 19% were ‘Assault on Women with Intent to Outrage her Modesty’ and 7% were ‘Rape’. Gender-based violence, rampant as it clearly is, has lasting mental health consequences.
And this isn’t the only challenge faced by women and girls in the country. Culture plays a role in determining the mental health of women too. Around 22% of women face common mental health conditions (including depression and anxiety) during pregnancy. Not surprisingly, risk factors for these conditions were reactions of the husband or in-laws to the dowry, difficult relationships with husband or in-laws, intimate partner violence, and pressure to have a male child. Unsafe abortions, adolescent pregnancies, lack of autonomy around if/when to have children, and miscarriages further link reproductive health and mental health. Suicides in young mothers is a growing problem that has not received sufficient attention either.
Societal and family norms directly impact mental health outcomes too. Women are forcibly institutionalised or involuntarily treated and overmedicated for mental health conditions, with a stark absence of autonomy. Sociocultural factors such as limited access to education, employment, a subservient status in a patriarchal society, and the stigma associated with mental illness lead to families institutionalising women against their will. Women are also then abandoned by families in institutions, and with a lack of economic independence, there is often no way out. Considering the excessive discrimination women with mental illnesses face in employment, marriage, housing and education, a very bleak picture is drawn for women encountering mental health challenges.
India does have laws to protect women. The Protection of Women from Domestic Violence Act, 2005 mentions the duty of the government to coordinate with the health ministry in cases of domestic violence, without any mention of the mental health of the victim. The Sexual Harassment of Women at Workplace (Prevention, Prohibition and Redressal) Act, 2013 mandates compensation to be determined by mental trauma and emotional distress faced by the victim as one of the factors, but the law does not lay out provisions for mental healthcare for women who have encountered sexual harassment.
There is a conspicuous absence of integration with healthcare, especially mental healthcare. There is also a lack of convergence between various laws to protect women.
The MHCA and MHP, progressive as they are in recognising the right to and importance of mental healthcare, do not adequately address gender-specific challenges. Gender-sensitive mental health services are not mandated. Gender-sensitive services could take a wide range of forms – including women in planning and designing services, comprehensive training about the needs to avoid gender bias and discrimination in service provision, accessible services for women who face barriers to care such as family and childcare responsibilities, easier pathways to care for women encountering abuse, and safe spaces in institutions where men, including men who are staff, are not allowed to enter.
Further challenges are faced by transwomen and non-binary individuals who do not find a place in healthcare delivery that addresses their gender preferences, the stigma they face, and their unique mental health needs. For instance, the minimum standards for mental health establishments in the country only necessitate separate ward for female and male patients.
The MHCA has rights to ensure confidentiality, access to information, informed consent, protection from cruel and degrading treatment, and provisions for legal aid. It has provisions for an individual to choose a nominated representative, a person who can make decisions on their behalf should they lose the capacity to do so at any point, and an option to make Advance Directives (written documents that allow a person to specify how they wish to be cared for and treated for a mental illness).
These rights are progressive. But a lack of their awareness combined with structural discriminations against women make them susceptible to coercion in mental health treatment. The question we should be asking is, does the MHCA sufficiently protect against coercion of women in psychiatric care on-ground, apart from providing for rights?
These challenges might not be easy to solve but solving them is essential. Healthcare, law enforcement and justice, and economic support can all come together to ensure that women are not falling behind when it comes to mental health and equity. India has taken steps towards tackling gender-based violence in an integrated manner. One-stop crisis centres are meant to provide medical care, legal support, psychological services, and emergency shelter. Sadly, implementation is lacking, with centres being nonfunctional or not having trained professionals for mental health support. Ineffective disbursal of funds limits their operation too.
The challenges to be addressed are broad and deeply entrenched in society. Mental health cannot be left as a health concern to be tackled by the medical field without addressing the lived realities of gender-based violence survivors, pregnant women, unpaid caregivers, and women battling stigma in marriage and employment. Women empowerment, similarly, cannot be addressed effectively without addressing mental health consequences of the challenges faced. Social justice, autonomy, family dynamics, economic empowerment, and women’s mental health are an intertwined web that requires an intersectoral solution.
Mental health is not a privilege, it is a right. It is not enough to want to empower women without adequately working on systemic changes to support it. This Women’s Day, it is essential to go beyond symbolic discussions of empowerment and equality and into the realm of strengthening legal protections and policy measures, allocating funds appropriately, and building bridges between various players involved in protecting women and their wellbeing.
Ramya Pillutla is a research associate at the Keshav Desiraju India Mental Health Observatory, Centre for Mental Health Law and Policy, Pune.
