Definitions and Symptoms
Major Depressive Disorder (MDD) is a health issue that can affect anyone given the presence of respective circumstances, yet sex workers are under a particularly high threat. Due to the constant exposure to traumatic experiences and the lack of awareness of and access to healthcare services, the target population becomes especially vulnerable. Therefore, further actions need to be taken to reduce the extent of MDD cases in sex workers.
The concept of MDD is quite complex since its causes are numerous and nuanced. According to the DSM-V definition, to diagnose MDD, at least five symptoms of the ones listed below have to be observed:
- low-functioning depression;
- diminished interest in all or most activities;
- weight changes, typically weight loss in adults;
- insomnia or hypersomnia;
- disruption in the psychomotor function;
- fatigue;
- feeling of guilt;
- failure to concentrate;
- suicidal ideations (American Psychiatric Association, 2013).
In turn, the target population for this analysis (sex workers) is typically identified as people employed in the sex industry (Gall, 2016).
Relationships and Obstacles to Health Management
The relationship between the target demographic and the issue of MDD appears to be direct and unambiguous. Sex workers are evidently affected by MDD due to the nature of their work and the threat of trauma and abuse received regularly (Abelson et al., 2018).
Several impediments to preventing MDD in the target community also needs to be mentioned. Namely, the lack of access to healthcare services and the generally low levels of health literacy among sex workers define a high probability of MDD development. In addition, exposure to trauma increases the threat of MDD for sex workers tremendously (Argento et al., 2020). Coetzee et al. (2018) assert that the combination of exposure to sexual abuse and the feeling of shame associated with the profession of a sex worker defines increased risks for MDD in the target community (Rayson & Alba, 2019). Although there is little evidence about sex workers being at higher risks for MDD than other vulnerable groups, it will be reasonable to claim that the target community does face greater risks for MDD.
Local Community Services That Provide Support and Treatment
To support sex workers, who have a very limited access to crucial health management resources, information about local communities offering support and treatment must be made readily available. Unfortunately, the environment of Reno, NV, does not have a plethora of mental healthcare services. In the target area, the following facilities cater to the needs of patients with MDD:
- Reno Psychiatric Associates (2020): support for victims of sex trade; focus on MDD management;
- Sexual Health Program (2020): experts offering assistance to patients working in the sex industry.
In addition, there are numerous Sex Worker Allied Therapists practicing in Nevada. Unfortunately, there are not many facilities in Reno, NV that adders the specific needs of the target population with the specified diagnosis. However, services that cater to the mental health needs of general audiences and extend their assistance to the members of the sex industry are also quite numerous. For example, the following facilities should be mentioned as the source of assistance:
- North Shore Center, LLC (2020): the facility offers a behavior-driven approach (cognitive behavioral therapy, CBT) to the management of MDD in patients,. Also reducing the stigma of MDD;
- Discovery Mood & Anxiety Program (2020): the facility provides an effective program for managing MDD in patients by using the ESTEEM System;
- Presence Therapy @ MidTown Mindfulness (2020): the facility has multiple areas of focus and addresses complex mental health problems, including depression, and focusing on interdisciplinary collaboration for better practice.
By focusing on the trauma experienced by sex workers, as well as the stigma that they face in modern society, healthcare experts will be able to reduce the levels of MDD in sex workers.
References
Abelson, A., Lyons, C., Decker, M., Ketende, S., Mfochive Njindam, I., Fouda, G.,… & Bissek, A. C. Z. K. (2019). Lifetime experiences of gender-based violence, depression and condom use among female sex workers in Cameroon. International Journal of Social Psychiatry, 65(6), 445-457.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). APA.
Argento, E., Goldenberg, S., Braschel, M., Machat, S., Strathdee, S. A., & Shannon, K. (2020). The impact of end-demand legislation on sex workers’ access to health and sex worker-led services: A community-based prospective cohort study in Canada. PLoS one, 15(4), 1-10.
Coetzee, J., Buckley, J., Otwombe, K., Milovanovic, M., Gray, G. E., & Jewkes, R. (2018). Depression and Post Traumatic Stress amongst female sex workers in Soweto, South Africa: A cross sectional, respondent driven sample. PLoS One, 13(7), 1-16.
Discovery Mood & Anxiety Program. (2020). With Discovery’s Esteem System, anything is possible. Web.
Gall, G. (2016). Sex worker unionization: global developments, challenges and possibilities. Springer.
North Shore Center, LLC. (2020). Reducing stigma in Nevada. Web.
Presence Therapy @ MidTown Mindfulness. (2020). Treatment center.
Rayson, J., & Alba, B. (2019). Experiences of stigma and discrimination as predictors of mental health help-seeking among sex workers. Sexual and Relationship Therapy, 34(3), 277-289.
Reno Psychiatric Associates. (2020). Christine Molina MD. Web.