I feel that University of Michigan is providing the bare minimum of what is necessary for the prevention and treatment of mental health. There are many more resources that U of M could supply regarding mental health. In lecture, the topic of dropping out of college because of mental health reasons struck me a little. I remember Carrie indicating that because University of Michigan has a numerous amount of people that are on the waiting list, it is easy to replace someone who drops out. I felt a little uneasy about this because it seems as if the University of Michigan can be a little insensitive to those who drop out because they people waiting to replace them. At the same time, I feel that if faculty/staff, or anyone involved, knew the reasoning behind a student dropping out of U of M (mental health, addiction , etc.), then they would cater to that student’s needs in the best way they could.
In terms of prevention and treatment, C.A.P.S. is almost always encouraged to go when someone is having issues with mental health. I’m sure C.A.P.S. is a great resource, but it is not available all the time, so there should be alternatives. Placing a counselor in the residence hall could be very beneficial, and maybe even training Residential Advisor on ways to prevent or treat mental health with students. I also think having more safe spaces around campus, or in residence halls, could allow for students to feel comfortable discussing mental health. Many students feel that they are alone when struggling with mental health, and safe spaces could give students the opportunity to communicate with other students who are also dealing with mental health issues.
Mental health is a topic that needs to be discussed in high school, maybe even as early as middle school. High school can very stressful students, and learning how to manage stress and cater to one’s mental health could possibly prepare high school students managing their mental health in college. This could, perhaps, improve future college students’ mental health, and lower the dropout rate.
Outside and in college, the world is very competitive. Sometimes people find themselves competing over how stressed they are. “I am so stressed about my Chemistry exam.” Then another person comes along and says, “You don’t even know what stress is, wait until you get to Orgo.” Either way, both students are stressed. This competitive nature could damage their mental health by making it seem like their stress is nothing to take seriously because another student has “more stress.” We should definitely reduce this stigma of competing over whose stress level, or mental health, is worse, and maybe this could improve mental health among college students.
As college students, it is so easy to just brush off the countless feelings of anxiety or sadness during the year, and we forget about the help available. I believe that U of M has one of the largest amount of resources available for those who are clinically struggling, and those who are just going over a rough patch. I do, feel, however, that there is more that could be done. Firstly, from my experience, many students are afraid of admitting they are feeling depressed due to the large amounts of red tape and legal work they will have to fill out, I know this is a public policy, but it is something that should be looked into. Also, students who are feeling stressed simply fear that they “don’t have the time” to attend a CAPS session or further appointments, and this should be made aware to those promoting mental health policy. I believe that even though our school does a great job at promoting healthy mental lifestyles, they are also creating an unneeded schism between “those who are mentally healthy,” and “those who aren’t,” simply referring to everyone on a spectrum like we were taught is a much better way to prevent a divide that is unnecessary. Lastly, I have been exposed to a lot of “busy” work in school this year, that was obviously done to fill time slots rather than promote critical thinking, which causes unneeded stress due to business. I feel that many educators should truthfully look at the material they are presenting to make sure what is being taught is important to teach. My question for fellow readers: do you feel that mental health will remain stigmatized? If so, why?
Many of us have seen the common instagram post of someone holding an African child in their arms, informing the world of their service trip to a developing nation. While these pictures don’t directly harm anyone, they can affect others perceptions of what a service trip/volunteering is. By framing these trips as a fun expedition to another land rather than a precise and calculated usage of time, knowledge, and resources, social media and advertising companies can make service trips highly appealing to those who can afford them, creating an influx of individuals who have the resources to pay a costly airfare and program cost, but who often lack any real world skills or knowledge that the receiving nation so desperately needs. Because of the commonality of such individuals, receiving nations may have altered perceptions of volunteers, and be less open to accepting help from individuals with actual expertise.
My question to you all: How can volunteers account for the pre-existing (and rather apparent) power/class imbalance present between a volunteer and who they are aiding? In other words, volunteers often come from high SES and privilege, but they often interact with those of a much much lower SES and privilege. How can someone communicate with who they are aiding in a way that displays empathy and understanding when they have never really faced a similar situation?
One thing that really resonated with me from Carrie’s lecture is when she said you’ll never be able to fully understand a region’s cultural and historical attitudes. It made me realize that even as a Michigan resident, I don’t know all of the cultural attitudes of all people in the state, and I may never. For example, I wouldn’t know the cultural attitudes of someone from the western Upper Peninsula, or a person from Big Rapids, because I haven’t had the same experiences that they have had. That isn’t to say you shouldn’t try your best to learn about the culture in the region you are doing work in. Some steps you can take to increase your cultural sensitivity in the place you are working are learning various aspects of the culture, practicing essential phrases in the native language, and getting to know the people from the region by spending time with them.
Going hand in hand with cultural sensitivity is research ethics. Reciprocity is crucial to the global health research experience. You aren’t going to another part of the world solely to take whatever information or experience you want without contributing something to the community you’ve gone to. Giving back to the community should not only be done, it should be prioritized. This means reducing your burden and in other cases this means maximizing the benefits to the host community. You can reduce your burden by being as culturally sensitive as possible, so you don’t accidentally attack the culture or impose your culture onto others. When choosing your topic to research, make it one that will actually benefit the subjects in some way.
Should you take on the task of becoming as culturally sensitive as possible, it is highly probable you will still make mistakes, just as when Carrie told us of her experience in Durban. After conducting all her research, she and her colleagues came to the conclusion that high reported school connection is a protective factor against perpetrating violence, and suggested that there be more after-school programs. She failed to realize, however, that it became dark quickly after school, so these programs could never come to fruition. Carrie told us of her experience not to discourage us, but to help prepare us for the unexpected obstacles that may arise in global health research and to encourage us to learn from mistakes.
If you are interested in doing global health work, how have Carrie’s experiences shaped your views on working around the world? If you’re not interested in doing global health work, what knowledge can you use from the lecture in practice here in the States?
This lecture was extremely near and dear to my health because it surrounded the ideas that Riana and I committed our whole semester to researching – the ethical complications of interventions abroad. I think Carrie touched on the large overarching problem that continually comes into play in these situations: we do not take the time to understand the cultures we are trying to help. Carrie emphasized this through her story about how she intended to make the education system safer. She had great intentions, but formed a solution that could not actually be applied in reality. This complication was rooted in the fact that she formed the solution using her previous experiences and was simply not equipped with the “tools” to problem solve for this region of the world. We find time and time again that we are not familiar enough with the cultures of the countries we are trying to help and yet we still go abroad and try to use solutions that apply in the Western world. This can be seen in many areas of intervention, whether these are social, structural, or medical interventions. A prime example of American ignorance that I found in my personal research of interventions in Africa was that many health care professionals proposed that African men be circumcised in order to prevent the spread of HIV/AIDs. In doing this the health care professionals compromised the African culture, as many of these cultures are against circumcision. It is a recurring problem that American health care workers attempt to assist in global health and arrogantly push solutions that simply do not fit into the cultures they are invading.
What examples arrogance or cultural ignorance have you seen in global health efforts?
I was a big fan of Carrie’s lecture this past week. Global Health is a subject which seems it may be hard to teach without giving examples of personal experiences, so I liked that her lecture was mostly experiential. What surprised me was simply how much she had seen and how many places she had gone/people she has helped. I was really inspired by it all because I have never travelled outside of the country so to see all of her experiences just induced such an interest in traveling in me. I think in order for my future colleagues and I to remain culturally sensitive in an ethical manner on hypothetical trips to places other than our own country, we must conduct a lot of research on the place we are going before we leave. We should try and get in touch with inhabitants of the place we are going who would be willing to talk to us about customs and traditions they have, and we should ask specifically what things we should not do to avoid offending anyone. We should also learn the language of the country in order to break language barriers. We should also just simply be respectful in situations where tension occurs because we can’t entirely be sure we will avoid it completely.
I think the most surprising thing about Carrie’s lecture was her feeling about it as a whole. She seemed to regret certain aspects of her research while in South Africa. She claimed that the way she handled herself while in Durban, South Africa led to her having less of an impact. She spent too much time interested in the bus system and other less important aspects of Durban, and didn’t notice that the building across the street from the school was extremely dangerous for kids. This lead to Carrie’s suggestions on limiting violence not being feasible for this specific town. This surprised me because I feel like I would have made the same mistake. When I travel, I tend to fall into more of a tourist than an actual observer of the culture. This has huge ramifications when one is actually doing research to help a community. It is so easy to get caught up in the less important aspects when one is in a place that is so different than what they are used to. To make a legitimate difference using research in a new culture, one has to put away their tourist side and get to the bottom of what they are trying to fix.
Another thing I think is very important when it comes to doing research abroad, is to know why you are doing it. Carrie talked about people that go to another country to set up a project that doesn’t help the community after they leave. These people will go to the country, take a picture with the native people there, post it on Instagram, then leave the country without making an impact. This is utterly unacceptable. Carrie went to Lima, Peru to help eradicate the spread of HIV. She went to Durban, South Africa to make the lives of children there safer. She knows exactly what she is doing every time she left the country, which is why she has such a successful impact. Find what you want to change in the world, then go out and do it. If you’re doing it to take pictures and put it on a resume, there is a chance you can do more harm than good.
The hardest part of doing research abroad seems to be figuring out the culture of wherever you are going to be. What would you all do to get a better understanding of the culture of where you are going? Who would you talk to? What research would you do prior to your arrival?
Probably the most influential story in Carrie’s lecture was about her MIRT research she did in Durban, South Africa and how they came up with a solution to lessen the school’s youth violence. She told us about how they completely failed to realize that the school is across the street from a liquor store and that it isn’t a safe environment for the kids past dark so her solutions weren’t applicable. This anecdote was a powerful reminder that although people may want to go do international work for global health and do their best to help, they may not know enough about the culture or environment to truly be helpful and all their work will just benefit them. This raises the importance of taking time to really get to know the people you are serving. It is important to be culturally aware and competent as well as to take reciprocity into account.
Last summer, I went on a mission trip to Bolivia and spent time with orphans in Santa Cruz. We had gone to help create and open a new orphanage near Santa Cruz, and some had gone to provide medical services. Upon the initial immersion into the country and primary interactions with the people, I came to realize just how unprepared some of us were for the trip. We surely were all competent enough for the main mission and the manual labor we had to do as we tried our best to limit the burden of our presence to them; however, I found that some of us still had a substantial language barrier. Carrie’s experiences she shared with us reminded me so much about how some of us had really wished we had gotten to know the language better before going to Bolivia. As she said, cultural sensitivity, competence, confidentiality, collaboration, and personal image should be part of the basis of global health work.
Because of Carrie’s lecture and my own experience, I think it is very important to first get to know the people you are serving/researching and understand their cultural norms and environment they live in. One can make sure their work is culturally sensitive by learning the people’s language, reading up on their cultural norms, or even spending time with them and asking questions. By making the proper preparations for the research immersion, one can limit their burden on the people they are serving and maximize reciprocity.
What else in Carrie’s lecture spoke to you guys? How do you think the information she shared with us in the lecture can help you in your future as a medical professional whether you are planning to participate in global health work or not? And if you will participate in global health work, how can you maximize reciprocity?
Often people may not see much of a connection between social justice and the medical field. People can see the medical field as a way to make a change in individual lives, but it may not be apparent how healthcare can play a role in overarching social change. From Carrie’s lecture, I learned that public health and global health are great platforms for social change within the healthcare field.
Carrie walked us through her occupational journey and demonstrated how we can be dedicated to social change and learning from different communities in the medical field. I was astonished by the work she did for HIV/AIDS by protesting, providing testing, counseling, and participating in conferences and campaigns to end AIDS. In doing this, she banded together with others passionate about the cause and worked to bring awareness to the public and the government. This is fundamental for social change.
Carrie also talked a lot about being sensitive to other communities’ cultures. In doing this, you have to come in with an open mind to a new and different set of standards and attributes. Engaging with the community and the people and organizations within it is a great way to learn about things you may be unfamiliar with. Carrie learned that even though she thought she had a reasonable solution, progress can’t be made unless you understand the community you’re working with. This is a valuable lesson as healthcare providers. Whether we want to serve people across the globe or here in Ann Arbor, we must dedicate ourselves to learning about the environment and the people we are serving. Only then can we really make long-lasting change.
What do you think about the role of social change and justice within healthcare? What are some ways that we can be culturally sensitive and ethical in working with different populations?
I really enjoyed hearing about Carrie’s domestic and international experiences. I was truly blown away by all of the work she has done and places she has seen throughout her life so far. You could tell that she really has her life together. Therefore, I was surprised when she was so honest about the mistakes she and her colleagues made while they were doing research in Durban, South Africa. What more could someone like Carrie, who had all of the right intentions, have done to prevent making mistakes while conducting global health work? Based on her lecture and my own experiences, I came up with a few points on how we can do global health work in the most respectful and ethical way.
- Be educated about the culture. In class, Carrie guided us through many ways to try to understand and learn more about a culture that is not our own: read their news, learn some of their language, be knowledgable about their religion, or even just use google to further educate yourself.
- Keep the perspective that your trip is not about you. Whether you are on a short-term service trip or conducting a year-long research project, the purpose of your trip is to impact your host community in a positive way. If at any point you feel that you are doing more harm than you are doing good, step back and re-evaluate.
- Be open to furthering your understanding of the world around you. Try to absorb everything about the community that you are in. While you are there, turn off your phone and forget about the stressors you have back home. Take advantage of the opportunity you have to understand more about a culture that is different from your own, and take what you learn home with you. If you encounter something that is culturally different than what you are used to, don’t act disgusted or surprised, because could be interpreted as disrespectful and can put a wall up between you and the community you are in.
- Accept that you are going to make mistakes (and admit to them when you do). In the beginning of class, Carrie mentioned that, even if you do all of your research, it is impossible to fully understand everything about a culture, unless it is your own culture. It is inevitable to make mistakes when you are working abroad. How you respond to your mistakes, however, makes all of the difference. When you make a mistake, make sure to recognize it, apologize, and educate others about what to do instead. Carrie did not have to tell us about her failed research project in Durban, but she thought it was important to humbly admit to it and share what she had learned with us so that we could use that knowledge during our own experiences.
My questions for you all: Did Carrie’s lecture provide you with any new perspectives about global health work? Do you plan on doing any work abroad? If so, how will you make sure that your work is culturally sensitive and necessary for the community you are in?