Impact of the COVID-19 pandemic on mental health among women: An editorial

This issue of the International Journal of Mental Health (IJMH) features four scientific reports examining the impact of COVID-19 pandemic on mental health across the world. While the pandemic and its consequences have, and are still, affecting populations worldwide, certain groups, including racial and ethnic minorities, but also gender minorities, have been disproportionally impacted (e.g., Jegede et al., 2021). Several studies have reported evidence indicating that women may experience poorer outcomes with regard to the psychological impact of the pandemic (e.g., González-Sanguino et al., 2020; Özdin & Bayrak Özdin, 2020). Reports in this issue of the IJMH, present converging data further suggesting that compared to men, women have been disproportionally impacted by the pandemic and the associated restrictions globally. These gender inequiies may be explained by both exposure to specific stressors and increased vulnerability.

First, women may be exposed to COVID-19 related stressors that are gendered. Specifically, Nyashanu et al. (2021) reported that during COVID-19 lockdown, women in Zambia were exposed to increased domestic violence, as well as stress with managing children indoors. In line with this, Al-Amer et al. (2021) also reported that among Jordanian female nurses depression, anxiety, and stress during the Covid-19 pandemic were higher among those who reported being a parent.

Second, women appear to be more vulnerable to experiencing detrimental psychological consequences than men, both when managing COVID-19 related stressors, and when recovering from COVID-19. Broche-Pérez et al. (2021) reported in a large sample of Cuban individuals, that women were more likely to experience medium to high levels of fear of COVID-19 compared to men, while Danquah and Mante (2022) reported in a sample of Covid-19 survivors in Ghana that, women endorsed higher levels of symptoms of anxiety, depression and posttraumatic stress disorder (PTSD) compared to men.

Thus, while, women have been shown to be at greater risk for psychiatric disorders in general (Kessler & Merikangas, 2004), results reported in this issue of the IJMH suggest that this holds true in the context of the COVID-19 pandemic, across global regions. These reports also point to the role of stress factors, across multiple levels and systems including gender roles and parenting, as well as labor inequities and a culture of violence against women. These initial data also highlight the need for additional work exploring the vulnerability factors that may be present at multiple systemic levels and contribute to these gender differences.

Thus, for example, health care systems appear to have been unable to respond appropriately to the needs of mothers during the COVID-19 pandemic, failing to implement strategies to support the physical, mental, social, and spiritual needs of pregnant women (Abu Sabbah et al., 2022). At the same time, the education system turned to home-schooling, while public health recommendations increased the burden of caring for older individuals due to their age being most restricted in terms of social distancing. Both childcare and care of vulnerable people are disproportionately carried by women (Power, 2020), and thus multiple systems contributed to compounded stressors and decreased support for women during the pandemic, likely contributing to poor mental health.

Furthermore, the COVID-19 pandemic amplified already existing cultural and legal barriers to health care for ethnic minority and migrant women, by treating women as a homogenous entity and, as a result, ignoring the individual needs of these separate groups (Germain & Yong, 2020). Considering women as a homogeneous group may also magnify the structural inequalities that have been observed as a result of the pandemic, through ignoring specific ethnic disproportions, economic and health vulnerabilities (Platt & Warwick, 2020).

Beyond individuals identifying as women, other gender minorities including individuals holding non-binary identities may also have suffered disproportionally from the pandemic. Emerging data also suggest that gender minority populations endorsed greater worsening of their physical health and financial stability, during the pandemic (Nowaskie & Roesler, 2022). Furthermore, multiply marginalized populations may have experienced compounded levels of risk and harm and adopting an intersectional lens in future work in this area would be valuable (Fagrell-Trygg et al., 2019).

Given these gendered disparities in risk and outcomes, interventions across levels including policy should be advocated for and implemented to help mitigate the gender inequalities that have emerged in the context of the COVID-19 pandemic. Governments should implement effective measures to prevent and address gender-based violence and domestic violence (Mittal & Singh, 2020). The continuity of core health and education services should be ensured even during time of crisis, keeping schools open in order to decrease childcare burden and act as community centers for connecting individuals with services (Viner et al., 2021). Efforts should be made to ensure that women and gender minority individuals are screened for psychological distress, and that additional resources are provided to limit barriers to access mental health care in these populations.

The COVID-19 pandemic has highlighted the frailty of the social and health care systems across the world, exacerbating gender-related disparities in mental health risk. This has provided, however, an opportunity to identify the most critical gaps in this area. Using these observations to inform long-term strategies to reduce these gender disparities, and prepare health care systems on a broader level is essential from a social justice perspective (Cogan et al., 2022), and in anticipation to future similar health crisis situations.