This book, unsurprisingly, has a very Antipodean perspective. Romans is a psychiatrist, firmly embedded in the medical tradition, as are several other contributors. Although the medical model slants thought and discussion towards considerations of illness and treatment, there is due consideration given to broader historical and sociological perspectives. Biology, psychiatry and sociology are elegantly balanced.
Brookes's interesting historical introduction to women's mental health includes moving stories of women incarcerated in asylums in New Zealand from their earliest days. The social influences on women's mental ill health, including the social pressures on value systems, are well articulated throughout the book.
There is an interesting section on undertaking research in this area; indeed, the primary impetus for the book came out of research undertaken at the University of Otago. Qualitative research techniques are given due weight, and there is also a balanced feminist perspective on women's mental health research. For those interested in intercultural issues, Cheung writes about the relationship between acculturation and mental health. It should be noted that ‘Asian women’ in New Zealand are mostly of Chinese and Cambodian origin. The concluding chapter is written by a woman sociologist who gives a moving account of her recovery from mental illness.
The contributors present a number of important conclusions regarding women's mental health. It is pointed out that women's disadvantaged social status is intimately linked to gender differences in mental disorders and that good social relationships are central to women's mental health. Furthermore, women have been under-researched and all too often treatment policies are extrapolated from data collected for men. Services are often inappropriate for women, failing to recognise their need for safety from violence and the importance of maintaining their mothering and affiliation roles. Cultural differences are important in the definition and assessment of mental health problems and need to be respected and understood. Finally, mental health services must work with many other sectors, such as women's groups, welfare agencies, churches and self-help groups, to provide a coordinated approach.
All in all, this is an interesting and enjoyable book, especially if you are concerned with issues of women's mental health, health care research and intercultural psychiatry.
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