Defending the rights of rural women with mental health problems
Summary
The JULIA project: Rural Women and Mental Health, promoted by the Mental Health Federation of Castile and León, is a best practice in psychosocial intervention in rural areas, aimed at promoting mental health, social participation, and the empowerment of women in environments with a high risk of exclusion. Through a community and gender-sensitive approach, JULIA seeks to break down isolation, raise awareness of the realities faced by rural women, and create support networks that extend beyond the boundaries of formal intervention.
For decades, rural Spain has faced depopulation, aging, and the progressive dismantling of public services, which has exacerbated territorial and social inequalities (Ministry for Ecological Transition and the Demographic Challenge, 2023). These conditions have a direct impact on the mental health of the population , especially women , who in many cases assume caregiving roles, economic dependence, and more pronounced social isolation (World Health Organization [WHO], 2022).
In the rural areas of Castile and León, characterized by their low population density and geographical dispersion, women with mental health problems face a double vulnerability : on the one hand, that directly linked to gender and, on the other, the stigma that still surrounds mental health and disability in small communities. Added to this is the difficulty in accessing general resources such as employment, transportation, and social support networks, or specific mental health services, which limits their autonomy and well-being (Mental Health Federation of Castile and León, 2021).
According to official statistics from the Regional Government of Castile and León , in 2023 there were 176,048 people with disabilities in the region. Disability due to mental or psychosocial disorders is the second leading cause of disability in Castile and León, representing 16.45% of the total. And, according to data from the Social Services Management of the Regional Government of Castile and León, in 2023 there were 28,964 people with a disability certificate due to a mental disorder , and of these, 47.10% were women (14,154).
Women with mental health problems, in addition to the stigma, must face the difficulty of accessing general resources for employment, transportation, and social or mental health support networks.
This situation highlights the need to create services and resources tailored to the needs of people with disabilities living in rural areas . In fact, nearly half of the people with disabilities in Castile and León live in rural environments (42.92%).
In this context, the JULIA Project emerged: Rural Women and Mental Health , a social innovation initiative driven by the Castilla y León Mental Health Federation, which centers on the voices of rural women, their right to mental health, and their capacity for participation. JULIA is based on the premise that mental health cannot be understood solely from a clinical perspective, but requires a comprehensive approach that considers social, gender, and territorial determinants.
Living with a mental health disorder in a rural environment
Promoting the participation and autonomy of the most vulnerable women
The JULIA Project promotes the autonomy, empowerment, and social participation of rural women with disabilities due to mental health problems or psychological distress, and places a special focus on the most vulnerable women, fostering spaces for meeting and mutual support that strengthen their personal and community networks.
Through participatory workshops, training, and support , the project works to improve self-esteem, decision-making skills, and the exercise of rights. Furthermore, the project incorporates a preventative dimension against gender-based violence, promoting the early detection of risk situations and raising awareness among the participants themselves and the surrounding rural community.
In this way, JULIA contributes to creating more equal, inclusive and safe communities , making visible the reality of women with mental health problems and promoting their full participation in rural society.
The JULIA Project promotes autonomy, empowerment and social participation of rural women with disabilities due to mental health problems, and focuses on the most vulnerable women.
The main objectives of the JULIA project are:
- Promoting the empowerment and personal autonomy of rural women with mental health problems or at risk of exclusion.
- Creating opportunities for the personal and social development of rural women with mental health problems.
- Promote formal and informal support networks , contributing to reducing isolation and unwanted loneliness.
- Strengthen resources for protection and prevention of social exclusion and gender-based violence.
- Promote territorial equity in access to psychosocial resources and mental health promotion.
- To empower women for the critical analysis of inequalities related to gender, disability, and mental health.
- To make visible the reality of rural women with mental health problems, combating stigma and promoting their community participation.
Promoting community mental health
The JULIA model aligns with international recommendations on promoting mental health with a gender and territorial focus , promoted by the WHO (2022) and the National Mental Health Strategy (Ministry of Health, 2022). Its status as a best practice is based on several elements:
Comprehensive and community-based approach
JULIA does not limit itself to individual support, but rather promotes community-based processes of transformation . Participants develop psychosocial skills, strengthen their self-esteem, and rebuild support networks. In this way, the project addresses protective factors for mental health: a sense of belonging, social participation, and a perceived sense of control over one's own life.
Intersectional Gender Perspective
The project acknowledges the specific inequalities faced by rural women, especially those with psychosocial disabilities or family responsibilities. The intervention incorporates an intersectional perspective, considering factors such as age, education level, employment status, and socioeconomic conditions.
Networking
One of the project's strengths is its ability to forge alliances among diverse local stakeholders : women's associations, social services, health centers, local councils, and third-sector organizations. This inter-institutional network ensures the continuity of processes beyond the duration of the workshops and facilitates referrals and support.
Support networks among women to empower themselves and break out of isolation
Replicability and adaptation
The JULIA model is characterized by its flexibility and scalability . Each workshop is tailored to the needs of its participants, their rural context, and the available resources, making it possible to implement it in other contexts. Furthermore, methodological guides and practical tools have been developed to allow the model to be replicated in other rural areas; and there is a specific online course that trains professionals for its development.
Impact on women and the community
According to evaluation data collected in the JULIA Project Impact Study (2023), of the 683 participating women, 85% reported improved emotional well-being and self-esteem, and 78% indicated that they had expanded their social networks and maintained contact with other women in the group after the workshop ended. Furthermore, self-managed groups have been established in several municipalities, which continue to meet informally, demonstrating the sustainability of the approach.
Beyond the individual benefits, JULIA has helped break the silence surrounding mental health in rural areas . In many villages, the project's presence has generated a shift in social perspective, highlighting the importance of psychological well-being and mutual support among women.
The project demonstrates that mental health in rural areas can be addressed with participatory, inclusive, and sustainable tools.
Furthermore, the technical teams have observed a multiplier effect : some participants have subsequently become involved in local associations, collaborated in community activities or assumed leadership roles, and have even been trained as support facilitators for subsequent editions of Project JULIA in other nearby locations.
Rural women participating in JULIA not only improve their mental health , but also become agents of change, multiplying the positive effects in their communities. The project demonstrates that mental health in rural areas can be addressed with participatory, inclusive, and sustainable tools , provided that resources and attentive listening are prioritized.
In a context where depopulation and aging are structural challenges, initiatives like JULIA are essential to redefine public policies on mental health and rural development with a gender and territorial equity perspective.
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