Virginia Richards has always been proactive about her mental health. But the pandemic – and years of juggling paid work and responsibilities at home – have taken their toll.
In 2021 she suffered a relapse of her anxiety, depression and complex post-traumatic stress disorder, which she had developed years earlier after being glassed in the face at work. She was on a waiting list for six months before getting in to see a psychiatrist.
Richards, a 37-year-old mother of two daughters, is now seven months pregnant with her third child. “I’ve had to go back on medication for depression and anxiety while I am pregnant,” she says.
The Melbourne woman previously worked in the hospitality industry until 2018. For seven years she worked night shifts, even with a newborn and toddler at home.
“I would be with them during the day because we couldn’t send them to childcare, because it was too expensive. And then I would work at night, so I would average about four hours’ sleep,” she recalls.
She and her now ex-husband were “ships in the night”.
“My entire childhood, I was raised to believe that I was an equal. At about 30, it hit me: there is nothing equal about what I’m experiencing.”
Now, although she has remarried a “wonderful husband”, sharing the domestic burden is a work in progress.
“I go to work every day. I don’t want to go to the supermarket at five o’clock in the afternoon, come home and cook dinner for two hours after I’ve already gotten up at seven o’clock with the kids to get them ready for school,” Richards says. “I do all the finances. I make all the decisions. I do all the planning.
“I always go to work. I always finish my job. I always meet my goals. But I’ve never found it as hard as I have with this relapse.”
For months she reached out for help with her mental health but she was knocked back, leaving her frustrated and desperate. “I’d never experienced that prior to the pandemic.”
Unpaid labour still falls to women
Psychological distress and mental illness among women has reached dire levels in Australia, with problems only worsened by the pandemic. One in four Australian women reported an anxiety, depression or substance abuse disorder in 2020-21, compared with 18% of males.
Increasingly, research suggests that the double burden of paid work and unpaid domestic labour may be raising the risk of poorer mental health in women. Experts and policymakers say that redressing the issue requires sweeping and long overdue structural and organisational changes to improve gender equity.
The most recent Household, Income and Labour Dynamics in Australia (Hilda) survey, released in December, noted that in the year prior to the Covid-19 pandemic, women did 21 hours more unpaid work than men each week, and experienced higher levels of psychological distress.
A paper published in the Lancet Public Health journal this month, which reviewed 19 studies involving more than 70,000 participants in 35 countries, found that for employed adults unpaid labour was negatively associated with women’s mental health.
“Women carry a disproportionate allocation of unpaid work and a large proportion of that is unpaid care,” says Dr Tania King, a social epidemiologist at the University of Melbourne and a co-author of the review.
King says the types of unpaid labour done by men and women also appear to be different, with more men doing “less time-pressured activities, such as gardening”.
“Women are more likely to carry out more time-pressured tasks like meal preparation, feeding children.”
There are two theories underlying the link between inequality in unpaid labour and higher rates of mental ill health in women. One is role strain, the idea that “combining paid work and a high unpaid workload increases role conflict and role overload,” King says. “This can trigger some stress-related pathways.”
The other is the time scarcity theory, in which a sense of time pressure and particularly a lack of free time negatively affects wellbeing. “Over the past 50 years there’s been an increase in the proportion of women entering the paid labour force,” King says. Although women are taking on more paid hours of work, the vast proportion of unpaid labour in the household is still falling to them.
Covid and the ‘missing middle’
The relentless stressors of the Covid-19 pandemic and the rise in care responsibilities was particularly taxing on parents. “The transition to remote and hybrid learning meant mothers, not fathers, reduced their workloads to meet these newfound demands,” the University of Melbourne’s Prof Leah Ruppanner has noted..
In households with children, fathers increased their housework at the start of the pandemic and maintained this for at least several months, Ruppaner’s research found. But because women also upped their contributions, gender gaps in housework persisted.
Barbara Pocock, a Greens senator for South Australia and the chair of the Senate select committee on work and care, describes the gendered norms in Australian society as “extraordinarily tenacious”. Prior to her election in May, Pocock was an academic who researched work, employment and inequality.
“Young men and young women often start out quite optimistic about how they will share [domestic work],” she says. “But the data tells us that … just getting married results in quite a significant increase in unpaid labour for women. The arrival of children drives that up yet again.”
Pocock says when the pandemic hit there was a “big kick up” in unpaid domestic labour, but the ratio of contributions of women and women stayed the same. “It exactly reproduced the ratio that’s been there for decades around domestic work.”
Prof Jayashri Kulkarni, the director of the Monash Alfred Psychiatry Research Centre, says the events of Covid-19 “really underline the need for women’s mental health to be recognised as a separate and under-resourced area”. She co-authored research that found the pandemic affected women’s mental health more profoundly than men.
“Women are more prone to stressors in their environment,” Kulkarni says. “They’re more likely to be the victims of violence, they have the stress of inequities with wages, have more poverty. There are more stressors in terms of caring for not just self, but for the next generation and the older generation as well.”
Richards’ experience is an example of what Kulkarni terms “the missing middle” – a growing group of predominantly women who need treatment but are not considered severe enough to be admitted to public mental health hospital beds. “At the same time, they’re too sick to be able to cope.”
The mental health system is inadequately serving the needs of this group, Kulkarni says. “There is an across-the-board shortage of space on psychologists’ and psychiatrists’ waiting lists.”
Structural changes needed
In addition to improved mental health services, experts say structural changes are required to improve gender equality at work and at home.
King says men are participating in unpaid labour such as childcare and housework to “a much greater extent than previous generations, but it’s still not the same as women”.
“We really need to have accessible, quality childcare that is affordable. Ideally, it’s free,” King says, citing other initiatives such as parental leave with a non-transferable component for fathers, and improved working flexibility for men.
Pocock agrees: “The fact that so many Australian men work long hours … contributes to their low rates of participation in unpaid domestic work.”
The Senate select committee she chairs is holding an inquiry into the impact of work and care responsibilities on wellbeing, with submissions closing on 22 September. Pocock expects the inquiry will hear about issues such as childcare, the Coalition’s scrapping of the “use it or lose it” portion of paid parental leave, and the effects of balancing a job with different kinds of care and domestic labour.
After her first two pregnancies, Richards felt pressured to return to work when both of her daughters were three months old. “My ex-husband didn’t take a day off when I went into labour – he came and watched the birth and then went back to work.”
When the next baby arrives, Richards’ partner is planning to take seven weeks of parental leave. “It’s a completely different scenario,” she says.