title: Gender and intersectionality: understanding and addressing women’s mental health within the cultural context of Saudi Arabia
Creators: name: Alghamdi, Nadia Ahmed Alhamad
Publisher: name: University of Glasgow
Year: 2024
Subjects: subject: intersectionality, gender equality, inequality, mental health, women, culture, depression, mental health policy and services, social disadvantages, Saudi Arabia.

description: Background: Intersectionality concerns the interconnected nature of social categories (e.g., race, gender, age, education) and how these ‘intersect’ to produce privilege and oppression. In the current context, this helps to understand women's mental health in socially disadvantaged positions, especially how intersections among gender inequality and factors such as socioeconomic status contribute to women’s mental health inequalities and experiences. Yet this remains an under researched area. This study’s overarching aim concerns understanding Saudi Arabian women’s mental health disorders, risks, challenges, and issues. For this, it has three objectives: to review the effects of intersectionality on this group within extant quantitative literature; to identify and explore the significant interactions among variables relating to this population’s social disadvantage and mental ill-health (e.g., gender and the risk of depression); and to analyse Saudi Arabia’s current mental health policy and gender equality. This study’s more specific aims involve furthering understanding of the effects of content, context, and actors behind mental health policies and programmes on Saudi women to help address their mental health needs. It takes the form of three studies. 

Study 1. This systematic review investigated quantitative methods used to study the intersectionality of multiple social disadvantages in women with common mental disorders. It reviewed studies on the intersectional effects of gender with multiple social disadvantages from the PROGRESS-Plus inequity framework and examined the quantitative methods these studies employ. The most common and means of studying intersectionality in mental health studies in the included studies was statistical interaction analysis. Other methods such as multilevel modelling and mediation decomposition analysis were also used. These robust statistical methods facilitate research on intersectional effects on mental health and improve understanding of the complex intersection of gender and other social disadvantages concerning women’s risk of common mental disorders.

Study 2: This study analysed the National Survey of Saudi Food and Drug Authority dataset, a nationally representative sample of individuals aged 18–88 in Saudi Arabia (3,408 participants: 1,753 males and 1,655 females). Evaluating variable risks of depression using the PHQ-2 screening questionnaire, it found significant correlations between depression risk and the variables of gender, education, family income, and employment status. Although a subsequent multivariate analysis found the only significant predictors of depression risk to be female gender and education below the bachelor level. No interaction effects were observed, implying an additive effect of gender and education on the risk of depression. 

Study 3: This study analysed Saudi Arabia's mental health policies and gender equality. Using Walt and Gilson's health policy analysis framework, it highlights the need to address gender inequalities in the country's mental health policies. It provides evidence-based mental health policy recommendations relating to women in Saudi Arabia about enhancing their mental health and well-being and establishing an equal health system.

Conclusions: Examining women’s mental health through an intersectionality lens can help policymakers address Saudi Arabian women’s mental health issue . To reduce inequalities, advances must be made in women’s education, training, employment, socioeconomic status, access and participation, equality, and overall independence. However, this must take place within a wider targeted and tailored reform agenda (legal, policy, political, PR, cultural, religious, economic, careers, educational) within which women must actively participate. Urgent inclusive, deep, and far-reaching intersectional initiatives, adjustments, research and reforms are needed to elevate Saudi women’s circumstances, experiences, and mental health and thereby address the current issue and ultimately improve society overall.