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Significant progress is being made in strengthening perinatal mental health support systems and in several related areas of women's mental health. Mental health support for women and families during pregnancy and the first year after birth – the perinatal period – remains a priority in most parts of the world. Mental disorders are among the most common perinatal health problems, with over 25% of women in many scarce resource countries and 10% in wealthy countries experiencing a disorder. There is growing recognition of feasible and effective ways to reduce the harm to women and children and their families through societal as well as health system initiatives. Successful initiatives including training and support for health workers and cross-sectoral work to prevent violence in families are operating in a number of countries. The presentation will consider how psychiatrists and other mental health professionals can contribute to the spread, scope and sustainability of this work, and other related contributions to women's mental health including the prevention of violence in the family.

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Every year, around 800,000 people die by suicide globally. Whist suicide mortality rates are higher among men, women typically have higher rates of suicidal ideation and behaviours. Despite this fact, suicidality in women is still of grave concern as 71% of women’s violent deaths is accounted for by suicide – a greater percentage than men’s. Suicide patterns among women differ between countries and regions. For example, there is a greater difference in suicide rates between men and women in high-income countries in comparison to low- and middle-income countries. Furthermore, many theories exist to explain women’s suicidality. Yet many of the dominant theories have been challenged from studies in both low- to middle-income and high-income countries. Further research that focuses on the context and culture, rather than the individual, is warranted and will be important for preventative efforts of women’s suicidal behaviours.

Abstract Body

Background - Studies suggest a high prevalence of depression and PTSD among survivors of human trafficking in contact with shelter services. However, evidence for interventions to support the recovery of survivors of trafficking is lacking. The broader literature on PTSD and depression indicates that ongoing social stressors can exacerbate and perpetuate symptoms. Advocacy-based, or “casework”, interventions, which address current stressors and social support, may represent a promising avenue of enquiry.

Objectives (1) Describe risk and protective factors for mental distress among trafficked people; (2) Present a preliminary theory of change describing how advocacy-based interventions may contribute to an improvement in mental health and wellbeing among survivors of human trafficking.

Methods - (1) Survey of adult male and female survivors of trafficking in contact with shelter services in England; symptoms of depression, anxiety, and post-traumatic stress disorder were measured using the PHQ-9, GAD-7, and PCL-C. (2) Theory of change workshop and review of intervention studies that assessed the effectiveness of casework, client support, or advocacy interventions delivered in health or community settings to survivors of trafficking or vulnerable migrants.

Results - 150 survivors of trafficking participated in the survey, 98 women and 52 men. In multivariate analyses, psychological distress was associated with higher number of unmet needs and lacking a confidante, suggesting that practical and social support is important in facilitating mental health recovery. The theory of change identifies common components in advocacy interventions delivered to survivors of trafficking, and proposes pathways by which these components contribute to improved mental health.