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Office of the Surgeon General (US). Surgeon General's Workshop on Women's Mental Health: November 30-December 1, 2005, Denver, Colorado. Rockville (MD): Office of the Surgeon General (US); 2006.

Cover of Surgeon General's Workshop on Women's Mental Health

Surgeon General's Workshop on Women's Mental Health: November 30-December 1, 2005, Denver, Colorado.

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Executive Summary

The Surgeon General’s Workshop on Women’s Mental Health brought together experts from the consumer, academic, advocacy, health insurance, health care delivery, program management, and public policy communities to explore sex and gender differences1 in mental health and to address critical mental health issues affecting girls and women. The goal of this workshop was for participants to develop practical and actionable recommendations for materials (referred to broadly as communiqués) and toolkits that could be produced by the Surgeon General to advance knowledge, understanding, and behaviors regarding women’s mental health issues – and ultimately to improve the mental health of our Nation’s girls and women.

A rich array of potential messages, materials, target audiences, formats, and dissemination strategies emerged from the day and a half of workshop discussions and presentations. Examples ranged from a Surgeon General’s Letter to the American People, to iPod messages for teens, audio materials, story-telling formats, public service announcements, messages on commonly used products (e.g., diapers), and profiles of promising practices or model companies that promote mental health. Also discussed were ways of identifying and harnessing existing resources, such as clearinghouses, assessment tools, studies, self-esteem-building models, and more. The specific ideas and recommendations are described within the chapters of this report.

A series of overarching messages and cross-cutting themes pertaining to the mental health of girls and women also resonated through the sharing of ideas that took place at this workshop. These messages and themes will serve to inform the development of Surgeon General’s communiqués or toolkits:

  • Women’s mental health is essential to overall health. Both mental disorders and mental wellness should be integrated as part of primary and other health care practice.
  • The disease burden of mental illness is enormous. Among developed countries, mental illness is second only to cardiovascular disease in prevalence and causes nearly a fourth of the disease burden.2
  • Women’s health matters. The last decade of research has underscored the importance of sex and based differences in the risk, prevalence, presentation, course, and treatment of mental disorders.
  • Mental disorders must be viewed like other chronic medical conditions and are highly treatable. This message needs to be further understood to combat stigma and encourage more people to seek the treatment they need. In addition, there is a need for a broader understanding of the variety of treatments available.
  • Mental health must be addressed across the life span, from early childhood to the later years. The types of risk, prevention messages, ways of building resilience, course of disease, and treatments vary according to age, reproductive events, and other life span issues. Thus there is a need for materials and messages adapted to audiences of different ages.
  • There are ways to promote resilience and factors that help prevent mental disorders. We need to define good mental health and promote prevention. This means building a wider understanding of protective factors that can help girls and women build resilience – including for those who experience mental disorders – and developing effective strategies to translate that knowledge into practice.
  • Culture is an important source of resilience but also of barriers related to the recognition and acceptance of mental health issues. Girls and women draw great support from cultural connections and identity but also feel the weight of cultural pressures to remain silent about personal issues, not to discuss problems outside the family, or to be strong.
  • Gender must be integrated into disaster training and planning activities. The lessons of Hurricane Katrina and other large-scale disasters indicate that women are at particular mental health risk due to factors such as family responsibilities, women’s higher rates of poverty, their greater risk of depression and anxiety disorders, and their vulnerability to sexual abuse and domestic violence.3
  • The importance of trauma, violence, and abuse needs to be recognized by providers, researchers, policymakers, and the general public. Trauma, violence, and abuse are far more prevalent in the lives of girls and women than commonly thought – and they may lead to serious, long-standing physical ailments, co-occurring conditions, and risky behaviors that, if left unrecognized and untreated, can compromise women’s health.
  • Recovery from mental disorders or from the effects of trauma, violence, and abuse is possible. Following the recommendations of the President’s New Freedom Commission, we need to move toward a health care system that is recovery based and consumer focused.
  • Health literacy is a public health and Surgeon General’s priority. It is critical to design communiqués that carry health messages in language that people use and understand. To be culturally competent, materials should be designed with the input and participation of target communities, which may represent diversity in race, ethnicity, age, geographic area, sexual orientation, or health status.

A final message that echoed throughout the meeting was the recognition that women’s mental health issues touch everyone, either directly or through the women they love. Recognizing this factor, participants shared an enormous amount of energy, expertise, and commitment to the workshop effort. The rich results of their work are a testament to their substantial and considered contributions.



Workshop participants defined the terms sex and gender as follows: Sex is a biological construct defined by the organs with which a person is born. Gender is a societal construct that reflects a person’s sex as it figures in the context of cultural, family, and social environments.


Murray CJL, Lopez AD, eds. The global burden of disease and injury series, volume 1: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press; 1996.


World Health Organization, Gender and Health in Natural Disasters. Geneva, Switzerland; 2005.

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