Beyond a One-Size-Fits-All Approach: Why Women’s Mental Health Is a Collective Priority

Livia De Picker, Assistant Professor of Psychiatry at University of Antwerp, Belgium And Psychiatrist at the University Psychiatric Hospital Campus Duffel, Belgium 

Women’s mental health has historically been under-researched and under-treated. Why is it now urgent to address this gap, both from a medical and a societal perspective? 

For many years, psychiatry followed a largely “one-size-fits-all” approach. In practice, this meant that a 45-year-old woman and a 20-year-old man presenting with depression would often receive the same treatment. Today, we know that this is too simplistic. 

Research has made it clear that both biological and environmental factors shape mental health, including meaningful sex- and gender-related differences. Hormonal changes during the menstrual cycle, pregnancy, the postpartum period, contraception use, and menopause can all influence mood and vulnerability to psychiatric symptoms. 

The challenge is that everyday clinical practice has not fully caught up with this knowledge. Many women seek help for mood changes linked to specific life stages but do not always receive clear, evidence-based guidance. Closing this gap between research and routine care is therefore urgent — medically and socially. 

Mental health affects education, work, relationships, and family life. When care is delayed or insufficient, the impact extends beyond the individual. Addressing women’s mental health more precisely is not about creating a separate system, but about delivering fairer and more effective care based on what we now understand. 

You recently launched an international commission on women health in partnership with The Lancet Psychiatry, one of the world’s leading scientific journals, and the Fondation FondaMental. Why is it so important today that women’s mental health be recognized, documented and debated within such a prestigious scientific framework? What specific gaps or shortcomings in current research, clinical practice and clinical guidelines does this initiative aim to address?  

Launching a Commission with a leading journal such as The Lancet Psychiatry sends a strong message: women’s mental health is not a niche topic, but a major public health issue. 

There are three main gaps we aim to address. 

First, research. Although progress has been made, we still lack robust data on how the female brain functions across key life stages, such as the menstrual cycle, pregnancy, postpartum, and perimenopause. Large, well-designed clinical trials remain limited, particularly regarding hormonal treatments and their role in mental health conditions. 

Second, clinical practice. Many clinicians have not been specifically trained to recognize how hormonal transitions may influence psychiatric risk. Symptoms like anxiety, sleep problems, mood swings, or cognitive difficulties are often treated separately, without considering their broader biological context. Women may consult several specialists without anyone connecting the dots. 

Third, clinical guidelines. Recommendations in menopause care often overlook mental health, and psychiatric guidelines frequently omit hormonal influences. Our goal is to bring existing evidence together and translate it into practical, integrated guidance. 

The Fondation FondaMental plays a central role in this commission through the development and coordination of MiaMental, an international digital platform designed to support women at key stages of life, from puberty to ageing.  By bringing together accessible, expert-led resources and support from The Lancet Psychiatry Commission on Women’s Mental Health (key information, books, practical tools, multimedia content, personal stories, events…) and making them accessible worldwide, how does MiaMental aim to transform prevention, early detection and care?  

MiaMental was designed to ensure that the Commission leads to real-world change, not just academic discussion. 

Publishing a scientific report is important, but knowledge must reach women, families, and frontline clinicians at the moment it becomes relevant. Too often, women struggle to find reliable information or are unsure whether their symptoms require medical attention. 

The platform offers clear, evidence-based explanations, practical tools, and accessible content tailored to different life stages. It helps women understand what may be part of a normal transition and what might warrant professional support. 

By making high-quality information widely accessible, MiaMental aims to close the gap between research and everyday care. The goal is earlier detection, better prevention, and more coordinated support. 

Biological factors such as hormonal fluctuations and immune differences play a significant role in women’s mental health. More broadly, how do biological mechanisms influence mood regulation, pain perception, vulnerability to psychiatric disorders, and responses to treatment? Why have these dimensions been so largely overlooked until now?  

Biology plays a central role in mental health. Ovarian hormones — oestrogen, progesterone, and testosterone — are not only reproductive hormones; they also act directly on the brain. They influence mood regulation, stress response, sleep, cognition, and pain perception. 

Oestrogen appears to have protective effects against depression and psychosis, which may partly explain increased vulnerability during hormonal decline, such as perimenopause. For a subgroup of women, likely around 10%, it is not the hormone levels themselves but their fluctuations that trigger symptoms, particularly premenstrually, postpartum, or during menopause. 

The immune system is another important factor. We know there are clear sex differences in immune functioning. During the COVID-19 pandemic, for example, men were more likely to die from acute infection, while women were more likely to develop long COVID, with persistent fatigue and cognitive or mood symptoms. Immune activity directly affects mood and energy. 

These factors were long overlooked partly because women were underrepresented in clinical research. Hormonal variability was also seen as too complex to include in study designs. As a result, many clinicians were not trained to systematically consider these influences. 

At the same time, gender norms and expectations affect how symptoms are expressed, recognized and diagnosed, with certain conditions, such as autism, still under-identified in girls. What could change with better awareness of these factors? 

Biology does not act in isolation — it interacts with social expectations and lived experience. 

Girls often learn to internalize distress, expressing it through anxiety, perfectionism, eating disorders, or burnout rather than disruptive behaviors. Boys, by contrast, may show more externalizing symptoms. This difference has contributed to the under-identification of conditions like ADHD and autism in girls. 

Recent data suggest that the gender gap in autism, for example, is likely much smaller than previously thought. Greater awareness could improve early screening, reduce misdiagnosis, and allow girls and women to receive appropriate support sooner. 

Early recognition is crucial because untreated neurodevelopmental conditions often lead to secondary mental health problems such as depression or anxiety later in life. 

There is sometimes a misconception that focusing on women’s health means excluding men. Why is this a false opposition, and how can research centered on women actually lead to better mental health care for everyone? 

This is a false opposition. Medicine improves when it becomes more precise. Understanding sex-specific mechanisms strengthens the science overall. Studying hormonal, immune, or stress-related pathways in women often reveals principles that are also relevant to men. 

The aim is not to prioritize one group over another, but to close knowledge gaps. Better understanding leads to better diagnostics and more tailored treatment for everyone. 

This international commission also emphasizes the societal impact of women’s health. How can improving mental health care for women benefit families, workplaces, and society as a whole? Why is it crucial to support these initiatives ? 

Women’s mental health has wide-reaching effects. Women are often central figures in families, workplaces, and communities. 

When women receive timely and appropriate support, families tend to be more stable, children show better resilience, and workplaces experience less burnout and absenteeism. In the long term, this reduces healthcare costs and strengthens social cohesion.  

Supporting initiatives like this Commission is important because it connects scientific evidence, clinical practice, and real-world implementation. It helps turn awareness into action — and that benefits society as a whole. 

The MiaMental international platform, dedicated to women’s mental health and developed under the initiative of The Lancet Psychiatry Commission on Women’s Mental Health, will officially launch on March 7th in celebration of International Women’s Day. 

On the same occasion, the International Association for Women’s Mental Health (IAWMH) will host the very first webathon focused entirely on women’s mental health, in partnership with leading psychiatric organizations including RCPsych UK, RANZCP, and The Lancet Psychiatry Commission on Women’s Mental Health. 

Women’s mental health is a societal priority. Take action today by providing tailored resources for the key challenges women face across all stages of life.