Dr Sue Outram: Experiences of mid-aged women in NSW seeking help for psychological distress.

This thesis has used a multidisciplinary perspective and qualitative and quantitative methods to explore mid-aged Australian women's perceptions and experiences of psychological distress, and in particular their experiences of seeking help for their difficulties. The high burden of illness for mental health problems in women is undisputed. However the diagnosis, aetiology and treatment of mental health problems is disputed territory, with the debate lying between extreme poles of the biomedical and social models of ill-health. The data used in this study came from Survey 1 of the mid-age cohort (n=14,000). Analysis was followed by a detailed sub-study of a sample of women with low mental health scores, and three indepth interviews four years later. The substudy used semi-structured telephone interviews with 322 women to explore their perceptions and experiences of mental health problems. There were many perceived causes, and these were mostly in the social domain, especially family difficulties. Women's dissatisfaction with their main relationship was one of the most consistent predictors of poor mental health.

Women consulted a wide variety of health professionals, with GPs the professionals most often consulted. Although most women reported fairly high levels of satisfaction with the responses of their GP, many were also critical of GPs in general, in terms of communication and caring, interest, knowledge and skills in mental health problems, an over-reliance on psychotropic medicines, and lack of holistic care. The assumption that GPs are the "best people" to treat mental health problems was questioned, and respondents identified a need for greater choice in health services, particularly for rural women. Finally, there was no single explanation, or remedy, for psychological difficulties in these women's lives. Stereotyped images of mid-aged women made unhappy by their empty nests or hormonal unbalance was not supported by these women's stories of their lives.