Eliminating Violence Against Women and Girls: Taking Care of Mental Health
Violence against women and girls (VAWG) comes in many forms – rape being one of the most severe. All VAWG has consequences. And for many, these consequences involve mental health issues. Of course, eliminating VAWG in its entirety is the goal, but until this can be achieved – and perhaps even in order to help achieve this – it is necessary to focus on the consequences of the violence that ensues. This means, first and foremost, believing women and girls when they speak up about sexual violence committed against them. It also means improving the accessibility to and quality of mental health care for those who have experienced sexual violence so they have a space to feel safe in, to feel heard, and to get the long-term care they may need. This care must be able to take an array of circumstances and reactions into account as sexual violence comes in a multitude of forms and people deal with its impact differently.
Listen, Inquire, Validate, Enhance Safety, Support
According to the WHO, mental health problems that stem from violence are poorly identified, partly, because women are reluctant to talk about their experiences with sexual violence unless they are asked directly about it. This reluctance likely comes from reactions resulting from and feeding into a culture of shame, blame, and disbelief that women and girls are confronted with every day. That’s why attitudes such as the WHO’s LIVES approach are an important starting point that should be adopted by healthcare professionals worldwide:
L – Listen closely with empathy, without judging the victim/survivor
I – Inquire about what they need
V – Validate their experience, show interest and assure them they are not to blame
E – Enhance their safety
S – Support and guide them to additional information, service and social support
Different countries have different approaches to mental health care for victims/survivors of sexual violence, but the LIVES approach can be used as a basic starting point for all. In England, the NHS has set out a five year plan from 2018-2023 to allow victims/survivors of sexual abuse and violence to receive a lifetime of mental health care to help them cope with any consequential trauma. In Germany, the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ) has launched the “Stärker als Gewalt” (“Stronger than Violence”) initiative. Through the federal funding programme “Gemeinsam gegen Gewalt an Frauen” ("Together against Violence against Women"), the BMFSFJ intends to provide an additional 120 million euro from 2020 across four years for the expansion of counselling centres and women's shelters.
Mental Health Care as an Over-Arching Attitude
The mental health of victims/survivors of sexual violence is not only affected by the act of violence itself. It is affected by the response of others – to this act and to sexual violence in general. Discourses of shame and blame aimed at the victims/survivors rather than the perpetrators are prevalent in everyday life. These discourses seep into legal systems and all too often begin the process of reporting sexual violence with a hostile attitude towards women and girls. As highlighted recently in the Chilean anti-rape anthem, A Rapist in Your Path, systems that are supposed to provide justice, are instead creating a situation of what is referred to as secondary victimisation. A culture of disbelief, alongside a culture of shame and blame contribute to poor mental health amongst victims/survivors of sexual violence. Mental health care should then not only be thought of as a package to be offered in response to the direct victims/survivors of sexual violence. It must also be thought of as an over-arching attitude towards women and girls – one that permeates every system and every conversation that is involved in dealing with sexual violence.
The Impact of Laws on Mental Health
In cases of sexual violence, part of the healing process for women and girls involves reclaiming autonomy over their bodies. Many laws across the globe deny women and girls this possibility. Instead, from one act of violence comes another as the trauma for women who have been raped often continues through laws that further deny their autonomy and impact their mental (as well as physical) health negatively. Still, today, in many countries, women and girls are denied access to legal and safe abortions even in cases of rape. Although some countries, such as Ireland, have recently repealed anti-abortion laws, other places, such as Alabama in the USA, are rolling back hard-won women’s rights by introducing anti-abortion bills where abortions are deemed illegal even in cases of rape and incest. In the regions of North Africa and West Asia, multiple countries have recently repealed or reformed laws that forced women and girls to marry the man who raped them. Clearly these laws would have an extraordinarily detrimental effect on women’s and girl’s mental health and their repeal or reform was long overdue.
The first step in mental health care is to listen to victims/survivors of sexual violence and to create systems that connect and collaborate and that aid the healing process, rather than systems of secondary victimisation. To do this, it is necessary to challenge the attitudes towards women and girls that lead to sexual violence and that result in victims/survivors of sexual violence being further traumatised and victimised by legal systems and insufficient professional care. New Zealand’s White Ribbon Campaign, where people are asked to “Challenge the #Unspoken Rules around masculinities”, is a step in the right direction. As part of the 16 days of activism against VAWG, it tackles discourses that result in sexual violence. It is a combination of this kind of approach, as well as access for all victims/survivors of sexual violence to professional mental health care that is needed.