Displaced Children: "Adverse Childhood Experiences Amongst Refugees from the Horn of Africa: Influences on Development, Attachment, and Risk/Resilience"
by Segen Zeray
Winter 2020 Global Mental Health
Global Mental Health is the area of research, practice, and advocacy that places priority on improving and achieving equity in mental health. Now more than ever, Global Mental Health is a growing concern in the United States and internationally. Low and middle income countries are home to more than 80% of the global population, with less than 20% containing resources to aid in mental health issues. As violence and turmoil increases in these global populations, effective treatment is important to improve the lives of people living with these disorders in all countries. Whether it be a temporary, mild condition or more persistent and serious condition, it is a concern for all humans. Join us for a discussion on mental health and its impact on global health.
The UC San Diego Global Health Program, Students for Global Health, and Global Forum (International House) held our twelfth event in Quarterly Conversations in Global Health on Wednesday, February 19th, 2020 with over 150 in attendance! This quarter’s panel spoke to the topic of mental health and its impact on global health.
Quarterly Conversations provides a forum for the Global Health community to come together to discuss relevant issues in the field from an interdisciplinary perspective and increase community interaction at UC San Diego.
Thank you to the community tables who participated in the event’s networking session: American Mock World Health Organization, Center for Global Mental Health, Global Health Reps, San Diego Access and Crisis Line, and Students for Global Health.
We would like to give our special appreciation to our event co-sponsors: UC San Diego Global Health Institute, UC San Diego Division of Social Sciences, UC San Diego Global Health Program, UC San Diego Associated Students, and UC San Diego Center for Global Mental Health.
The Winter 2020 Quarterly Conversations in Global Health featured three panelists who presented their research, insights and experiences on various health issues as they pertain to the field of Global Mental Health.
We were delighted to have Dr. Thomas Csordas, Director of UC San Diego’s Global Health Program, moderating the event as our Master of Ceremonies.
Panel Recap
Dr Janis H. Jenkins first held the floor as the panel portion began. She is a psychological and medical anthropologist with expertise on culture and mental health. She is on faculty for the Global Health Program and Director of the Center for Global Mental Health at UC San Diego. Her principal interests are mental illness conceived as a fundamental human process and what she terms ‘extraordinary conditions.’ Dr Jenkin’s presentation began with a discussion of mental health and illness as existing on a diverse continuum. She emphasized that this field of study has grown increasingly prominent in recent decades, noting that this is reflected in our definitions of health such as that of the World Health Organization which states there is “no health without mental health.”
Despite the strides made in legitimizing mental health, Dr. Jenkins argues that the global community has yet to make this an explicit priority. Dr. Jenkins cites three misconceptions that must be challenged if mental health is to become a global concern. The first of these misconceptions is that mental health is “not real.” Dr. Jenkins addresses this by citing a national network of voices, comprised of advocacy groups and chapters, which legitimizes the reality of the mental health experience. Dr. Jenkins challenged the following misconception, that mental health is unimportant, by calling attention to the issue of social stigma which pervades our everyday language and discounts the suffering of others. She argues that the final misconception, that mental health is untreatable, is entirely inaccurate given the vast amount of studies which provide robust evidence for the efficacy of mental health interventions. The latter portion of her presentation spoke to the interplay between lived experience and cultural validity; the way we talk about risk factors, treatments, subjective experience, community support, among other fundamental aspects are culturally shaped, states Dr. Jenkins. This is especially crucial in the efforts toward prioritizing patient needs, desires and social resources.
Dr. Bonnie Kaiser is an Assistant Professor jointly appointed in the Department of Anthropology and Global Health Program. Her research focuses on elucidating cultural models of mental health and illness and exploring their connections to care-seeking; developing and adapting measurement tools for cross-cultural research and interventions; improving cultural adaptation of global mental health interventions; and critically exploring concepts of trauma, risk, and resilience. Dr. Kaiser began by discussing research in the field of mental health. She highlighted the difficulties of adapting measuring tools and exploring trauma as well as touching on the importance of cultural adaptation.
Dr. Kaiser went on to raise the question of how one might conceptualize and measure mental health cross-culturally. Dr. Kaiser used her research experience in Haiti to demonstrate the importance of bridging these cultural gaps. She then introduced another aspect of her research work which focused on the notion “idioms of distress.” Dr. Kaiser examined the “khyal attack” of the Cambodian culture as well as the Haitian “thinking too much,” to demonstrate how culture influences the language and frameworks an individual uses to describe their mental health. Given this diversity, Dr. Kaiser proceeded to discuss the measurement tools used to bridge these cultural divides and their effectiveness. Ultimately, she argues that the strongest measurement tool was that which combined idioms of distress and believes that advances in the field of global mental health will necessitate this broad use of this method.
Giselle Sanchez, M.A, is a doctoral student in the Department of Anthropology at UCSD. Her primary research interests include culture and emotion, adolescence, and mental health among diverse populations. She is an engaged member of an interdisciplinary research team conducting research on adolescent wellbeing in Northern Mexico and on adolescent mental health in Southern California. She has published on the experience of loneliness among adolescents in Tijuana and has presented on various conference panels on Global Mental Health. Giselle’s discussion began with the health risks of loneliness, as well as the portrayal of loneliness as a “silent plague” in the media and news outlets, which leads to the overarching question of: what is loneliness? As part of the Center for Global Mental Health’s research team on Cultural Perceptions of Emotional Well-Being and Patterns of Help-Seeking (Bienestar), Giselle delves into how a surge in homicides due to cultural violence and defiant infrastructures in Tijuana, Mexico has impacted the everyday lives and mental health of high school students. Giselle and her team lead 35 interviews with students aged 15-17 years old, 26 interviews with parents, and focus groups with teachers to identify the socio-structural adversity and conflicts (i.e. economic precarity, structural violence, familial conflict and peer relation conflict) of this population. Though the interviews did not explicitly ask about loneliness, Giselle’s examples of students interviewed highlighted the social isolation of these students as well as the interrelations of between feelings of depression, anxiety and anger. As the ethnographic data from this population in Tijuana shows thus far, Giselle affirms that cultural validity matters and that there should be a focused attention to adolescent mental health.