From self-care tips on social media to innovative forms of frontline medical care, mental health is increasingly on our radar these days. As the conversation moves in new directions, medical professionals are experimenting with a wider array of services to suit the needs of heterogenous populations. But according to a new study published by CHÉOS Scientist Dr. Joseph Puyat, one important factor continues to affect how those diagnosed with clinical depression are treated: gender.

Dr. Joseph Puyat

Setting the Stage

In BC, approximately 100,000 people are diagnosed with depression each year. Of these, 65 percent are women and 35 percent are men. Depression is a broad category, easily treatable for some and chronic for others, and therefore requires a range of available treatments.

After diagnosis, the common clinical treatments for depression are divided into two broad categories: counseling/psychotherapy and antidepressant therapy. While these therapies seek to treat depression in different ways, studies have failed to show differences in effectiveness when it comes to sex or gender; men and women respond to counselling/psychotherapy and antidepressant therapy equally well. Healthcare practitioners should offer these services to all their patients, thereby providing methods of care that are suited to the individual.

The Importance of Sex/Gender

Dr. Puyat addresses the role of sex/gender in his research, examining whether men and women are treated differently when it comes to depression related care in BC. He analyzed health administrative data from across BC between 2005 and 2012. For those diagnosed with depression, he compared the proportion of men and women that filled anti-depressant prescriptions and received counselling visits. Dr. Puyat’s findings reveal a surprising disparity.

His research shows that while women are more likely to be medicated, men are more likely to receive counseling. “The proportion of those with depression who receive psychological therapy remained higher in males than females, while the proportion that receives antidepressants remained higher in females than males” notes Dr. Puyat. Since neither counselling nor antidepressants are universally more effective, the disparity remains startling.

It is unclear why this gender disparity in treatment exists, or whether it impacts mental health outcomes in the long term. Nevertheless, women and men are receiving different types of care. “We require a concerted, deliberate, and systematic approach to understanding the underlying processes or pathways that give rise to these disparities” argues Dr. Puyat. Understanding the cause of this gap could help provide care that is better suited to all genders, with an eye towards equity when it comes to mental health treatment. Moreover, the lack of studies investigating this disparity is surprising, especially considering the strong association between gender inequity and mental health.

Dr. Puyat’s study also reveals the depth of this gender disparity in mental health treatment, which has showed little change over a seven-year period between 2005 and 2012. In order to address this problem, Dr. Puyat argues that healthcare experts must develop specific targets for reducing disparities. “There is no one-size fits all approach. Healthcare innovation must take gender seriously if we are to move forward with more effective treatments for all.”