Director: dr. E. Reale
Mental Health Service and Female Psychiatric Disorders: the Experience of Women’s Mental Health Service in Naples, Italy:Journal of the Norwegian Psychological Association, vol. 24, n.9, 1987.
Our work for women friendly psychiatry and
psychotherapy began in 1977 in the
Public Psychiatric Hospital "Frullone" in Naples. There we treated and
Psychiatry underestimated women's mental problems, revolved around
biological explanations of mental illness and treated women mostly with
Psychology overcame the biological view of psychiatry regarding women,
but underlined the importance of women's personality factors as "passivity,
fragility, dependence" in the genesis of mental illness, in particular of
That is Psychology showed an axiomatic and nativistich view on women's
Research on etiological and risk factors was mainly
orientated to evaluate, in an exclusively or principal way, the correlation
between depressive pathology and hormonal cycle leaving out, prejudicially,
different factors such as work and environment.
The under evaluation of the weight of environment and
work (family and out side work) risk factors for women had clear consequences on
the exclusion of women from important preventive prospects.
We thought it was necessary to modify criteria and
standards in Psychiatry and Psychology regarding women and create new
interpretative hypotheses and a new practice.
This led to the organization of a mental health service only for women,
and to the proposal of a methodology specifically created and applied to women's
welfare. At the same time, in 1978 law n. 180 settling mental health care was
applied in Italy. Thanks to this law many mental hospitals were closed and
psychiatric care was organized in out-patients mental health centres.
Our out-patients Centre is a public health care Centre specialized in
women's mental health problems.
The equip is made up of: psychologists, a psychiatrist, a medical
doctor specialized in homoeopathy, a sociologist, nurses. The Centre exemplifies
the possibility of carrying on, within the Public Health System, activities of
gender oriented Prevention, Treatment, Research and Training.
We have been working on
women for more than twenty years and for many reasons. As women dealing with
women’s disease we are interested in investigating certain features regarding
their more frequent resort
to psychiatric help compared to
more elevated consumption of medicine;
high incidence of psychic disorders especially at the early in their
married life when the children are
very young: on the one hand this is certainly the age of the greatest
development of their female role but, on the other, it is also the one of
greater responsibilities, environmental pressures and work.
Without doubt this is the
most difficult stage of life for housewives and outside workers as well;
the poor quality of their
life compared to men – as the annual report of the World Health Organization
and many national and international epidemiological
studies have indicated.
Up to this time, about 6.000 women have been treated in
our mental health service, and 1503 women have been treated in the last five
years (1996-2000). From an epidemiological point of view, this population corresponds to
the general female population of Italy. It consists mainly of adult married
women, with children.
Main symptoms are anxiety, depression, and/or
psychosomatic troubles. In the recent years the demand for care has been
growing, also from younger women, aged between 15 and 44.
statistics have confirmed the international statistics. These show that psychic
pathologies (major depression, anxiety, eating
disorders) are prevalent and rising among women within the general
population. Depression, specially, is the main cause of burden diseases among
women between 15 and 44 years of age. The prevalence rates, in depression, are
between 2 and 3 times higher among women than in men; in panic attacks they go
up to three times more than in men.
The prevalence rates in women, compared to men, are clearly rising
starting from first adolescence time. Female
adolescents run a higher risk of disease and, in some cases like eating
disorders, the rate for women goes up to 9:1 (90% of the total cases).
range of activities is based on difference in age and status of female patients.
set up three approaches: 1. for
married women, with children; 2. for adolescents and post-adolescents; 3. for
women in menopause.
We offer: counselling, individual and group psychotherapy, self-help groups, expression and capability strengthening groups, homeopathic and allopathic treatment.
Center develops research projects and training courses on the following topics:
psycho-social risk factors related to mental disorders in woman and in
stress and women's daily life;
violence and pathology risks;
depression and risk of psychodrugs abuse.
background of our mental health work can be summed up in the following 4 points:
Everyone is subjected to different kinds of pressures (economical,
political, cultural, psychological, etc.) that can contribute to determine
Gender and sexual difference are additional causes of general pressure
The sociological notion of female role implies a number of rules
of private and public behaviour aiming to create and increase a social and
The oppression of this
role can become unbearable for the woman. When this happens, then the
psychic trouble may rise as the only possible expression of her suffering, of
which she cannot recognize the source.
life analysis is the field of our clinical and therapeutic treatment. It shows
that two main factors contribute to the oppression linked to the female role:
the burden and stress connected with
the pressures exercised by the social and family environment, which lead the
woman towards role behaviours, and induce her to accept global burden of
The analysis of being a mother and its characteristics (that is
responsibility, expectations, models, tirelessness, her psychological dependence
on the satisfaction of the needs of others, etc.). This analysis can form the
central point of observation of the risk factors of mental illness for women.
The characteristics of being "maternal" are part of gender
identity and they do not apply only, nor specifically, to those women who have
Maternity is a social model which determines woman's behaviour and makes
her neglect her personal needs
to the advantage
Maternity is the prototype of a relationship of dependence, within which
the person who is defined as socially in need of protection, is given a series
of tasks to do, not considered as work but as services provided in the interests
of personal realization.
Increasing self-esteem among
the women who ask for our help is our main objective, regardless of their age,
education and intensity of disease. This
objective originates from the assumption – as many years of clinical
experience have already validated
– that the disease comes from a wrong reading of the individual needs and as a
consequence of assent
to someone else’s point of view.
risk of confusing one’s own interests and points of view is higher among women compared to men, since the spirit of self-sacrifice for
someone else’s own good is assumed
to be a natural connotation of female identity and it is
also required so as to conform
to socially accepted role models.
The general goals of this treatment are:
to modify women’s
perception of themselves as being ill because of what is, in traditional
psychiatry, a weakness
· - to modify their way of life and their dependence on those who are the cause of the symptoms and women’s perception of illness.
The specific goals of
psycho-clinical treatment are:
to give women an opportunity to talk about their troubles and symptoms
without thinking they are “ill”
to make it possible for women to understand and recognise behind their
symptoms the reasons for mental disorders linked to the events of everyday life
(oppression, violence, work overload for the family, etc.)
- to research and begin to test more suitable strategies for the expression/construction of personal needs and for overcoming pressures, violence and negative judgment expressed by the social context (often, specifically by the partner).