Half of mental health disorders first manifest themselves before the age of 14. Seventy per cent appear before the age of 18, in response to data from the European Society for Child and Adolescent Psychiatry. The connection between mental health, age, socio-economic status and gender is the topic of accelerating research. But how do adolescents perceive their mental health in relation to their gender? And the way does their gender influence the best way that they cope with mental health issues?

Until now, most studies checked out this relationship through a binary sex labeling that has proven insufficient to know the links between mental health and gender. A latest study, published in European Child & Adolescent Psychiatry, explores these links and proposes an index to work with in the longer term that features a broader and more complex view in one of these study of the connection between mental health and gender. The study was led by Xavier Cela Bertran, who has a PhD from Universitat Rovira i Virgili (URV) and is a former course instructor with the UOC’s Faculty of Psychology and Education Sciences. This text is predicated on his doctoral thesis, supervised by ángel Martínez-Hernáez, professor within the Department of Anthropology, Philosophy and Social Work at URV, and by Asun Pié Balaguer, professor and researcher within the CareNet group of the Faculty of Psychology and Education Sciences on the Universitat Oberta de Catalunya (UOC), as a part of URV’s doctoral programme in Anthropology and Communication. Each thesis supervisors are also co-authors of the article.

The connection between mental health and gender

Every 4 years, the Barcelona Public Health Agency (ASPB) produces a comprehensive report on adolescence and health: Risk Aspects in Secondary School Students (FRESC). The ASPB conducts a survey with almost 4,000 adolescents aged between 13 and 19 years old that covers a really broad range of questions, from substance use patterns to eating habits. Nevertheless, like other similar studies, it conceptualizes gender in a binary way, through an easy query: whether the respondent is a boy or a woman.

The FRESC data are very interesting, but we found that they weren’t at all times analysed intimately. We believed they held far more invaluable information. The Barcelona Public Health Agency was delighted to be a part of the evaluation team and to offer us with the information. Based on this, our research team looked for trends in mental health.”

Xavier Cela Bertran, PhD from Universitat Rovira i Virgili (URV)

The study confirmed that each age and having a low socio-economic status have a negative impact on the self-perceived health and level of psychological distress or emotional well-being of young women.

“We are able to say that gender influences the ways by which people express mental suffering, but additionally the ways by which they seek help. As such, adolescents who discover as girls usually tend to suffer from emotional issues, although they behave in a more prosocial way [positive behaviour for socializing and communicating with others],” added Pié. “Against this, adolescents identifying as boys usually tend to suffer from behavioral issues, symptoms related to attention deficit and problems with their parents.”

In keeping with Pié, the poorer mental health or greater mental distress expressed in socialized women might be explained by two reasons. First, it’s the results of a sexist and patriarchal social system, where gender inequalities and male violence against women have an effect on their mental health. Second, it is expounded to the capability of women to specific vulnerability and affection, a trait related to female socialization that’s far more developed than in individuals who socialize as men.

A tool to look in additional depth at the connection between mental health and gender

The primary objective of the study was to show the existence of a transparent relationship between gender and mental health. The opposite objective was to take this further by making a gender adherence index that proposes ranging from a non-binary idea of mental health and gender that takes a deeper take a look at what it means to be a person, what it means to be a lady and what mental health is. “We were looking for to develop tools that might capture a non-binary reality at a scientific level,” said Cela.

The study puts forward the Gender Adherence Index (GAI), an index based on a multivariate evaluation of behaviours and social habits and beliefs related to gender. “The calculation of this index is used to analyse the relationships between the mental health of adolescents, their behavioural patterns and their gender socialization, regardless of their sex determination or, where appropriate, providing an accompanying explanation to this binary label,” added Pié.

The final hypothesis of the study is that gender, as a social process, influences the extent and ways of expressing mental distress amongst adolescents. As such, gender conditions the processes of looking for help, each formal and informal, in addition to the strategies with which they confront difficult situations. Accordingly, the Gender Adherence Index is meant so as to add explanatory value to the information that may help to design higher measures for prevention and care.

In this primary study, the researchers acknowledge that, although the contribution of the GAI is critical, its effect continues to be moderate. This is especially on account of the undeniable fact that the available data are insufficient, for the reason that FRESC report survey was not designed for this purpose. Moving forward, it’s vital to perform a more detailed and in-depth study of the variables and their relationships in an effort to improve the interpretative power and to design the questions of the Gender Adherence Index appropriately.

“We aim to develop an efficient tool for a more in-depth study of the connection between gender and mental health in future editions of the FRESC or some other study of this sort. The top goal can be to integrate this tool into larger public health studies that typically address the gender issue in a short time, with an easy binary query,” concluded Cela.

Source:

Universitat Oberta de Catalunya

Journal reference:

Xavier, C.-B., et al. (2023). Understanding the connection between gender and mental health in adolescence: the Gender Adherence Index (GAI). European Child & Adolescent Psychiatry. doi.org/10.1007/s00787-023-02150-7