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Mental Health: Thinking Upstream

2/28/2020

3 Comments

 
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Treating mental health is not easy.  It is multi-faceted and should be tailored to each individual person.  Culture is a large aspect of a person’s individuality.  We are all so different from each other including language, beliefs, spirituality, norms, taboos, food, etc. Addressing the culture is key in developing interventions that work for that person.  A refugee suffering from PTSD because they witnessed torture and death will not benefit from the same treatment as a non-refugee who seeks help for coping with the death of their mom due to cancer.  Another example of cultural comparisons is from the assigned video, Culture Matters: Indigenous Perspectives on Behavioral Healthcare (2011).  This video highlights a camp that demonstrated the way that indigenous Alaskans work through their mental illness. The participants describe the camp as a home or family.  They work together to live, cook, clean and even discover ways to stay warm in freezing temperatures.  They look after and care for each other.  They are a very spiritual culture and believe that alcohol is spiritual.  If you take alcohol away from an alcoholic, you must fill it with something else that is spiritual.  For these Alaskans, they filled that void with their beliefs and customs.  These types of interventions proved successful for their culture, but that doesn’t mean that it would be successful for a different culture.   
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While taking in the assigned readings, I was reminded of a conversation I had with a fellow nurse a few months back.   She is a friend of mine and for the purpose of this blog, I was call her Amy.  Amy asked me why so many white Americans have depression. I had no answer for the question, but I continued to think and reflect on it frequently.  Amy is Black, Muslim, raised in Sweden but born in Kenya.  I think she asked me that question because I was a White American.  While watching the video, The Emptiness in my Heart: Coping with Mental Illness in a Foreign Land (2012), I wondered if Amy had grown up in a culture similar to Jackie, in that they did not talk about depression and mental health? If that were the case, then it would make sense that Amy believed that few people in her culture had mental illness because people were too ashamed to admit that they were suffering.  There be friends, family or loved ones in her life that are living with depression but are too afraid to seek help because of the social stigma.  For me, this realization of cultural differences in mental illness will follow me for the rest of my life.  I will take it to work as a nurse and use it in my personal life as well.   In addition, I will for sure follow up with Amy to continue our conversation with my new perspective. 

Dr. Nadine Burke is a strong female pediatrician who is making waves in healthcare.  Her TED TALK, How childhood trauma affects health across a lifetime (2014), describes her work. She was recently named California’s first Surgeon General. This is an important milestone because she is a black and female, but her real work is her study of adverse childhood experiences, or ACE. Burke created a screening tool to detect ACE. The results of the tool help guide caregivers in appropriate treatment. This tool should ask about experiences that involved physical abuse, substance abuse, poverty and mental illness. Studies have shown that children exposed to these experiences are strongly linked to health risks later in life. Since being elected into her current position, Burke has worked with California’s governor to invest $60 million into early development screening and $45 million into the state’s Department of Health Services. This money will fund ACE screenings every three years to those under 65 years old on MediCal.   My question, which is more like an ongoing question is why is there so much resistance to creating laws and policies that help prevent issue that affect our healthcare like increased health risk for kids with traumatic experiences? I think it is related to lack of education and willingness to think outside the box. I think it is easier for people to accept that this is “just how it is”.  

The TED talk by Vikram Patel (2012) is equally enlightening.  His approach can be used by anyone using the SUNDAR method.  This includes simplifying the message, unpacking the treatment, delivering it to where the people are, making it affordable and available; and reallocating to specialists to train and supervise.  Similar to Dr. Burke, Vikram created a proposed solution to the problem of mental health worldwide.  These are relatively simple solutions; they do not require advanced medication or research.  So why aren’t we utilizing these methods more? In my opinion, I place the blame on the stigma that surrounds mental health.  This topic is personal to me because my sister suffered from depression.  She never directly told any of her friends or family that she was suffering until it was too late.   She passed away in November.  We still don’t know the cause of her death because we are waiting on toxicology results.  After she passed, her journals and writing reflected a deep depression that she internalized for years.  Without the help of others, she tried to figure out other ways to cope.  Unbeknownst to us, Liv started drinking heavily.  In addition, she stopped taking her seizure medication.  Although we still don’t know for sure, this deadly combination is most likely what caused my sister’s life to be cut short.   

I have so many regrets in this situation and how I failed as a sister.  I want to channel that energy to good and use my platform as a nurse to help others like my sister.  Mental illness contributes to a burden of physical diseases.  It should be treated with the same urgency as any physical disease, but unfortunately this is not the case.  The stigma and shame behind disorders such as depression and anxiety can prevent individuals from seeking help.  One of my goals is to create a program that educates on mental illness, creates a safe space for people to talk and provides resources for help.  I am currently working at Mercy House in Lynnwood creating a program for their Kids Club.  It is a work in progress, but I am trying to find ways to de-stigmatize mental health.  Talking about it can help educate kids about what it is and healthy ways to cope and seek help.  I feel like my role in this project is fulfilling both Dr. Burke and Vikram’s work. 

-Samantha Sinclair 



References: 
Ciorogan, Nick. (2012, October 8). An Emptiness in My Heart: Coping with mental illness in a foreign land. YouTube. Retrieved from https://www.youtube.com/watch?v=PGjDNUtTX1w&feature=emb_title 
Harris, N. B. (2014, September). How childhood trauma affects health across a lifetime. TED. Retrieved from https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime. 
Patel, Vikram. (2012, June). Mental health for all by involving all. TED. Retrieved from https://www.ted.com/talks/vikram_patel_mental_health_for_all_by_involving_all 
Wide Angle Studios. (2011, August 11). Culture Matters: Indigenous Perspectives on Behavioral Healthcare. YouTube, Retrieved from https://youtu.be/yfdCaFEls_c 
 
3 Comments
Hannah Berg
3/1/2020 12:55:29 pm

Hi Samantha,
I just want to commend you for being so open and willing to discuss these pertinent problems related to our current state mental health care. I am deeply sorry for your loss and hope that you are able to find a sense of comfort and peace in this time of grief. I really like the question you posed around a lack of policy level accountability in providing wider mental health services, especially when these issues pose severe health risks. I am in complete agreement to the point that you made; many people have set beliefs and when others develop novel concepts that challenge established practices it can come as a shock. Further, I want to reiterate how much I appreciate you devoting your professional work to improving mental health resources. Taking the events of your sister’s passing to fuel your drive to help and prevent others from suffering in the same way is so incredibly influential. Thank you Samantha for the fantastic post!

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Jody Early
3/3/2020 09:13:18 pm

Samantha,
My heart goes out to you and aches for your loss. I know what it's like to lose a sister (two, actually). Your humility and willingness to not just learn more, but to do more, is inspiring for us all.

Reply
Angelica Estira
3/15/2020 04:17:03 pm

Hello, thank you for sharing. I understand the feeling of losing a sibling one as well. I am sending my thoughts and prayers to you and your family. I was looking at your photo that you chose and I didn't quite get it until I read your blog post. And I think you chose a very good photo that resonated so much with your feelings and thoughts here. I really appreciated you sharing this because there are many others who could be helped by this in so many ways. Thank you!

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