Mental health isn’t separate from women’s health - so why is it still treated that way?
We know mental health matters, but in women’s health, accessing it still means going elsewhere
When we think of menopause, we think of hot flushes. Postpartum is framed as physical recovery. Fertility journeys are discussed in terms of timings, hormones and treatment plans.
Mental health, meanwhile, is often treated as something separate.
Yet, when it comes to real-life experiences, it’s often the mental health symptoms that are the most disruptive. Anxiety and brain fog are among the most commonly reported symptoms during menopause. Perinatal mental health conditions are now recognised as one of the leading complications of childbirth, affecting up to one in five women. And speak to anyone navigating fertility, and it quickly becomes clear that the emotional experience is never separate from the physical one.
Women rarely experience physical and mental health in silos. Yet the system still seems to make them.
A different model is starting to emerge - one where mental health is not treated as a separate service, but built directly into care itself.
That’s critically needed because of how the system has been built, says Dr. Clare Palmer, Director of Evidence at ieso.
“The healthcare system has been created to have specialties and verticals,” she says, “but that isn’t the way our bodies work. That isn’t the way people need care.”
“We need to disrupt the entire healthcare system,” Dr. Palmer adds, “to create something that is far more integrated.”
Friction sets in
Even as women’s health has expanded beyond reproductive health into a broader, whole-person view, mental health still sits outside the core of care.
Where progress has happened, it has largely focused on hormonal transitions - puberty, postpartum and menopause. But chronic conditions, inflammation, pain, stress, caregiving load and financial pressure all shape mental health, too - often at the same time.
Support may exist, but rarely in one place. Accessing it often means more research, more decisions, more admin - at exactly the moment women have the least capacity, with mental health support typically sitting elsewhere.
“You end up with a situation where users face this insane amount of choice of where to find help,” Dr. Palmer says, “and they’re having to educate themselves, advocate for themselves and make the right decision, which is really difficult.”
Care unintentionally breaks down
This is the heart of where many women’s health companies, and the women who rely on them, find themselves today. A fertility platform may acknowledge the emotional toll of treatment, then point users towards a therapist directory. A postpartum app may include a handful of resources, but still expect a struggling new mother to seek support elsewhere. A chronic condition platform may know that anxiety or burnout is affecting engagement and outcomes, but still treat it as outside scope.
“By referring them out, you’re creating more friction,” says Dr. Palmer. “Just referring people out isn’t giving people the support they need in the moment they need it.”
This can impact outcomes, too. Mental health does not sit alongside physical health; it influences motivation, adherence, decision-making and follow-through. In other words, it determines whether care actually works.
“By bringing them together is where you have the maximum impact,” Dr. Palmer explains.
She describes her own experience of trying to access mental health support while living in the US. After calling her insurer, she was given a list of therapists and told to contact them individually to find availability.
“I immediately felt paralyzed,” she recalls. “I was like, I can’t do that. That’s too much.”
When someone is anxious, low, overwhelmed or burnt out, asking them to do more healthcare admin work could be the very thing that stops them accessing care at all.
Meeting women where they are
That next phase is already starting to take shape - embedding mental health directly into the physical health journeys women are already navigating.
At ieso, that means integrating mental health support into existing digital care pathways - whether that’s a fertility platform, a postpartum service or a chronic condition app - rather than expecting users to go elsewhere to access it.
ieso’s AI-guided program, Velora, delivers structured cognitive behavioral-based support for depression and anxiety symptoms through a white-labelled conversational interface. The aim isn’t to replace therapists, but to make support more immediate, more flexible and easier to access in the moments it’s actually needed.
“The stronger case is meeting women where they already are - inside the care journeys they’re already using and trust,” Dr. Palmer says.
“Not every woman is going to have the energy to find a therapist, let alone to be available every Tuesday at 2 p.m. to see them.”
From service to infrastructure
ieso’s roots are in digital mental health. Founded in 2000 by two psychologists, the company was an early pioneer of internet-delivered cognitive behavioral therapy, publishing one of the first large-scale randomized controlled trials in the field. Since then, it has treated more than 145,000 patients within the NHS, delivering over 800,000 hours of therapy.
More recently, its focus has moved towards using AI to extend and personalize that model - integrating evidence-based support into digital health programs, making it available at greater scale.
There is now a growing evidence base behind this approach. Meta-analyses covering more than 100 clinical trials show that digitally delivered CBT can significantly improve anxiety and depression. ieso’s own peer-reviewed research, led by Dr. Palmer, suggests AI-supported delivery can achieve outcomes comparable to clinician-delivered care, with no serious adverse events reported.
More recent data (currently in preprint) shows similar results, with meaningful symptom reduction after relatively short use and low levels of generative AI safety risk at scale.
In a space where generative AI is moving quickly, safety is a central concern. Dr. Palmer is clear that not all AI tools are equivalent.
“We are not a wrapper around ChatGPT,” she says. “This is a purpose-built, constrained architecture designed by an experienced clinical team.”
Rather than an open-ended chatbot, Velora delivers structured, clinician-designed support that helps people build skills and resilience to manage symptoms over time. The AI personalizes how those techniques are delivered to each person. Built-in safeguards monitor for risk in real time, escalate when needed, and keep user data in a secure, controlled environment.
The new default
Whether women’s health companies like it or not, the gravitational pull towards AI for therapy-like advice is already happening.
Women are turning to general-purpose tools like ChatGPT in moments of overwhelm - because conversational support feels immediate and personalized in a way that a blog post, Google search, or PDF on a website does not.
A recent Rock Health survey, for example, found that 1 in 3 people (32%) have turned to general-purpose AI chatbots like ChatGPT and Gemini for health information, including mental health support, compared to just 16% a year ago.
“People can open a browser and start talking so easily, but we know that’s not going to give them evidence-based and appropriate support,” Dr. Palmer says. “The question becomes: how do you create something as easy as that, but that is actually clinically safe, trusted, and genuinely helpful?”
If platforms do not build more responsive, useful, and human-feeling support into their own experiences, women will look elsewhere - often to unregulated tools that are not safe and were not designed specifically for clinical use.
“Every healthtech company today is competing against ChatGPT in a way,” Dr. Palmer explains.
There’s an added risk here, too, that women receive inconsistent or low-quality guidance at critical moments, potentially undermining the very outcomes women’s health platforms are trying to achieve.
That does not mean every women’s health company needs to become a mental health provider. But it does mean thinking more carefully about how and where mental health is shaping outcomes - whether that’s treatment adherence, engagement, symptom management, or long-term retention.
“The message to founders is: think about what outcomes you want to move the needle on for your end users,” Dr. Palmer says. “And to what extent can integrated mental health support boost those outcomes.”
As women’s health has matured as a category, care design and delivery matters more than ever before. Dr. Palmer believes that the next phase will be won by solutions that truly reflect the reality of how women actually experience their health - in an interconnected and overlapping way.
“If we start doing that as femtech founders and builders today,” she says, “then we can use that to catalyse systemic change for the future.”
That may sound like a lot to aim for. But the alternative is to keep asking women to stitch the system together themselves.
And that is the one thing they have been doing for far too long.
This article is part of a paid partnership with ieso for Mental Health Awareness Month.