16 Days of Activism against Violence against Women and Children: Access to mental health services is imperative in combatting GBV and its effects

Charles Okoth

Gender-Based violence refers to harmful acts directed at an individual based on their gender. It is rooted in gender inequality, the abuse of power and harmful norms. Gender-based violence can include sexual, physical, mental and economic harm inflicted in public or in private. It also includes threats of violence, coercion and manipulation. This can take many forms such as intimate partner violence, sexual violence, child marriage and female genital mutilation.

Mental health, on the other hand, refers to a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. It takes into consideration basic cognitive and social skills; ability to recognize, express and modulate one's own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events. Mental health function in social roles and harmonious relationship between body and mind which represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium.

"Universal values" captured in the definition is deemed necessary, in the light of the misleading use of this expression in certain political and social circumstances. The values being referred to are respect and care for oneself and other living beings; recognition of connectedness between people; respect for the environment; respect for one's own and others' freedom.

The concept of "dynamic state of internal equilibrium" is meant to reflect the fact that different life aspects require changes in the achieved equilibrium like adolescent crises, marriage, becoming a parent or retirement are good examples of life epochs requiring an active search for a new mental equilibrium. This concept also incorporates and acknowledges the reality that mentally healthy people may experience appropriate human emotions including fear, anger, sadness and grief while at the same time possessing sufficient resilience to restore the dynamic state of internal equilibrium timeously.

All components proposed in the definition represent important but not mandatory aspects of mental health; as a matter of fact, they may contribute to a varying degree to the state of equilibrium, so that fully developed functions may offset an impairment in another aspect of mental functioning. For instance, a very empathetic person, highly interested in mutual sharing, may compensate for a moderate degree of cognitive impairment, and still find a good equilibrium and pursue her/his life goals.

GBV isn't a one plane thing but affects men as well and as research findings from Kenya done by Kenya National Bureau of Statistics indicate that; lack of jobs, 'idleness' and finances are top priority concerns facing men; however, alcohol and substance use are equally co-factors of GBV. Family problems, crime and general psychosocial issues (e.g., high stress, low self-esteem) are also reported as key issues that spike up GBV as men tend to withdraw socially, changing behaviour and increasing alcohol consumption are definite signs that men are experiencing mental health challenges and above all, as studies indicate there are more GBV incidences reported as a result of alcohol use, believing men resorted to drinking because of having 'too much time', marital conflict, psychosocial issues and access to alcohol. The findings theorize that a circular link between unemployment, alcohol and crime is likely to contribute to familial, psychosocial and gender concerns and that men's mental health support may assist to re-direct a trajectory for individuals at risk of perpetrating GBV.

On the other hand findings on women in reference to a recent research carried out by the United Nations Development Programme on GBV shows that more than a third of women worldwide have experienced physical or sexual violence in their lifetime, which has a dramatic impact on health. Violence results in physical injuries which can be life-threatening, an increased risk of sexually transmitted infections, including HIV, and for pregnant women – who are sadly more likely to face intimate partner violence – a heightened risk of miscarriage and low-birthweight. The mental health impacts are as devastating. There is an exponential rise in mental illness, including depression, anxiety, post-traumatic stress disorder (PTSD) and suicidal ideation for women who have experienced violence and abuse. The reverse relationship is also true: Women living with severe mental illness are significantly more likely to fall victims to violence. They are six times more likely to experience sexual violence during their life.

Yet, so often, mental health services are not available for survivors of violence, and where available, they are rarely integrated into the primary health care system. Providing women with comprehensive and gender-sensitive mental health services can allow them to take back control of their bodies, sexuality, and lives.

In the belief that comprehensive health and legal services are foundational to the achievement of women's rights, including partnering with civil society and local advocates to increase women's access to services. Other recommendations would include:

Provision of mental health and psychosocial support to GBV survivors and vulnerable women, men, girls and boys which would be a boost to the survivors as well in the following ways:

  • Offering Mental Health and Psychosocial support services and assistance aimed at addressing the harmful emotional, psychological and social effects of gender-based violence  for GBV survivors, vulnerable women, men, girls and boys
  • Counselling: Which  is a face-to-face communication through a dynamic process of interaction between two or more people during which the counsellor, who has received professional training, helps the client to identify and process symptoms s/he is experiencing and taking decisions to help alleviate her/his suffering and involving active listening to people talking about their problems; giving them comfort in an the atmosphere of empathy and helping them to work out what to do about their problems with a focus on the empowerment of the client.
  • Psychosocial and recreational activities: Community self-help and resilience strategies to support survivors and those vulnerable to GBV, such as through women's groups/recreational activities aimed at home activating and rebuilding social networks.