How do gender and mental health interact?

Professor Cath Chapman
Director of Research Development and Strategy, the Matilda Centre

As more long-term data become available on the changing mental health of Australians across the lifespan, we are starting to get a clearer picture on sex and gender-based differences in the experience of mental health and substance use.

Some examples of gender differences in mental health include:

Dedicated long-term research on how gendered experiences relate to mental health and substance use can help develop targeted research, policy and programs that provide support where and how it will be best received.

As part of an Investigator Grant, Professor Cath Chapman aims to generate new knowledge about gender-specific risk and protective factors for mental health and substance use conditions. In this Researcher Profile, we learn more about Cath’s journey to the Matilda Centre and her passion for gender-informed approaches to mental health.

Mental disorders are typically higher among girls and women, whereas substance use disorders and related harms are more common among boys and men. Whilst this is still the case we are seeing some significant gender-specific changes.

In Australia and elsewhere whilst rates of depression, anxiety, and self-harm have increased, particularly among adolescents, and these shifts are driven by greater increases among girls than boys. Similarly, whilst alcohol and drug use among adolescents is plateauing or decreasing, this seems to be driven by greater decreases among boys than girls.

We don’t know what is driving these trends, so it raises some questions not only about how mental health and substance use conditions relate to each other, but also the way in which risk and protective factors might operate differently for girls and boys at individual, peer and community levels.

My research aims to explore some of these questions.

Typically, the development of prevention programs in mental health and substance use hasn’t been driven by knowledge of gender-specific differences in the experience of these conditions. Added to this, we are seeing worrying trends in the mental health of young people and indications that the mental health of girls and women is getting worse, not better. 

Looking at the way in which gender-specific risk and protective factors operate at individual, peer and community levels is a critical part of the story if we are to uncover the drivers of these changes and reframe the content, timing and targeting of our responses – hopefully increasing their impact.

We often ‘control’ for gender in research as opposed to considering how integral it is to a person’s experience of the world, including their experience of mental health and substance use. Added to this, many existing population datasets don’t differentiate between sex and gender, nor account for gender diversity. 

I’d like to see more epidemiological research that takes a holistic approach to sex and gender as a central part of the story – and ultimately informs development of contemporary gender-informed interventions in mental health and substance use.

This year marks 30 years since Professor Maree Teesson (now Director of the Matilda Centre) gave me my first job!  I had graduated from the University of Sydney with a Bachelor of Arts degree with Psychology Honours and was not sure what I wanted to do. I had planned to work for a year, save money and travel. What I hadn’t planned on was meeting Maree, and realising I really liked research. I worked in public mental health services alongside Maree for several years, trying to map and understand needs of staff and consumers as they navigated a challenging system of care.

I went on to enrol in a PhD focused on treatment seeking for anxiety disorders with Professor Gavin Andrews, while continuing to work full-time on various research projects. During that time, I worked as a data analyst for Australia’s first National Survey of Mental Health and Substance Use Disorders alongside Tim Slade (now Director of Epidemiology and Biostatistics at the Matilda Centre, and another long-term colleague and friend). Together we also worked on the Comparative Risk Assessment Project for the World Health Organisation Global Burden of Disease (GBD) Program, mapping the global prevalence of childhood sexual abuse and attempting to quantify its relationship to mental health and substance use disorders by age and sex. This work informed GBD estimates and ultimately policy and funding responses. It was challenging, but I learnt a lot.

I didn’t follow a linear career pathway from there. I took significant time away from my career after having kids and, when I came back to work part-time (six and half years later) the pathway back to research wasn’t clear. So, focusing on the close working relationships I had previously forged, I started working again with Maree and Tim. In some ways the rest is history - that was 14 years ago!

Being part of the Matilda Centre from the start has been a privilege. I get to work alongside some amazing, clever and supportive peers – as well as a generation of early and mid-career researchers who are quietly (and sometimes not so quietly!) breaking new ground in mental health and substance use research. They are challenging current thinking, and bringing so much passion and humanity to their programs of research, as well as a genuine collaborative openness. This can be hard in a highly competitive and uncertain funding environment but they are so willing to take on the challenge. It’s exciting for the Matilda Centre and for the future of mental health research in Australia – and it is hugely motivating to be part of this.

Interested in learning more about Cath’s research? Get in contact!