When governments design mental health strategies, they often treat mental health as a system design problem: how many beds, which referral pathways, what integration models. That approach can improve access and efficiency, but it sidesteps a harder question: what is actually driving women’s and girls’ mental distress in the first place?
AAWAA’s submissions to Tasmania’s ‘Rethink and Beyond’ mental health strategy starts from that question. We argue that unless the strategy names and addresses the structural conditions that produce women’s distress — male violence, the loss of female‑only services, economic insecurity, perinatal neglect and the absence of sex‑disaggregated data — it will deliver incremental service improvements while leaving the underlying causes untouched.
This post draws on the evidence base we presented to the Tasmanian Government in May 2026. What follows is not a list of individual problems, but a pattern of structural harms that policy has both the obligation and the capacity to address.
Male violence is the primary structural driver
Male violence against women is not a ‘social issue adjacent to mental health’ — it is a primary structural driver of women’s mental distress. In Tasmania, an estimated 95,600 women (43% of the female population) have experienced violence since age 15, and 28.1% have experienced intimate partner violence. Nationally, on average, one woman a week is killed by a current or former intimate partner.
Male violence towards women and children causes trauma, depression, anxiety, suicidality, substance use, housing instability and repeated crisis contact with health, housing and justice systems. In Tasmania, between 2012 and 2016, 70% of suicides in which a partner‑related stressor was identified involved partner conflict, and 62% involved a history of conflict or violence involving a partner.
A mental health strategy that does not treat male violence as a central determinant — rather than an afterthought — will remain structurally incomplete.
Perinatal mental health is under‑resourced and life‑threatening
Perinatal mental health is one of the most serious gaps in women’s mental health care, yet it is chronically under‑resourced. Nationally, perinatal anxiety and depression affect up to one in five women during pregnancy and in the year after birth. Suicide is one of the leading causes of maternal death in Australia — and when late maternal deaths are included, it is the leading cause.
Recent research from Queensland shows that the prevalence of suicidality in pregnant women and new mothers is almost twice as high as previously estimated, underscoring the scale of unmet need. Yet continuity of care between maternity services, primary care and mental health services remains weak, and Tasmania is now the only state without a public residential mother‑and‑baby mental health unit.
General practitioners have called explicitly for standalone mother‑and‑baby units in Hobart and Launceston. Evidence from Queensland and other jurisdictions shows that access to specialist perinatal mental health services, including MBUs, can be life‑saving, and that the absence of such services has been identified in coronial and clinical reviews as a contributing factor in maternal deaths.
Girls and young women: eating disorders, self‑harm and gender distress
Girls and young women are experiencing a significant deterioration in mental health, driven by identifiable social and cultural pressures. Nationally, more than one in four females (27.9%) aged 16–24 have self‑harmed in their lifetime, and 8.7% had self‑harmed in the previous 12 months. In the same age group, girls experience substantially higher rates of mental disorders and self‑harm than boys.
Eating disorders carry among the highest mortality rates of all mental health conditions, and suicide accounts for approximately two‑thirds of all non‑natural deaths in individuals with anorexia nervosa. AAWAA’s submission to the UN OHCHR identified social media algorithms and pornography as significant contributors to girls’ mental distress, normalising unhealthy body image standards and contributing to eating disorders, suicidal ideation and gender distress.
Gender distress among girls and young women also requires careful, evidence‑based attention. Referrals to youth gender clinics in Australia and comparable countries have shifted over the past decade from being predominantly male to being female‑dominated. A growing number of national health authorities, including in Finland, Sweden, Norway and the United Kingdom, now recommend cautious, exploratory psychosocial interventions and regard medical interventions for minors as experimental or restricted to tightly controlled circumstances, following systematic evidence reviews. Girls presenting with gender distress frequently have co‑occurring conditions including autism, depression, anxiety, trauma and internalised homophobia, and deserve access to a full range of therapeutic options, including respectful, exploratory psychotherapy.
Women in prisons: chronically under‑resourced, largely invisible
The mental health needs of women in Tasmanian prisons are poorly served and have received insufficient strategic attention. Nationally, more than half of people entering prison (51%) report a previous diagnosis of a mental health disorder, and around one in five report a history of self‑harm, with many more likely to be undiagnosed. Women in prison carry disproportionately high rates of mental health conditions, and most have histories of male violence and trauma that drive their distress.
The Tasmanian Custodial Inspector’s 2023 Adult Health Care Inspection Report found that mental health input to the Mary Hutchinson Women’s Prison ‘may require review’ and recommended an audit of need, noting that the Crisis Support Unit has ‘insufficient cells for the current mental health needs’ of the prison. Subsequent commentary from the Custodial Inspector, the Mental Health Council of Tasmania and AMA Tasmania has highlighted chronic under‑resourcing, with prison mental health services operating at less than a quarter of recommended staffing levels.
Older women: the invisible cohort
Older women are largely absent from mental health policy frameworks in Tasmania and nationally, despite facing compounded vulnerabilities. The 2021 National Elder Abuse Prevalence Study found that one in six older Australians (15%) living in the community experienced elder abuse in the preceding year. Women retire with significantly less superannuation than men and face markedly higher rates of poverty in old age. Women over 55 are the fastest‑growing group of homeless people in Australia.
AAWAA’s April 2026 submission to the UN Special Rapporteur on Violence Against Women and Girls documented that older women’s mental distress is produced by structural conditions — poverty, financial abuse, institutional neglect, administrative failures, and the continuation of long‑term intimate partner violence in old age — that policy systematically fails to name or address.
The erosion of female‑only services
Female‑only services are not a historical arrangement to be rationalised away. They are a clinical and ethical necessity for a significant population of women whose capacity to engage with mental health care depends on the safety and privacy of female‑only environments. Research and survivor testimony demonstrate that trauma‑informed, female‑only services are essential to effective recovery for many women who have experienced male sexual violence.
In Australia, AAWAA has documented a pattern in which female‑only medical and legal services have become increasingly difficult to access and sustain, as policies prioritising gender identity over biological sex have led services to repurpose themselves as general rather than female‑only services to avoid perceived legal and funding risks. This shift is likely to have disproportionately harmed economically vulnerable and migrant women, who are most reliant on low‑cost, accessible women‑only services.
What Tasmania needs to do
Tasmania’s mental health strategy must name women and girls as a priority population, recognise male violence as a central mental health determinant, protect and fund female‑only service options, mandate sex‑disaggregated data, and address the specific needs of girls and young women, perinatal and maternal mental health, women in custody, and older women.
All our submissions have been accepted and you can read all five, below.