Spring 2020 San Diego City College Student Anthropology Journal
Edited by Nicholas Roberge
Published by Arnie Schoenberg
Cover Photo: “Contrasting Paths" by Kelani Van Slyke,(2/11/2020)
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Volume 4 Issue 1
Spring, 2020
latest update: 6/13/21
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As a newly pregnant woman I had anticipated the biological and physical possibilities associated with pregnancy and birth. However, the mental health aspect had not yet entered my realm of contemplation until the unforeseeable occurred and I experienced firsthand the debilitating effects of postpartum depression and anxiety. This led me to an intense search for practitioners, specialists, and programs to facilitate treatment with the ongoing process and associated need. Surprisingly, there were very few programs and facilities that dealt with the niche of postpartum mental health and while I ultimately recovered with time and excellent care from aforementioned practitioners, the lack of readily available resources was astounding. This article looks at how the postpartum movement came about, the gender role and how cultural dynamics and geography play an enormous part in how postpartum mental health is viewed and the need for increased awareness and resources for this niche within the mental health movement.
Taylor explained how the formation of the postpartum movement came about in the early 1980’s due to the experience of women in two geographical locations of the US.
The social movement that participants refer to as ‘the postpartum depression self-help’ movement consists of two separate but interacting national social movements D.A.D and PSI. Both groups formed in the mid-1980’sout of the experiences of women in two separate regions – Pennsylvania and California – who suffered serious postpartum psychiatric illnesses and were unable to find sources of treatment and support. [Taylor 1999:12]
Here it is imperative to note that within the women’s movement postpartum women’s health was a subcategory within women’s health. While there has been recognition that postpartum depression and anxiety are occurring in western society my attempts to find health care providers resulted in very few tangible options for new mothers. Generally, severe postpartum episodes would be treated in a general psychiatric ward for inpatient needs. Whereby a mother would be admitted to the hospital in a general ward with persons suffering from other mental health and psychotic conditions. This does not serve a new mother well as to be placed in the facility would require separation from the newborn as well as family members for an extended period of time. One of the only facilities that caters for the specific needs of postpartum depression and anxiety is UNC Chapel Hill. “The UNC Center for Women’s Mood Disorders has opened a 5-bed unit for women with moderate to severe postpartum depression (PPD). Our unit is the first of its kind in the United States” (UNC 2011). The other being an outpatient program designed for postpartum mood disorders at UCSD.
Therefore, despite the recognition in the 1980’s that postpartum depression was certainly a needed mental health movement, very little progress has been made. This could be in part due to gender role stereotypes perpetuated by the media that new mothers should be grateful and have it all together. The ideal ‘Instagram’ image comes to mind of unrealistic expectations for new mothers whose circumstances may be vastly different from the image. “One in seven women have depression in the year after they give birth according to a study released on March 13th in the online edition of JAMA Psychiatry. The findings come from the largest screening of postpartum women ever conducted and the only one in which women who showed signs of depression were given a full psychiatric evaluation” (Rope 2018). Studies have shown that the prevalence of PPD (postpartum depression) is not only increasing but still a major mood disorder suffered by women, yet treatment availability is not on par with the growing statistics. “‘In the United States, the vast majority of postpartum women with depression are not identified or treated, even though they are at higher risk for psychiatric disorders,’ says Wisner. ‘It’s a huge public health problem.’ She adds that screening initiatives must be accompanied by accessible and effective treatment” (Rope 2018).
Looking at postpartum disorders from a cultural perspective introduces other factors to consider such as why women don’t seek diagnosis, help, and treatment. In Western culture it may still be frowned upon.
The incidence of postpartum depression in any given cultural setting may be related to broader patterns of depressive disorders, as well as to factors particular to childbirth. [...] While their proportion has grown in recent years, reports continue to show a pattern of symptoms in African patients which contrasts with Western patterns: symptoms tend to be mainly somatic; there is little self-blame or feeling of personal worthlessness; and feelings of sadness are not as acute [Harkness 1987: 196]
As Harkness mentioned, her studies in Africa revealed that PPD would not be viewed as a health or mental health condition but rather attributed to personal shortcomings and failures as a woman. “One study found that postpartum depression rates in Asian countries could be at 65% or more among new mothers” (Carberg 2019). Many immigrants and minority groups who have relocated to the West may continue to hold these beliefs and further perpetuate the dismissal of urgent PPD care.
Furthermore, PPD is a relatively new occurrence and has been referenced as a disease of modern civilization (Hahn-Holbrook 2014). It is caused by a combination of biological, cultural, and epidemiological factors. “Rates of postpartum depression will vary across cultures because of differences in breast-feeding, traditional diets, active lifestyles, daily sun exposure, and the presence of kin” (Hahn-Holbrook 2014: 400).
Postpartum mental health is an issue that needs further investigation and resources for women across the country and within all social groups. The growing number of women who experience PPD cannot be treated in the 5-bed capacity facility at UNC and so the need for specific care needs further investigation and implementation of suitable programs. This suggests that prenatal education for mothers could be substantially more beneficial than even postpartum care.
Hahn-Holbrook, Jennifer, and Martie Haselton. “Is Postpartum Depression a Disease of Modern Civilization?” Current Directions in Psychological Science, vol. 23, no. 6, 2014, pp. 395–40
0.
Taylor, Verta. “Gender and Social Movements: Gender Processes in Women's SelfHelp Movements.” Gender and Society, vol. 13, no. 1, 1999, pp. 8–33.
Harkness, Sara. “The Cultural Mediation of Postpartum Depression.” Medical Anthropology Quarterly, vol. 1, no. 2, 1987, pp. 194–2
09.
Rope, Kate. “New Study Reveals Disturbing PPD Statistics - Seleni - Maternal Mental Health Institute.” Seleni, Seleni - Maternal Mental Health Institute, 16 Mar. 2018, www.seleni.org/advice-support/2018/3/16/new-study-reveals-disturbing-ppd-statistics.
Trisha Varathaiah is a South African native. She graduated high school in 2006 and took several college classes before pursuing alternative employment as an 'After School Program' coordinator for a local community center. She moved to the United States in 2014. She is a former laboratory and quality control analyst for Centurion Medical Products and her experience includes laboratory testing, and regulatory compliance. She has always had a particular interest in the medical and health field and has volunteered both locally and abroad with numerous organizations. She is currently a Red Cross Volunteer.
After working in Arizona, she relocated to Japan with her military spouse. During this time, she conceived their first child and the experience was riddled with medical complications and anxiety. She delivered their baby at the Naval Base in Yokosuka. This experience, along with the excellent and dedicated service of her provider led her to pursue her passion for medicine. She is now enrolled as a SD City College student with the intention of transferring to a four year institution to follow the path of premed, majoring in Biology, and hopes to gain entry to medical school as a non-traditional student. Her intention is to not only provide excellent medical service to patients but to specifically address the need for postpartum mental and physical health resources. Her ultimate goal is to ensure that every state has relevant and adequate care for mothers with new children and that, within the department of psychology and psychiatry, this niche is addressed with the relevant urgency it deserves.
Cultural anthropology illuminates the key differences between cultures all over the world and explains how these differences create society’s thoughts and behaviors. Sexual education is a topic that is rarely openly discussed and reforms for this issue have made little progress. This study advocates for mandatory comprehensive sex education (CSE) programs in all 50 states. I used various ethnographies to examine how cultures handle the education of bodily functions, and moral and emotional dilemmas. This study aims to compare and contrast sex education programs cross-culturally. I discuss how to effectively implement a CSE program and why it is necessary. The results of this study confirmed that it is completely possible that the United States mandates CSE programs for all 50 states, and this will greatly prepare the youth for the future.
Anthropology actively questions humanity and searches for the answers that explain how we adapt and evolve in different parts of the world. One of the topics that is studied by cultural anthropologists revolves around gender and sexuality. The way communities around the world view concepts like sex, self-esteem, stigmas, etc. change drastically and all handle the information differently. This inspired me to research a topic that is otherwise not usually discussed. Sexual education has been a controversial topic because of conflicts between morality and medically accurate information. Many states currently have pieces of sexual education programs for high school students that include misguided information that create harmful stigmas and do not effectively educate youth about their bodies and reproduction. Due to this haphazard education, sexually transmitted diseases and teenage pregnancies are common outcomes for states with underprepared programs. For this project, I researched comprehensive sexual education programs (CSE). According to the information handout by Guttmacher, CSE programs seek to educate youth about reproduction, body image, mental health, sexually-transmitted diseases, abuse, and a variety of other topics with similar themes. The programs seek to not only provide accurate medical information, but to also teach positive attitudes and decrease stigmas (Guttmacher Institute n.d.). I studied different ethnographies that took to the field to implement these comprehensive sexual education programs in the United States, as well as countries abroad, such as various countries in Latin America. Since I did not go into the field to gather data, I relied on participant-observation to illuminate differing beliefs around sex education and suggest how to implement a successful community program. After reviewing a sample of literature, I developed a campaign for the United States to mandate comprehensive sexual education programs in all 50 states in middle and high school. The campaign includes facts, stories, and evidence from other CSE programs and is made up of a petition, letter to editor for local newspapers, letter to government, and a powerpoint to show to the community.
As I thought back to my experience with sex education in middle school, I realized the overall lack of knowledge I was deprived of. Reforms need to be made. So, I began my research by looking at current policies. Currently, there is not a country-wide mandate for comprehensive sexual education programs. In order to learn about CSE programs and their effectiveness, I compared ethnographies from different countries. The authors went into the field and used participant-observation to evaluate the programs. I used these sources as a basis for a petition mandating CSE programs in all 50 states.
To begin my research, I looked into current state policies regarding sex education, starting with California. I began with research into statistics and definitions of comprehensive sexual education. I contemplated whether I wanted this research to support either actively teaching a new sex education program, or simply advocating for reforms in education to the public and government officials. I weighed the different restrictions and overall reachability of either actively speaking in schools with students versus persuading government officials to reform. Going to schools and teaching sex education would have meant more ethical problems: requiring parental permission, school guidelines, and current laws in place. Cultures vary from state-to-state, but many believe that sex is to be saved for marriage and anything outside of that is a sin. Recently, in liberal regions, sex has become more widely discussed, celebrated, and taught. However, before this recent change of views, and even now in some states, the idea of sex and using it for pleasure is a huge taboo. If I were to go into the field and educate youth, I would need to assess how most schools and parents still believe that it is the parent’s job to teach the child, and the information being taught revolves around abstinence and marriage.
As this project progressed, Covid19 brought the world to a halt, therefore impacting the method of the dispersion of the information. After contemplating my options, I chose to go down the path of petitioning and persuading rather than being in the field, in order to insure the safety of myself and others.
From this decision, I began my at-home research into various ethnographies and academic articles regarding sex education intervention programs in small towns in the United States, as well as, small villages in other countries. I started with basic websites, such as Planned Parenthood, that gave statistics and short explanations of the laws currently set in place. I did this in order to understand the current situation in the US and get a good idea where the reforms would be most severe.
I wanted to look into various aspects of culture, such as sex, morals, community support, and how to successfully execute an intervention. Some of these ethnographies just researched stigmas and vulnerability around sex, others looked at actually implementing a program into a strict community, and another looked into how semantics deeply impacts aborpstion of information. I gathered evidence using their field observations and individual interviews. Then, I looked into an anthropology textbook, Perspectives: An Open Invitation to Cultural Anthropology, specifically the chapter “Gender and Sexuality”, to gain a general understanding of moral beliefs around sex in various cultures. Using my resources, I compared and contrasted the differing beliefs of the cultures and how they affected successful CSE programs, and how this information is beneficial for the United States to change their laws.
After gathering all the needed information, I consolidated the most important evidence into a simple petition and powerpoint. I wanted the petition (Appendix A) and powerpoint to have very basic and easy to understand facts about CSE programs, so as to not overwhelm or bore individuals with too much nonessential information. I put more in depth information in the letter to the editor (Appendix B) and letter for the government official (Appendix C) in order to better persuade higher authorities. With the different forms of dispersion, the information would be spread to various communities and well received.
In the beginning of my research, I found that Guttmacher looks at the state policies and collectively presented the facts that, “currently, only 27 states mandate general sex education and HIV education...29 states require abstinence being the main topic/only option and 7 of those states require attitudes that homosexuality is immoral” (Guttmacher Institute 2020). Currently, California is one of the sole states that provides comprehensive sexual education programs for students. Most states have outdated and inaccurate programs that most conservatives require to never change because it will conflict with religious beliefs. While most states are behind in the times, there is still an open conversation about sex at one point or another in the school system. The same cannot be said for other cultures, which is where my research took me.
I wanted to understand competiting beliefs about sex, whether it can be talked about or if it was taboo. Starting in Tanzania, researchers observed the society’s norms (attitudes and behaviors) around sex and reproduction. Daniel Wight (2005) and a team of researchers studied the sexual norms versus expectations by completing participant-observation in several small villages: a few inland rural villages and a couple fishing villages. The researchers lived in the villages for 158 weeks and conducted interviews and group discussions about the daily life and writing extensive fieldnotes.The researchers asked questions about sexual relationships and the context in which sex is innappropriate or allowed. The authors concluded that the majority of the villages believe students need to be abstinent; however, sex can be discussed in the appropriate setting and in secret. They also concluded that there are differences between the generations and the topic of sex is becoming less taboo with each new generation, which is shown through the common activity of transaction of sex for material items (Wight et al. 2005, 995). This ethnography showcased that sex was strictly forbidden to be discussed with others, including close family relatives. Many elders believed that sex was for married couples and anyone who partakes in sex and is not married or is too open about it is to be punished and disowned. Similarly, “Gender and Sexuality” highlights the common behavior in some cultures, where families act violently towards young women who bring “dishonor” to the family by behaving sexually (Mukhopadhyay 2018, 240). Young villagers viewed sex as something fun and risky or something to use in order to gain wealth or labor. Mukhopadhyay states that most individuals in other cultures harshly punish women for exhibiting inappropriate behavior, and this leads to less openness to sex education.
This article helped me look into the beliefs of a culture completely different from the United States and showed that there needs to be more interventions in order to gain the approval of everyone in the community. The big question is, how do you educate youth about the safe practices of sex and body image when the authority in the community harshly punishes anyone who mentions sex or acts sexually? This led me to research more ethnographies that went into a conservative culture and implemented an intervention.
Moving on to actually putting the programs into action, I read an ethnography from Latin America. The study, done by Erica Nelson et al. (2014), hypothesized that with more open communication between child and parent, accurate knowledge of sexual health will be taught and youth will practice safe habits. The anthropologists hoped to better understand community discussions about sex and other health education. Interviews and group discussions with children and parents were held before, during, and after, intervention programs. The study used qualitative data that included participant-observation field notes that used quotes and descriptions of scenarios. The quotes from the group discussions exposed the different perspectives of sexual education. The programs were helpful to the youth because they provided knowledge about sex, emergency contraception, and condoms. Whereas to the elders, the programs were viewed as something that promoted sex and other shameful activities (Nelson et al. 2014:194). The study talks about the term “confianza” which to researchers simply meant “open communication”, including private topics about sex. However, to the community the term referred more to trust and intimacy of a bond, excluding immoral topics like sex (Nelson et al. 2014:192). Linda Light defines the concept of pragmatics as the “social and cultural aspects of meaning and how the context of an interaction affects them” (Light 2018:78). Nelson’s study concluded that pragmatics played a large role in intervention programs including how parents and teens interact. Pragmatics deeply impacts the engagement and the absorption of education. The study found that while the programs intended to help facilitate communication, the overwhelming conflicting views on the meanings of words ended up lessening the effect of the education.
This study helped me compare and contrast cultures and different meanings of sexual concepts. While the American researchers believed that trust and intimacy included sex related topics, the elders of this culture still saw sex as taboo even for the most intimate relationships. I first looked at general beliefs about sex and with this article focused on how to approach the topic to appeal to the community and not to offend anyone’s longstanding beliefs. This study showed that depending on the location of the intervention program, the information needs to match the current meanings of the words as the culture uses them. My next step was to see how to adapt my intervention to our culture and evaluate successful outcomes.
Let’s look now to CSE programs being used in North America, more specifically in a conservative rural area, North Dakota. Hillary Clinton’s run for presidency in 2016 was an example of “an ‘America’ that is changing demographically, socially, religiously, sexually” (Mukhopadhyay 2018: 261). The majority of society is changing to new beliefs and morals and there needs to be reform in the education system, politics, social standards and other areas to match the changing perspectives. Molly Secor-Turner et. al (2017) sought to start that reform in one of the more conservative states. The study offered a comprehensive sexual education program, in a partnership with local Planned Parenthood, North Dakota University, and other local community organizations for at-risk youth, such as homeless shelters. The program held group sessions over a couple months, where the individuals were taught new and differing sexual information. The qualitative data showed that in order to be successful, a program needs to have ties with a known local organization, such as Planned Parenthood or a university, and law-makers. Additionally, the program needs to be flexible so it can adapt to the differing needs of the diverse group of youth in every state. With room for changes, the program is regarded much better than if it were a fixed plan (Secor-Turner 2017:546,551). The researchers showed that with “patience, persistence, and good will” (Secor-Turner 2017:552), a comprehensive sexual education program can be implemented in any state regardless of the political affiliation of the local government. With partnerships with the right community organizations, and with medically-accurate and well-rounded material being taught, the youth of America can feel safe in their bodies and with others. The study concluded that a successful comprehensive sexual education program not only provides the proper knowledge, but also strengthens the bonds between youth and their communities.
This study helped me examine the logistics of implementing a CSE program. The previous ethnographies were precursors to the actual program put into effect. After seeing the program in progress, and the positive increase in attitudes, knowledge, and safe practices, I was convinced that this is what every state in the U.S. needs. After understanding attitudes, stigmas, pragmatism, and lastly seeing the full program in effect in a conservative environment, I connected the concepts and application of the knowledge to effectively campaign for a mandated comprehensive sexual education program.
Anthropology is a mixture of different aspects of the world that seeks to observe and learn from humanity in order to adapt and evolve. Anthropologists are always searching for the answers. More specifically, cultural anthropologists look at different parts of the world to compare and contrast the languages, traditions, food, and any other aspect of the culture you can think of. Anthropologists don’t only look at the present way of life but also look at past history and compare it to now to see how far we, as society, have changed. There are many different ways to apply this knowledge once anthropologists acquire it, and one of those ways is action anthropology. Action anthropology takes the field research and uses it to create reform for the better. It takes the differences and the concepts needed to improve and push for change. My project could be an example of action anthropology, as I am using previous studies that include field work and using that to advocate for reform of our education system. I have researched not only the United States but also other cultures across the world. My research illuminated the beliefs of different communities and how something can be the norm in the U.S but completely taboo in Tanzania. I used this awareness of other cultures in order to broaden my own mind and see how it can help change the norm.
After researching and compiling the needed facts and information, I created my forms of communication to reach the most people in America to truly advocate for change. With the powerpoint, I am able to spread this information quickly to schools and town meetings. Through the petition (Appendix A), I can gather community support in a physical form to show government officials. With the letters (Appendices B &C), I appeal directly to the source and actively work to persuade and empathize with the authority figure. It has been a long journey studying and learning how this reform could work for all 50 states and the correct way to approach it. However, it can be concluded that this is definitely still a work in progress and will need constant campaigning and support from society at large in order to see a significant change. With that being said, the youth of America will benefit from a comprehensive sexual education program which would result in fewer STDs and teen pregnancies, higher self-esteem, more positive attitudes, safer practices, and better emotional and physical health.
Guttmacher Institute. n.d. “A Definition of Comprehensive Sexuality Education.” Demystifying Data Toolkit, www.guttmacher.org/sites/default/files/report_downloads/demystifying-data-handouts_0.pdf.
Guttmacher Institute. 2020 “Sex and HIV Education.” 1 May 2020,
www.guttmacher.org/state-policy/explore/sex-and-hiv-education#.
Light, Linda “Language” In Perspectives: An Open Invitation to Cultural Anthropology Edited
by Nina Brown, Laura Tubelle de González, and Thomas McIlwraith. 2017. American American Anthropological Association. http://perspectives.americananthro.org accessed: March 26, 2020
Mukhopadhyay, Carol C., Tami Blumenfield, Susan Harper, and Abby Gondek “Gender and
Sexuality” In Perspectives: An Open Invitation to Cultural Anthropology Edited by Nina Brown, Laura Tubelle de González, and Thomas McIlwraith. 2017. American Anthropological Association. http://perspectives.americananthro.org accessed: March 26, 2020
Nelson, Erica, Alexander Edmonds, Marco Ballesteros, Diana Encalada Soto, and Octavio
Rodriguez. 2014. “The Unintended Consequences of Sex Education: An Ethnography of
a Development Intervention in Latin America.” Anthropology & Medicine 21 (2): 189–201. doi:10.1080/13648470.2014.918932.
Phulambrikar, Rutuja, Anup Kharde, Varsha Mahavarakar, Deepak Phalke, and Vaishali Phalke.
“Effectiveness of Interventional Reproductive and Sexual Health Education among
School Going Adolescent Girls in Rural Area.” Indian Journal of Community Medicine 44, no. 4 (October 2019)
Secor-Turner, Molly, Brandy A. Randall, Katie Christensen, Amy Jacobson, and Migdalia
Loyola Meléndez. “Implementing Community-Based Comprehensive Sexuality Education with High-Risk Youth in a Conservative Environment: Lessons Learned.” Sex Education 17, no. 5 (September 2017): 544–54. doi:10.1080/14681811.2017.1318273.
Wight, Daniel, et al. “Contradictory Sexual Norms and Expectations for Young People in Rural
Northern Tanzania.” Social Science & Medicine, vol. 62, no. 4, 1 Sept. 2005, pp. 987–997., doi:10.1016/j.socscimed.2005.06.052.
Mandate Comprehensive Sexual Education Programs in Schools in all 50 states.
According to the information handout by the Guttmacher Institute, Comprehensive Sexual Education programs seek to educate youths with knowledge surrounding reproduction, body image, mental health, sexually-transmitted diseases, abuse, and a variety of other topics with similar themes. The programs seek to not only provide accurate medical information but also teach positive attitudes and decrease stigmas among the community (Guttmacher Institute) .
Currently, only 27 states mandate general sex education and HIV education. Within those states only 17 of those states mandate that the education is medically correct. On top of that, 29 states require abstinence being the main topic/only option and 7 of those states require attitudes that homosexuality is immoral. Only 3 states require that there is no religious involvement within sexual education. (Guttmacher Institute)
THE NEXT STEP - Using the participant-observation field studies, it can be concluded that implementing comprehensive sexual education programs is a step in the right direction for the safety of the youth. Not only will the children of America be better equipped with medically correct knowledge about their body and organs, and STDs, but also have the right information on the mental aspects, such as body image, self-esteem, decreasing stigmas, etc. America needs to have this intervention program in order to properly educate the youth and prepare them for adult life.
To Jeff Light,
The emotional and physical health of the youth of San Diego are in need of your attention and resources. I am writing to appeal to the community of San Diego to support the mandating of comprehensive sexual education programs in middle and high schools. According to the information handout by the Guttmacher Institute, Comprehensive Sexual Education programs seek to educate youths with knowledge surrounding reproduction, body image, mental health, sexually-transmitted diseases, abuse, and a variety of other topics with similar themes. The programs seek to not only provide accurate medical information but also teach positive attitudes and decreasing stigmas among the community. I was not given the proper sexual education growing up and I have struggled with many aspects that could have been prevented if I was prepared with the right frame of mind. I do not want the next generation to suffer the way I did; therefore, there needs to be an intervention program.
Looking at one past study, done in rural North Dakota, researchers implemented a comprehensive sexual education program and found positive results. The program held group sessions that lasted varying hours over a couple months length, where the individuals were taught new and differing sexual information. The study concluded success in providing a comprehensive sexual education program that not only provided the proper knowledge, but also bonded youth to their communities. I believe we can use this study as a prime example for what can happen with youth in San Diego.
So what’s the next step? Using the participant-observation field studies, it can be concluded that implementing comprehensive sexual education programs is a step in the right direction for the youth’s safety. Not only will the children of America be better equipped with medically correct knowledge about their body and organs, and STDs, but also have the right information about the mental aspects, such as body image, self-esteem, decreasing stigmas etc. San Diego needs to have this intervention program in order to properly educate the youth and prepare them for adult life.
Thank you,
Isabella Crocicchia
i...@gmail.com
To Betsy DeVos,
The emotional and physical health of the youth of America are in need of your attention and resources. I am writing to appeal to the community of America to support the mandating of comprehensive sexual education programs in middle and high schools. According to the information handout by the Guttmacher Institute, Comprehensive Sexual Education programs seek to educate youths with knowledge surrounding reproduction, body image, mental health, sexually-transmitted diseases, abuse, and a variety of other topics with similar themes. The programs seek to not only provide accurate medical information but also teach positive attitudes and decreasing stigmas among the community.
I was not given the proper sexual education growing up and I have struggled with many aspects that could have been prevented if I had been prepared with the right frame of mind. I do not want the next generation to suffer the way I did; therefore, there needs to be an intervention program.
Looking at one past study, done in rural North Dakota, researchers implemented a comprehensive sexual education program and found positive results. The program held group sessions that lasted varying hours over a couple months length, where the individuals were taught new and differing sexual information. The study was successful in providing a comprehensive sexual education program that not only provided the proper knowledge, but also bonded youth to their communities. I believe we can use this study as a prime example for what can happen with youth in all of America.
So what’s the next step? Using the participant-observation field studies, it can be concluded that implementing comprehensive sexual education programs is a step in the right direction for the safety of the youth. Not only will the children of America be better equipped with medically correct knowledge about their body and organs, and STDs, but also have the right information about the mental aspects, such as body image, self-esteem, decreasing stigmas etc. America needs to have this intervention program in order to properly educate the youth and prepare them for adult life.
Thank you,
Isabella Crocicchia
i….@gmail.com
Isabella Crocicchia is a second year student in her last semester at San Diego City College. She is a Psychology major and working towards a B.S. in Psychology and then will be applying for a Physician Assistant program. She will be transferring in fall 2020 to Baylor University in Texas to work on her B.S. and will be able to attend their PA program. Crocicchia chose Psychology as her major because the different aspects of human behavior initially interested her in the science/medical field. She later discovered her passion for more than just behavior and wanted to learn more about human biology and physiology/anatomy, so she has decided to continue her education with more of an emphasis on Pre-PA. Crocicchia currently works full time as a Certified Nursing Assistant in a skilled nursing facility and has loved every second of it. Although she has to do most of the dirty work, she loves going to work and assisting our community's seniors in living a happy life. She also loves working in the healthcare field and gaining as much patient care/medical experience and knowledge that she can. Crocicchia hopes one day she will be a practicing PA successfully making a difference in people's lives.
Mental health in prisons: the United States has it all wrong and we can improve the system that both protects us, and helps them.
The United States leads the world in incarcerations with a hefty 25% of the entire world's prison population (World Population Review, 2020:1). Statistics like these fool people into believing that the prison system understands how to give the care that the inmates deserve. To study the culture of anything is to better understand the realities of other people, figure out what you like, and how to incorporate that to become the individual that makes you special. This paper looks at a part of society that most never want to find themselves in, and it may educate you on injustices that might otherwise go unnoticed. The following will show that the prison system is not equipped to handle the often-unmentioned afflictions that played a part in the initial incarcerations. While you read this, please keep in your thoughts the prisoners who were convicted but did not commit a crime. Many were unable to defend themselves due to a social stigma of having mental afflictions and the preconception of being dangerous.
It is a mostly unmentioned but well-known fact that most Americans see mental illness as a problem that is best left forgotten until it affects you. We need to change our view of mental illness to develop proper methods to help those afflicted. My hypothesis before writing this paper was that the United States had too many prisoners to be able to get a good grip on the amount of medical attention that is needed to help mentally ill inmates cope with prison and reintegrate with society at the conclusion of their prison sentences. I thought mentally ill patients would be denied treatment they require to help them be considered upstanding members of society again.
There are many assumptions about the treatment of mentally ill patients in prisons but the information in this paper allows any astute individual to form their own opinion about where we are headed. The methodology used in this ethnology consists of fact-based information pulled from reliable sources on both the internet as well as published experiences in the subject. The idea is to gather multiple different sources that correlate to each other. Reports from across different prison systems in the world are compared to show the audience the difference between a prison system which has little regard for mental health patients, a prison system that is still developing but needs obvious improvement, and a prison system which has developed a method that has worked so far to identify mentally ill convicts and treat their condition with helpful professionals.
Prison and prisoners are foreign to our daily lives. This research was inspired by this overlooked minority and the social stigma that the mentally ill have in the United States. Books and articles such as Bryan Stevenson’s (2014) Just Mercy show us that victims of mental illness are targeted by the criminal justice system as a scourge on society and forced to serve harsh sentences, even if they are innocent of their crimes (Stevenson, 2014: 186-202). The mentally ill are not always given the best representation and they do not always have the means to understand their rights which puts them at a disadvantage to defend themselves. You can find prison systems in countries such as Denmark that identify and help the victims of mental illness when they are convicted so that they have a chance to recover and reintegrate into society (Boztaz, 2019: 1). On the opposite spectrum, you have prison systems which have no regard for the mental state of the prisoners before or during incarceration. From the research included in this paper, I conclude that America is currently undergoing a renaissance of prison reform which addresses mental illness as a disease that can be treated. There is still a long way to go but the United States appears to be on track.
I compare differences between countries that advocate for the mentally ill to countries with little regard for mental illness in prisons. Statistics from the World Population Review (2020) show trends and areas with high incarceration, and can be used to correlate many factors such as poverty and the effectiveness of the country’s laws. Just Mercy recounts the memoirs of lawyer Bryan Stevenson. They exemplify the mistreatment of mentally ill prisoners on death row. I also include detailed accounts of prison systems in the United States, Denmark, and Venezuela and show the differences in prisons for each country.
The United States has tried previously to deal with mental illness in prison, and they are making huge progress, but they still have hurdles to jump to provide the best care for these convicted patients. Johnathan Beynon explains:
Prisons are the wrong place for many people in need of mental health treatment, since the criminal justice system emphasizes deterrence and punishment rather than treatment and care. Legislation can be introduced which allows for the transfer of prisoners to general hospital psychiatric facilities at all stages of the criminal proceedings (arrest, prosecution, trial, imprisonment). For people with mental disorders who have been charged with committing minor offences, the introduction of mechanisms to divert them towards mental health services before they reach prison will help to ensure that they receive the treatment they need and also contribute to reducing the prison population. The imprisonment of people with mental disorders due to lack of public mental health service alternatives should be strictly prohibited by law. [Beynon 2007:3]
I believe that many people assume a lack of development reduces a prisoner’s self-control and heightens the chances that they will act upon pure impulse, vice thinking--failing to think before doing something heinous enough to be convicted of a crime. “The question of the difference between an inmate who is mentally ill and an inmate who is ‘just a criminal’ is one which cannot be asked without considering beliefs surrounding what it is that a criminal is” (Gruner, 2019: 101). Beynon summarizes that “within most societies, people with mental disorders face marginalization, stigma and discrimination in the social, economic and health spheres, due to widespread misconceptions related to mental disorders” (2). Statistical reports hint that more research is required to determine how many actual prisoners have mental illnesses that need treatment.
The National Alliance on Mental Illness (NAMI) reports that “2 million people with mental illness are booked into jails each year” (2017). The US Bureau of Justice Statistics reports that half of all prison and jail inmates had a “mental health problem” in 2005 (James & Glaze, 2006). The British NHS reports their analogous figure to be much higher at 90% of all inmates (Birmingham, 2003). The conditions of these prisons are often highly detrimental to a person’s mental health as well, causing many conditions due to alienation, isolation, trauma from guards and other prisoners, and a slew of other factors (Haney, 2003). There is a general narrative of how this happened, endorsed by activists and prison superintendents alike, that local jails and state prisons have become “the new asylums” (Rembis, 2014). A typical version of this, though slightly liberally tinged, is that after the deinstitutionalization movement successfully closed most state hospitals, society failed to adequately invest in social services to replace the aspects of state hospitals that were still necessary, causing the former patients to eventually become inmates after committing a criminal act. [Gruner 2019:1]
Some countries dump their “undesirable” people with mental diseases into their prison system where corrections officers are tasked with “unburdening” society. “In some countries, people with severe mental disorders are inappropriately locked up in prisons simply because of the lack of mental health services” (Beynon, 2007:1). This could possibly explain the gap between the two developed countries mentioned by Gruner, but more research is required to determine the validity. While prison staff are evolving and able to adapt to some of the changes of holding mental patients as prisoners, they are not yet able to overcome bias in all cases due to the predisposition that convicted criminals have on most people, especially corrections officers.
Staff resistance to the changes as well as there being a tension between the punitive/paramilitary discourse of corrections and the incitement towards therapeutic or de-escalating engagements with prisoners. In interviews, staff resistance was present in a number of discursive forms, including: reactionary emphasis on staff safety, a power-reversal perception that the “inmates are in control,” reactionary perception that inmates are “more valued,” reliance on “us vs them” language, and regulation of the boundary between “mad” and “bad.” Trainer reliance on “gallows humor” and irony to gain buy-in from trainees may undermine the overall goal of instilling compassion for prisoners diagnosed with mental illnesses” [Gruner, 2019: 55]
The corrections officers are so undertrained that they are skeptical of the validity of certain mental illness classifications that the state puts prisoners in (Gruner, 2019: 60). The seriousness of mental health should be shifted to be that of a serious physical affliction. The corrections officers even commented “I’ve heard it’s really boring, and you hug each other” before his training even began (Gruner, 2019: 61).
The toughest part of diagnosing a prisoner with mental disease is to know what signs to look for. The mental disorder known as post-traumatic stress disorder (PTSD) was discovered only 40 years ago in 1980 (Gruner, 2019: 156). The United States labels those who have certain mental illnesses as a pariah where other nations believe that they are a gift.
Schizophrenia, a condition with genetic as well as environmental components, provides another interesting example of cross-cultural variation. Unlike anxiety or depression, there is some consistency in the symptom patterns associated with this condition cross culturally: hallucinations, delusions, and social withdrawal. What differs, however, is the way these symptoms are viewed by the community. In his research in Indonesia, Robert Lemelson discovered that symptoms of schizophrenia are often viewed by Indonesian communities as examples of communication with the spirit world, spirit possession, or the effects of traumatic memories. Documenting the lives of some of these individuals in a film series, he noted that they remained integrated into their communities and had significant responsibilities as members of their families and neighborhoods. People with schizophrenia were not, as often happens in the United States, confined to institutions and many were living with their condition without any biomedical treatments. [Henninger-Rener 2020: 433]
This tells us that the United States is not alone in not having the right answer in accurately diagnosing and treating mental illness. The American prison system is just beginning to be able to accurately diagnose and source the cause of mental ailments in criminals. This leads to a cycle of treating the symptom instead of the problem. America needs to stop looking at the mental health crisis of prisoners as something which needs to be hidden since isolation has been proven to be a main contributing factor of worsening mental illness (Henninger-Rener, 2020: 434).
The mental health crisis that is seen in America is not seen in every country in the world. There is a solution to this terrible problem. Some countries in Europe show promise in what prison reform will eventually become when mental health becomes a priority. In the Netherlands, the route that the criminal justice system takes is very different to the one that America takes: “in countries like the UK and US, prisoners with mental health conditions often end up in the general prison population. But in the Netherlands prisoners are streamlined into specific segments following a charge. The idea is that this way, they can receive the proper, and particular, care they need” (Hogenboom, 2018: 1). The Dutch ensure that once they have a person incarcerated, qualified personnel determine if there are any mental instabilities to give the inmates the care they need to succeed in rehabilitation: “when a person first enters prison, they are again quickly seen by a psychologist or psychiatrist” (Hogenboom, 2018: 1). The Dutch Entrustment Act also known as TBS is a revolutionary system that Holland has adopted which has helped create an unparalleled decline in criminal activity in the Netherlands. The theory is that when a prisoner is convicted of a crime and sentenced for longer than 4 years, the program prioritizes reintegrating the prisoner into society as a normal functioning adult. “TBS has very specific conditions. People must have committed a crime with a minimum prison term of four years and have a high chance of recidivism: the programme works on specifically on their reintegration into society. If this is not deemed possible, or they refuse to cooperate, they can eventually move to a normal high-security hospital and be confined indefinitely” (Boztaz, 2019: 1).
America has come a long way in their prison system when it comes to treating the mentally ill. Some other countries do not have the proper medical means to treat their patients or the integrity in their laws to prevent these injustices. In Venezuela, the prison system has trouble enforcing its own laws. The conditions of the prisons are themselves horrifying. They “violate both Venezuelan law and international human rights standards binding on Venezuela” (Human Rights Watch, 1997: 1). Basic services are not provided to prisoners so the treatment that the mentally ill need is nonexistent. When human rights advocates from the United States visited a prison in Venezuela they were appalled. They found many inmates who would qualify as mentally ill, but the prisons were not equipped to provide psychological treatment (Human Rights Watch, 1997: 1). Even outside of prison the mentally ill are being refused treatment in Venezuela due to lack of medical resources in the country “Mental institutions have released thousands of patients because they can no longer treat them, according to physicians” (Casey, 2016: 1). All in all, the United States can take notes from countries such as Venezuela to understand what happens to a prison system that pays little attention to treating underlying issues such as mental illness, while also noting that there are areas of the world that could use help improving their treatment of the mentally ill by setting an example, and thriving.
The immorality of keeping an undermanned and undertrained corrections staff in charge of recognizing and treating mental illness needs to be questioned if we are ever to get out of this barbaric stage of punishment instead of rehabilitation. If America is to treat the mentally ill in their prison system and prevent crimes from reoccurring, we need to look towards other countries such as Denmark as an example. The less we pay attention to this atrocity, the closer we are to becoming inhospitable to those who are in need. This research should hopefully give some insight on how we need to change as a nation and stomp out the social stigma that we place upon the mentally ill.
World Population Review, Incarceration Rates by Country Population. (2020-04-06). Retrieved on 20 April, 2020, from http://worldpopulationreview.com/countries/incarceration-rates-by-country/
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Gruner, D. (2019). "Frontline in Mental Healthcare": A Discourse Analytic Clinical Ethnography of Crisis Intervention Team Trainings for Corrections (Doctoral dissertation, Duquesne University) pp iv-169 Retrieved from https://dsc.duq.edu/etd/1840 (Links to an external site.). Visited on March 09, 2020.
Stevenson, Bryan, author. Just Mercy: A Story of Justice and Redemption. New York: Spiegel & Grau, 2014. pp 186-202.
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Hogenboom, Melissa (2018). “Criminal Myths”: The unique way the Dutch treat mentally ill prisoners pp 1 Retrieved from https://www.bbc.com/future/article/20180423-the-unique-way-the-dutch-treat-mentally-ill-prisoners visited on April 21, 2020.
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26-year-old Joshua Byrd was born in North Carolina and lived there until the age of 18. His earliest endeavors led him to enlist in the United States Navy for the next 6 years of his life. He spent this time developing new perspectives on life in many different countries across the world by observing and taking part in multiple cultures. While experiencing all of this, he learned valuable knowledge in the computer and networking field revealing his passion to further pursue this field in his career. After his tenure, he began working for an engineering organization specializing in computers. His next goal in life is to earn a degree in Computer Science to help him further his vision of developing new ways to use technology that could help revolutionize society.
