Sex Differences Among the Long-Term Mentally Disabled

Abstract

Although the “chronically mentally ill” have become a subject of national concern and although differences among the young, old, and minorities have been recognized, sex differences have been largely ignored. The authors describe the experientially determined problems of long‐term mentally disabled women. Research is presented from a review of 320 hospital records of patients served in seven community and state hospitals throughout Michigan, encompassing client variables and service information. Significant sex differences were found for client age, marital status, living arrangement, diagnosis, functioning level, voluntary/involuntary status, admission information, medications, medical care and destination post‐discharge. Many of the results confirm stereotypes of sex differences in institutionalized populations (age, diagnosis, and so forth). Other results, such as more women living independently and no sex differences in violent behaviors, are contrary to popular assumptions. Using case studies, the authors further discuss the important issues suggested by the results, e.g., why women become psychiatric patients, discharge planning, and over‐medications. A plea is made for a greater amount and intensity of research on women with long‐term mental disabilities.

Depression, Disability, and Rehabilitation Services for Women

“…In fact, the wide array of needs of mothers with mental illness (e.g., pre- and postpartum services, child custody support, benefit and entitlement planning, family counseling, trauma and abuse services) remains largely unaddressed in the mental health treatment field at large (Cook & Steigman, 2000). Moreover, residential PSR programs seldom offer training in community safety skills to help women living on their own to avoid victimization in the community (Mowbray & Chamberlain, 1986), and few offer residential rehabilitation settings in which children can reside with their mothers (Cook, 1994).…”

The consumer as expert: Women with serious mental illness and their relationship-based needs.

“…For decades important life-defining variables, such as gender, were excluded in the analyses, discussion, and understanding of the experience of people with serious mental illness (Bachrach & Nadelson, 1988; Imber-Black, 1986; Mowbray & Chamberlain, 1986; Mowbray, Herman & Hazel, 1992; Test & Berlin, 1981; Test, Burke & Wallisch, 1990). A gender-blind approach, more often than not, meant using a treatment paradigm that was originally designed to meet the needs of men (Carmen, Russo, & Miller, 1981; Imber-Black, 1986; Mowbray & Chamberlain, 1986; Test & Berlin, 1981; Test, Burke & Wallisch, 1990). Rather than assessing women's specific needs and implementing appropriate treatment programs, women with serious mental illness were simply expected to fit into and benefit from existing models.…”

“…often than not, meant using a treatment paradigm that was originally designed to meet the needs of men (Carmen, Russo, & Miller, 1981;Imber-Black, 1986;Mowbray & Chamberlain, 1986;Test & Berlin, 1981;Test, Burke & Wallisch, 1990). Rather than assessing women's specific needs and implement ing appropriate treatment programs, women with serious mental illness were simply expected to fit into and benefit from existing models.…”

Family education and support: Just for women only?

“…Men have an earlier age of onset of schizophrenia, with a higher incidence for males under the age of 30 and for females over the age of 40 (Iacono & Beiser, 1992). Men with diagnoses of schizophrenia exhibit more physically aggressive and assaultive behaviors, experience more frequent and longer inpatient hospitalizations, and are more likely to be hospitalized for bizarre and threatening behaviors (Angermeyer, Kuhn & Goldstein, 1990;Bennett, Handel & Pearsall, 1988;Mowbray & Chamberlain, 1986). Adult men with mental illness have poorer social networks, are less likely than women to be or to have been married, sons to provide care to their aging parents (Brody, 1981;Dwyer & Coward 1991;Spitze, Logan, Joseph & Lee, 1994).…”