Today the Interim Report of the Royal Commission into Victoria’s Mental Health System was handed down, following receipt of 3,267 submissions and testimony from 99 witnesses before the four Commissioners. In the wake of yesterday’s announcement of the formation of the Women’s Mental Health Alliance, Sarah Squire (@SquireSarah) of Good Shepherd Australia New Zealand (@GoodAdvocacy) analyses how well the report responds to the mental health needs of women and girls.

It’s been nine months since the Governor of the State of Victoria issued Letters Patent for the establishment of the Royal Commission into Victoria’s Mental Health System. Heralded by the Victorian Government as a wide-ranging, first of its kind inquiry, consumer and mental health sector expectations have been raised to a high level. However, this long gestation seems to have birthed an analysis and accompanying set of recommendations for reform which are devoid of considerations of gender.

As the newly established Women’s Mental Health Alliance has said, despite the evidence that Australian women have poorer mental health compared to men, there has been limited attention shown to women as a group by the Royal Commission in its public hearings and consultations to date. This includes women in all their diversity, including groups at greater risk of poor mental health and suicidality such as girls and young women; Aboriginal and Torres Strait Islander women; members of the LBTIQ+ community; and women and girls from migrant and refugee communities.

The report: nods to gender and intersectional lenses

From first glance the Interim Report provides a welcome acknowledgement of gender as a social determinant of mental health – including the impact of discrimination and family violence, and broader gender inequities and their role in mental health outcomes.

The Commissioners also note the role of gendered stereotypes and expectations – explaining that they ‘can play a central role in influencing mental health outcomes’, while differences in prevalence of mental health conditions between women and men are also acknowledged (p 38).

In line with the Commission’s Terms of Reference there is a focus on the particular experiences of Aboriginal communities, migrant and refugee communities and LGBTIQ+ communities. The Interim report notes there is little confidence by people within these groups that the current system is safe and inclusive.

The report includes a focus on the safety of people in adult acute mental health inpatient units – it is clear that Commissioners listened carefully to the witnesses who shared their experiences of violence in inpatient units, as well as noting the findings of the Victorian Mental Health Complaints Commissioner’s Right to be Safe 2018 report. The interim report notes that it is predominantly women who have shared their experiences of sexual assault and harassment in the mental health system (p 236). The Commissioners also find that lack of investment in mental health service infrastructure has affected the ability of services to effectively respond to safety concerns and provide therapeutic environments to assist consumers in their recovery (p 621).

A ‘gender-neutral’ report means women remain largely invisible

However, despite an overwhelming response from women - 62 per cent of individual submitters identified as female – the Interim Report is silent in response to many concerns identified as critical by Women’s Mental Health Alliance members, and women themselves. This invisibility is surprising given the Victorian Government’s acknowledgement of gender as a primary influencer on health outcomes, and their commitment to increasing gender equality in other policy domains.

While many of the proposed reforms and increases in investment will have a positive impact on women and girls, along with several other cohorts, the report does not propose actions that address the specific experiences of women and girls in the mental health service system.

For the report’s ambitious suite of reforms to make a difference in the lives of all Victorians, a stronger focus on the needs of women and girls in the Commission’s final report is needed.

The social drivers of poor mental health differ significantly between women and men; ignoring this means women have a much harder time having their needs acknowledged and addressed. Image credit: Pixabay.

This post is part of the Women's Policy Action Tank initiative to analyse government policy using a gendered lens. View our other policy analysis pieces here and follow us on Twitter @PolicyforWomen

Nine months of Royal Commission but women and girls’ mental health is still largely invisible