White, masculine, rich: this is where medicine is designed. This was once again demonstrated by research published these days on the Journal of Internal Medicine of the American Medical Association, according to which pulse oximeters work poorly in blacks and Hispanics, making their blood richer in oxygen than they really are and altering the assessment of patients’ severity, with the consequence that during the pandemic, people belonging to minorities go suffer from an inequality of and, while because of Covid, life expectancy has dropped by about a year among whites, three years of life have been lost among blacks and Hispanics. All this has always happened to women, who are half the world’s population, who are systematically ignored and excluded from medical tests and studies, who do not consider them in their difference, exposing them to risks that can cost them their lives. Until about ten years ago, for example, no one had noticed that women have a different clinical picture of myocardial infarction than men, considered “normal”, universal: the consequences you can easily imagine. In short, women do not exist, they are invisible: they are not present at social gatherings, at decision-making tables, in textbooks, in everyday language. A gap that makes society poorer and cities less inclusive, less suitable for everyone, not to mention how it makes women feel themselves: inadequate, alien, too much.
That’s why the authors of “Practices for Gender Mental Health” (Vita Activa Edizioni), presented a few weeks ago at the Turin Book Fair and this afternoon at 16.00 in Rome at the International Women’s House (via della Lungara 19) on the occasion of Femisme Dona publishing fairthey decided to talk to each other, because “while my being a woman remained silent, not mediated, there was always a deep insecurity,” as Luisa Muraro says, quoted by Valentina Botter, one of the curators together with Sergia Adamo. and Marina Barnabà.
Health, even more so mental health, is not just a matter of illness, but is the result of so-called social determinants, which are the level of education, income, employment, the environment in which one lives and the network of relationships. is working every day: the WHO says so with increasing conviction, but Franco Basaglia had firmly stated this, inviting us to put the person and their dignity back in the spotlight and to put the disease in parentheses, because “the patient is not”. only a sick man, but a man with all his needs. It is as a result of this deep conviction that in Trieste, the seat of the Basaglian revolution, a series of services and realities were born after the closure that serve people in the truest sense of the word “through emotional participation and complicity.” . as stated a few years later by Assunta Signorelli, one of her students, who always paid special attention to what we could define as indirect aspects of care such as the environment, the furniture, the colors, the organization of the spaces, etc. doing everything possible to shorten the distance between doctor and patient and in the first place to be responsible for responding to the real needs of the person suffering.
And responding to real needs means, first of all, being aware that “gender is a relevant factor and an impact on health inequalities,” they say. Marina Barnabà and Anna Stavro in the contribution that opens the book. The patient, one might say, is not just a patient, but a man or a woman with all his needs. Need to try to take over the articulated services present in the area, the strength of which, he says Francesca Bertossi, lies in the gaze of the spectator asking for help, in his ability not to reduce this issue to the analysis of a symptom in which the person disappears, by taking charge in a collegial way (“The disease “It’s something we can only deal with as a team and online in the sense of a network of answers that has to include a number of things,” said Signorelli, “considering gender as an approach to complexity. , knowing that doing a gender internship is not enough to offer an accountant dedicated to women, because such a complex topic cannot be closed in on an important organizational element. We must take into account all those elements that represent risk factors for mental health that are now universally recognized, as it reminds us. Valentina Botter: the gender gap, gender discrimination, violence suffered, the different workload inside and outside the family. Because most women get sick of it and it is not with the prescription of psychiatrists that it really helps them, drugs that have been studied about male invariance, while now it is known and established that female hormonal composition is different at different times in life (childhood, adolescence, pregnancy and postpartum, breastfeeding, menopause). Botter writes, it is necessary to vindicate, to demand sexual scientific research, sexual diagnoses, sexual counseling, sexual prescriptions, sexual rights. But above all it is necessary to be close, looking at subjectivity, valuing specificities and differences, trying to alleviate, if it is not possible to eliminate them completely, also the social and economic problems that determine mental illness, aggravating the conditions. , as stated. Silva Bon, whose contribution describes the history of women’s positions in the Department of Mental Health in Trieste, unique in Italy in its gender trajectory. And we need to ensure autonomous spaces for women to create relationships between women. This is the experience of the association Luna e L’Altra, founded in 1990 to support vulnerable people in a relationship of equality, of which he speaks. Tiziana Giannotti, which highlights the value for those who are especially vulnerable to the possibility of having a series of treatments available in environments free of any health label, where to find someone willing to listen, perhaps drinking a tea. Sometimes, some of the women say, welcome is the only reason to get up and leave the house with a lot of effort and come back calmer, even though we know that the fight will start again the next day. “Listening,” continues Giannotti, “is perhaps the most felt need among frail women. They should always talk about the present, but also about their past. All this must be developed in parallel with the practical part that involves the activation of a whole series of custom paths. This could include support courses for individual habitability, parenting support, schooling, temporary expulsion, contrasting the risks of social exclusion, support for resumption of work, support for the work of family caregivers and much more. ” it is about the promotion of fundamental rights, those for which many women in Trieste and beyond have fought because -as she writes Te Giorgiwhich owes its transformation from a lonely, silent feminist to an active feminist in the encounter with Basaglia’s experience – Article 3 of the Constitution is not an empty statement of principles.
A book born “of an obvious need to narrate, to tell, to give an intelligible and recognizable form of history to what is taken into account,” he writes. Sergia Adamo, but “not to circumscribe and close the thought created by actions and experiences. In this case, the narrative seems to be a space to take risks and to take note of the vulnerability that allows us to always ask ourselves new questions. “A book, then, absolutely to read, but above all to continue writing all together.
(Sergia Adamo, Marina Barnabà, Francesca Bertossi, Silva Bon, Valentina Botter, Silvana Cremaschi, Letonde Hermine Gbedo, Tiziana Giannotti, Tea Giorgi, Elisabetta Paci, Annalisa Saba, Anna Stavro, Paola Zanus Michiei, “Practices for the mental health of genre. Notes. for a manual “, Trieste, Vita Activa Edizioni, October 2021, pages 226, 16.00 euros)