mental health – UAB Institute for Human Rights Blog

The Texas Social Worker’s Code

social work student listening to lecture — Social Work Students’ Accreditation Visit 3.26.13. Source: Southern Arkansas University, Creative Commons

Social work is a field in which professionals are intended to do their best to help connect members of vulnerable populations with the resources necessary to allow them to live with their rights and general well-being safe. However, on October 12 of this year, during a meeting between the Texas Behavioral Health Executive Council and the Texas Board of Social Work Examiners, a section of the social workers’ code of conduct was altered. A section which previously stated, “A social worker shall not refuse to perform any act or service for which the person is licensed solely on the basis of a client’s age; gender; race; color; religion; national origin; disability; sexual orientation; gender identity and expression; or political affiliation.” During the meeting, the words “disability; sexual orientation; gender identity and expression” were taken out. They instead replaced that phrase with the word sex, making the social workers’ code match the Texas Occupations Code.

This is concerning for a few reasons, the most glaring one being that it leaves members of the LGBTQ+ community and people with disabilities in Texas, two populations that are already seriously vulnerable, even more vulnerable than before, as social workers can now turn away potential clients from those communities.

This led to an uproar among advocates for the LGBTQ+ community and people with disabilities, as at puts their ability to access important resources that are related to their basic human rights directly at risk. There is an increasingly serious concern that members of these populations will face even more obstacles in accessing the things they need than they already do.

The Human Rights Connection

It’s important to recognize that is an issue of human rights, even outside of the clear issue of discrimination against these groups that is involved. Consider some of the jobs of social workers. They include therapists, case workers, workers for Child Protective Services, and much more. In addition to working with people with disabilities and members of the LGBTQ+ community in general, many social workers specialize in work with children and older adults, two groups which overlap with the former. Then these vulnerable populations are unable to get the support they need in order to access the tools, programs, and resources that exist specifically to help them live life and access their basic needs, they are by extension often kept from being able to access their basic human rights.

Sign that reads "Social Workers change the world" — Source: Yahoo Images

One clear example of this is when people with disabilities require financial aid to support themselves do to an inability to be a part of the general workforce. Social workers are an important part of the process of connect the people affected by this issue with the resources and government programs they need. Without the aid of social workers, they might have significant difficulty accessing their “right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control,” as recognized in Article 25 of the United Nations’ Universal Declaration of Human Rights.

The fact that this allows social workers to discriminate certain groups in accepting clients is human rights issue in itself, as according to Article 7 of the UDHR, all are entitled to equal protection under the law and, “All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.”

The Purpose of Social Work: Helping Vulnerable Populations

Another reason this change in the Texas social workers’ code of conduct is problematic is that the field of social work is inherently meant to involve professionals helping vulnerable populations (such as the LGBTQ+ community and people with disabilities). According to the National Association of Social Workers’ (NASW) Code of Ethics, “The primary mission of the social work profession is to enhance human well–being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.” A vulnerable population is a group or community “at a higher risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability.”

Social work is also built a set of core values: service, social justice, dignity and worth of the person, importance of human relationships, integrity, competence. It is the job of a social worker to do what they can to uphold those values by helping vulnerable populations access the resources they need. Therefore, social workers’ turning away members of the LGBTQ+ community and people with disabilities, particularly vulnerable groups, goes against the social work code of ethics.

The ethical principles of social work also bar social workers from participating in acts of discrimination on the “basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical ability.”

There is a meeting set for October 27, 2020 so that the Texas Behavioral Health Executive Council can discuss the issue of discrimination as it applies to the changes that were made to the Texas social workers’ code of conduct. It is vital that we do not underestimate the significance of this situation and the serious harm that it can cause.

Not Fair, Still Lovely: The Perpetuating Toxicity of Colorism

advertisement for a skin whitening cream — Source: Adam Jones

This past summer, two pandemics plagued the world: COVID-19 and systemic racial discrimination and prejudice against Black communities. While the former was making modern history, the latter had been happening for centuries. As I thought of ways to address and educate myself and my family on these injustices, I found myself revisiting and reevaluating my own biases, particularly those I’ve experienced within the Indian community.

Growing up in South India, I would mimic my mother and grandma’s daily skin care routine when they used “Fair and Lovely,” a skin lightening and bleaching cream. I was constantly told to not play outside because I might get too dark, and my foundation for dance competitions and rehearsals was often shades lighter that what it needed to be. I was raised in a world where your worth was defined by the color of your skin, and if by chance your skin was too dark or too tan, then you were seen as un-beautiful, unworthy, and incompetent. Most women like my mom, my grandma, and I, as well as other individuals that suffer from the stigma that being dark is ugly, have often fallen prey to companies that profit off the ideology that whiter skin is equivalent to beauty, self-confidence, and self-worth.

Colorism in Indian Society

Colorism is an issue that is often ignored and rooted in societal pressure around fairness. It is a discriminatory practice in which institutions or individuals treat those with lighter skin tones more favorably, upholding instead White, Eurocentric standards of beauty. India is a mixture of diverse cultures, languages, and shades of brown. With different skin tones came colorism that continues to perpetuate stereotypes, prejudices, and discriminatory actions. For generations, Indian society has been brainwashed into the ideology that fairer skin is more desirable, leading to the nation developing a multibillion-dollar skin lightening industry. Everyday products like Olay’s Natural White Glowing Fairness Cream, Lotus Herbal’s White Glow Skin Whitening and Brightening Gel Crème, Pond’s White Beauty Daily Spot-Less Lightening Cream, etc. promote stereotypes against darker skin tones through their marketing strategies. For example, a current advertisement shows a young woman with a darker skin tone being rejected from a job later ends up using a fairness product to become more beautiful and thus confident. She then goes on to score an even better job at the end. Mainstream media also fails to provide accurate representations of India’s population, with many actors being light skinned and with frequent recruitment of foreign and predominantly White-presenting actors. Often the practice of “brown-face” is used among these actors and production companies to fit a certain role or aesthetic, thereby enforcing negative stereotypes when proper recruitment should’ve happened in the first place. Even more disturbing is that these stereotypes are so enforced in people’s homes and daily lives and can affect prospective marriages, job opportunities, and other relationships due to preferential treatment towards lighter skin.

The Origins of Colorism

Often, people mistakenly identify the origins of colorism with the caste system present in India. The caste system divides the Indian population according to labor and promotes the idea that each subgroup has its own functionally important role in society. Over time, this led to misrepresentation and manipulation of the caste system, because higher status on the ladder typically meant more prestigious work related to education, religion, trading, etc., whereas lower status meant more labor-intensive work that typically meant occupations in dirtier, outdoor environments. Naturally, those individuals lower on that ladder became darker due to their exposure to natural environmental conditions. Their natural and seasonal tanning along with their status as Dalits (“the untouchables”) within the caste system can be argued to have contributed to colorism. While the caste system does play a part in this ideology, it doesn’t fully explain why discrimination continues to happen, especially among individuals that identify with a higher status on the caste system but are also darker. Apart from that, multiple text depict Hindu deities as “dark-skinned,” and who hold a tremendous amount of respect, honor, and power. Neither the caste system nor religion can wholly explain the origins or colorism and why it still continues to perpetuate today.

A chart depiction of the Caste system. — Source: Source: The Ancient Wisdom Project

Colonization, the third factor of this equation, seems to be the missing part of the puzzle. Like many countries, India was not exempt from British rule and had only in the past century gained its independence. During the centuries of British rule and oppression, “colonization was embedded in the idea that fair skin people were the ruling class, and darker skinned people were the subjects.” Apart from this, there was also blatant favoritism by the newly erected British government towards light skinned Indians that directly affected social and class mobility as well as a family’s socioeconomic status. This was seen through discriminatory practices, such as offering lighter skinned individuals government pardons, jobs, and a voice, which were not offered to Indians of darker skin tones. This mindset, that the only way to be worthy, to be accomplished, and to be civilized and beautiful, slowly became an innate mantra amongst the Indian population, creating generations of individuals that strive for a beauty standard deeply rooted in anti-ethnic, anti-Indian, and anti-minority sentiments. The effects of colonization intermingled with the stereotypical notions of the caste system to give us unique and deeply rooted coloristic principles.

Difference between racism and colorism

Earlier, I mentioned that I wanted to address my own biases regarding systemic racism and educate myself on this issue. However, as an Indian-American immigrant, I found it difficult to navigate the differences between racism and colorism as the two are often intertwined and seen together in my community. But the more I researched on this issue, I found that people, often non South Asians, frequently mistook colorism for racism because it can perpetuates anti-Black sentiments within South Asian communities. Except, they are very distinct concepts. For example, in the U.S. (but not exclusive to the U.S.), skin color is the foundation of race, and continues to be a criterion in determining how they are evaluated and judged. The United States’ historic treatment and oppression of Black Americans is racially based, and within that exist preferences for certain skin tones. However, in a lot of Asian and colonized countries, race is not the primary indicator of how an individual will be treated. Instead, the color of a person’s skin on the wide range of the color spectrum will be the major determinant. While the two sound very similar, “the pervasiveness of a color hierarchy” is the crucial factor in social and class mobility, not necessarily race. Colorism and racism, while closely related problems need different solutions, and while these some of these solutions may overlap, each has a unique set of problems.

Woman holding a Black Lives Matter sign. — Source: Socially Urban

Right now, certain skin care and make-up companies, such as Unilever’s “Fair and Lovely,” that release skin whitening, bleaching, and lightening products have issued public apologies and are removing, re-advertising, and rebranding their products. While this alone is not enough, because the consumption of such products is based in generational trauma surrounding discrimination around darker skin and beautiful shades of brown, it is a step forward in addressing how such companies are profiting off anti-Black sentiments and how to halt such practices.

What can I do?

Follow Nina Davuluri’s “See My Complexion” petition and project.
Continue to callout and critique companies that promote skin bleaching and whitening products because cosmetic changes such as rebranding products is not enough to halt harmful beauty standards.
Most importantly, it’s important to address and actively combat our own implicit biases that are rooted in generational trauma.

Let’s #BreakTheChains

“I used to be chained around the waist and one ankle. My waist used to hurt because the chain was so heavy. My leg used to hurt, I would scratch it and cry. I felt relieved when the chain was removed.”

–Rose, Kenya

An estimated 792 million people globally – that is 1 in 10 people, including 1 in 5 children – have a mental health condition. Despite this irrefutable fact, governments spend less than two percent of their health budgets on mental health. The absence of proper mental health support and knowledge of how to cope with a mental health condition has lead to thousands of people being shackled in inhumane conditions.

“People in the neighborhood say that I’m mad [maluca or n’lhanyi]. I was taken to a traditional healing center where they cut my wrists to introduce medicine and another one where a witch doctor made me take baths with chicken blood.”
—Fiera, 42, woman with a psychosocial disability, Maputo, Mozambique, November 2019

This brutal practice is an open secret in many communities, according to Kriti Sharma, the senior disability rights researcher at the Human Rights Watch. Sharma and her team compiled a 56-page report titled “Living in Chains: Shackling People with Psychological Disabilities Worldwide,” shedding light on the conditions in which people with mental disabilities are bound by families in their own homes or in overcrowded and unsanitary institutions against their will. This is due to the widespread stigma and taboo of mental health issues within governments and health institutions in several countries. In state-run, private, traditional, and religious institutional “healing centers,” people with mental health conditions are often forced to fast, take medications or herbal concoctions, and face physical and sexual violence.

“A mentally ill patient is chained in a cell at Mia Ali Saeb Shrine in Samar Khel, Afghanistan on Nov 12, 2008. Patients, usually brought here by family members, are only given daily rations of bread, black pepper and water, and are kept in their cells for 40 days. With mental illness widely misunderstood, many Afghans believe God will cure the patients with such treatment.” Source: Yahoo Images.

The Human Rights Watch’s study of 110 countries unveiled evidence of shackling people with mental health conditions across age groups, ethnicities, religions, socioeconomic levels, and urban and rural areas in about 60 countries. Countries that indulge in these types of practices include Afghanistan, Burkina Faso, Cambodia, China, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Palestine, Yemen, and several more.

Though a number of countries have started to acknowledge mental health as a real problem, the inhumane act of shackling remains largely out of sight. There is no data or coordinated effort at either international or regional level to eradicate the binding of people who are mentally ill. The act of shackling impacts both the mental and physical health of someone who is already ill. Some effects include post-traumatic stress, malnutrition, infections, nerve damage, and cardiovascular problems, not to mention the loss of dignity. The #BreakTheChains Movement is an organization devoted to bringing awareness of shackling to nations and increasing access and awareness of mental health services in countries where shackling is a common problem. The movement has been successful in Indonesia where its country-wide interviews and advocacy led the government of Indonesia to deepen its commitment to #BreakTheChains. Over 48 million households in Indonesia now have access to community-based mental health services.

Laymen can also assist the movement by following two easy steps: sign the pledge, and share the movement on social media to promote awareness. It is time to acknowledge that mental health is a real issue that affects millions of people, and shackling and ignoring the issue will not resolve any issues, nor will it reduce the stigma associated with mental health. If we, as global citizens, have learned anything from this pandemic, it is how deathly and dangerous the invisibility of a disease is. Mental health is invisible like COVID-19, but there are always symptoms. Make an effort to educate yourself, and take the opportunity to check in on people by simply asking how someone has been. It really is that simple.

Brief Video about the Chained

COVID-19’s Effect on Mental Health

Amidst the global pandemic, we have all had to make some changes to our daily lives. It used to be normal to go to restaurants, movie theaters, and concerts, but now, for the most part, we stay away from those activities and social distance instead. While social distancing has slowed the spread of COVID-19, most of us are aware of the toll it takes on our mental health. Humans are a very social species, and social isolation can have a severe impact on overall wellness. Financial hardships and anxiety over illness contribute to a decline in mental health as well.

Social isolation has many benefits when it comes to slowing the pandemic. However, it drastically impacted the lives of many people in an unintended way. Loneliness has skyrocketed due to people only having contact with the people they live with—or no one. The effects can be even more confusing because social isolation affects everyone differently. Some people have pre-existing mental health conditions, and when the pandemic forced them into isolation, they recognized their symptoms worsening. While their original symptoms worsen, they also are more likely to develop PTSD than their counterparts without pre-existing conditions.

Even those without pre-existing mental health conditions are vulnerable to worsened mental health when facing social isolation, especially children and adolescents. Many people in this age group get most of their social interaction through school, and with many schools closed or on limited schedules, they’re not receiving the social interaction they need to grow. Because of the loneliness these children and teens are feeling, there is the increased risk that some of them will develop depression at an early age, with even higher rates than normal among those that have a family history of depression.

College students are facing very similar challenges that adolescents in middle and high school experience, except many have the added pressure of being away from their families while also no longer having a strong social network on campus to rely on. Many students are experiencing increased fear and anxiety in addition to depression, which can lead to physical health issues; anxiety and depression can worsen sleep and eating habits, which can have profound effects on a student’s energy, and in turn their performance in school and overall health.

Financial struggles have been shown to have severe impacts on a person’s overall wellbeing outside of this pandemic. Over a third of the United States’ population experienced negative financial impacts due to the pandemic. Hourly workers, who typically already struggle financially, were hard hit, which creates a lot of stress for them and their families. People who are worried about their finances may also be unable to seek mental health help from professionals, which could potentially improve mental health.

Many people with stable work before the pandemic hit, lost their jobs. They experience an added stress of worrying about evictions and foreclosures and where their next meal is going to come from. This can lead to higher levels of anxiety and depression, and in the past, economic downturn, which we have experience during the pandemic, is associated with an increased rate of suicide.

This pandemic has been a new experience for all of us. The COVID-19 pandemic wasn’t the first pandemic, and many are realizing it won’t be the last. This realization is increasing anxiety in many people, along with worrying about the health of immunocompromised loved ones or personal health. Additionally, many are worried about dying alone. This increase in stress can lead to an increase in anxiety and depression, along with other mental health issues, and worsen existing mental health conditions.

Being home all day has kept people in front of the TV, watching the news. It’s beneficial to be informed, but studies have shown that too much COVID-19 news can worsen mental health issues. This can exacerbate issues that already existed. One way to reduce being overwhelmed with the news, but to stay informed is to limit the time watching the news and instead get reliable information from the CDC, which updates information regularly.

Mental health is a human right, and should be a priority, especially during times or social isolation, financial hardship, and illness. An emphasis should be put on practicing self-care, but it’s also important that people who need help from a psychologist or psychiatrist get the chance to see them. During this pandemic, mental health has been put on the back burner. While many of the steps taken have saved countless lives, their impact on mental health should not be overlooked. In the future, when we take drastic measures, such as social isolation, we need to make sure the mental health aspects will be given the attention they need to be able to keep our population healthy in every way possible.

Cancel Culture: A Societal Obligation or Infringement on Free Speech?

A large majority of people spend their time online talking to friends, sharing and obtaining news, or connecting with family. Our lives being connected to the internet has forced us to learn how to network and find our way around social media platforms. Social media platforms, such as Twitter, Facebook, Instagram, and TikTok, facilitated the creation of “cancel culture” as we know it today. Cancel culture is used to call out behaviors and actions of individuals and corporations that convey opinions or feelings which are objectively questionable or not appropriate from a public perspective. Engaging in cancel culture typically requires a series of hashtags that proclaim an individual is being cancelled. A hashtag followed by the word cancelled or a hashtag with a person’s name followed by the phrase “isover” are the most commonly used hashtags within the tradition of cancelling. This brings us to an interesting dilemma of whether or not cancel culture is an infringement on freedom of speech.

Infringement on Freedom of Speech

Cancel culture has proven to be an effective method to identify the actions taken by individuals and corporations to rectify mistakes. Recently, in light of social justice movements such as the Black Lives Matter Movement and #MeToo; during an election year, cancel culture has been used to take down racist statues, rename buildings named after white supremacists, call out celebrities and prominent figures in society, and address “racist, sexist, or homophobic views or ideologies.”

Cancel Culture from Two Perspectives

The first perspective is often from the people who are advocating against cancel culture. These people often have large platforms, and they are upset that their freedom of speech is being infringed upon due to the policing of cancel culture and they’re afraid of being criticized for their opinions. The first perspective against cancel culture revolves around the inability to take criticism.

The second perspective involves those that do not engage in exercising their right to free speech and expression. People are afraid of the repercussions of cancel culture so they choose to not express themselves. This second perspective of cancelling is more concerning because it involves actively suppressing the beliefs, ideologies, and perspectives of people and a true cancelling of these voices.

There is a delicate balance in defending the right to freedom of speech and holding individuals and corporations responsible for their actions. The issue with cancel culture is that there is no gradation and all missteps have the same severity of punishment. People can be fired, and student admission can be halted as a result of this. In most cases, it’s a trend to be cancelled where people jump on a bandwagon without the slightest amount of information on what they are cancelling.

On the other hand, “defending speech has become a tool to bully others into silence.” Often, proponents of free speech will quote the right to speech and expression granted by the Constitution to prevent others from criticizing them. While it can be a useful tactic in the short term to support an argument, it leaves no room for compromise. This tactic makes it impossible to find the equilibrium in a conversation, which I argue can be almost as bad as cancel culture.

A protestor holds us up a fundamental part of what defines the freedom of speech. Source: theduran.com — A protestor holds up a fundamental part of what defines the freedom of speech. Source: theduran.com

A Different Option: Call Out Culture

More often than not, free speech is not being infringed upon. It is often a case of what boundaries are being set to speak in a public setting and if those boundaries are acceptable. While it is our responsibility to be open and receptive of opposing views, these views are not always in concordance to what a majority of people might believe. This gives leeway for a new type of action where the public can participate in call out culture instead of cancel culture. But before calling out, it is still important to give the opponent a chance to respond and hear their responses to avoid regressing and participating in what can be a very toxic culture. Responses do not need to include canceling, suppressing, or removing, but can include educating, accepting, and forgiving. This gives room where we can set boundaries safely and simply say, “I do not agree with you,” but even with this it is very situational where some actions are above disagreeing and need to be addressed properly.

For example, in 2016 a Pepsi advertisement featuring model and influence Kendall Jenner was incredibly tone deaf, and downplayed the severity of protests and the Black Lives Matter movement. The outcry against the ad prompted a response from Pepsi and Jenner apologizing for the missing the mark on trying to project “unity, peace, and understanding,” and for putting Jenner is this position. The public seemed to not hold Pepsi to the same standards that Jenner was held, and to this day still is, and essentially made her accountable for the apology, when every one that participated in the situation and production should have also been held responsible. On the other hand, Larry Nassar, who was national team doctor for USA gymnastics, was charged for hundred of cases of sexual assault under the pretext medical treatment for the athletes. Him, his actions, and his behavior harmed hundreds of lives and families, and so the public outcry against the individual, his actions, and the system that supported him was warranted and justified in a situation. Did he deserve to get cancelled? I think most people would argue yes, in a situation that is very black and white both morally and legally. Then the question becomes one of gradation. Did Jenner, a decent person often on the right path, deserve to get cancelled and held to the same standards of accountability, just as Nassar, and risk facing a stagnant and declining career for a misstep? For this, I think most people would argue no, because, yes while the ad was harmful to several communities, it was no where near the severity of Nassar’s actions. Yes, her participation needed to be addressed, but did it warrant “cancelling” a targeted individual because of their background instead of education them?

How to avoid cancel culture?

Do your own research on the situation or individual – the one being called out or cancelled as well as the individual doing the calling out or cancelling.
Evaluate the gradation and the consequence of the action in question, and ask yourself if cancel culture actually works.
Try to address how toxic it can be for your mental health and identify if there is another way to help.
If you do decide to engage, make sure to call out and educate instead of cancel.

Fires and COVID-19 Race Through Lesvos Migrant Camp

“We are asking for the European community to help. Why are they not listening to us? Where are the human rights? We took refuge in the European Union but where are they? There are no toilets, no showers, no water. Nothing. Not any security or safety. We die here every day.”

Devastation in Moria

On the night of September 8^th, 2020, fires raged through Europe’s largest migrant camp in Moria, Lesvos in Greece. It is home to more than 13,000 people which is 6x its capacity. Recently, Moria has caused deep political divisions and unrest in Europe over Mediterranean migration. Moria serves a direct transit point for hundreds of thousands of people seeking refuge from Afghanistan and Syria with the European Union. After Europe started closing its borders and putting a quota on the number of immigrants 4 years ago, life in Moria began to be plagued by mental and physical health issues and desperation. What was originally a temporary camp, became the home of deplorable conditions for people who were running from another deplorable environment.

On the night of the fires, thousands of Moria residents were displaced and are currently being refused entry into Europe, being refused basic rights to shelter and safety, being refused access to proper shelter and sanitation, and being refused their human rights. Since fleeing the fires, the refugees have resorted to sleeping on fields and the sides of roads. Thousands of migrants are now demanding more permanent housing because their situation is so out of the norm and they just want to feel safe in one environment, but their cries for help are continuing to go unheard. The Greek government has taken positive steps to build a more permanent migrant camp, but this leaves little to no hope for refugees seeking a better life outside of Lesvos.

This picture shows the a part of the residential area of the Moria camp where proper housing is severely limited and lacking along with our necessities. Source: Marianna Karakoukali

While accounts of how the fires started are currently being investigated the Greek government is claiming to have identified the culprits. Rumors of how the fires started are illustrative of ethnic and political tensions on Lesvos. The refugee migrants are tired of their poor living circumstances and the local population is upset with lack of regional, national, and international support for managing the influx of migrants and refugees on the island. While a second civil rights movement is happening not only in the United States, but all around the world, racial and ethnic tensions are high. Many refugees feel the European Union is turning its back on them. The European Union is becoming less tolerant for migrants and refugees, when it had once promised to help.

So how is COVID-19 affecting Moria?

Earlier this year, Greece went into lockdown and put travel restrictions on tourists coming in and residents going out. At the beginning of September, there was a small outbreak among the residents at the Moria camp, and human rights advocates are concerned that the Greek government is using this outbreak as an opportunity to further constrain the lives and freedoms of the migrants. The Greek minister for migration; Mitarchi, released a statement saying that the outbreak suggests need for a more “closed and controlled” environment for the migrants. This is odd considering that Moria has experienced far fewer cases than the rest of Greece, but the restrictions placed over the lives in Moria were much higher in comparison. In the Spring, the United Nations was so overwhelmed and concerned with livelihood and the living conditions at Moria that they called to expedite the migration process and related paperwork. So along with the day to day living conditions at Moria, COVID-19 and readily available access to healthcare is making life harder for the migrants. The fires may have been set in retaliation against the newer COVID-19 restrictions by the migrants or they might’ve been set by the local residents who fear the spread of COVID from the camp.

What is going on now?

In the meantime, while the Greek government is talking to French and Italian national leaders, riot police have been deployed to both the site where fires have been set, and also to the new refugee camp that is being set up to shelter those abandoned in Moria. This new site is at Kara Tepe where local media has identified helicopters that have been transporting tents and other necessities for the residents. In the fires, refugee documentation and belongings have been lost and burned, so it is still being determined how accessible the new site at Kara Tepe will be. Many refugees are now saying that they will not go back to another refugee camp where proper living conditions are not guaranteed, but the Greek government is saying that it will “not be blackmailed.”

Refugees sleep on side of the road following the fires, while they await further government housing and instructions. Source: Tasnim News Agency

What can you do to help?

Tweet European Leaders
Donate to grassroots organizations: Kitrinos, Movement on the Ground, Refugee4Refugees
Follow Choose Love Help Refugees organization on Instagram for other resources

The Right to Mental Health and the Importance of Self-Care

While it seems that most people today would agree that taking care of one’s mental health is important, it may come as a surprise that mental health is actually a human right. According to Article 25 of the Universal Declaration of Human Rights, all people have the right to “a standard of living adequate for the health and well-being of himself and his family…” The Office of the United Nations High Commissioner for Human Rights has declared that “that the right to health is a fundamental part of our human rights and or our understanding of a life in dignity.”

Mental Health as a Human Right

The United Nations Human Rights Council recognizes three principles regarding the right to health:

The first is that it is an inclusive right. This means that it extends “not only to timely and appropriate health care, but also to the underlying determinants of health.” This includes things like access to clean water, safe working conditions, and important information about health. These factors, while clearly relevant to physical health, are also important in maintaining one’s mental health.

The second principle is that the right to health includes both freedoms and entitlements. Freedoms would include things like “the right to control one’s health,” while entitlements would include things like “the right to a system of health protection that provides equality of opportunity for people to enjoy the highest attainable standard of health.” This is significant because one needs to be able to access important information and resources related to mental health in order to have meaningful support for their mental health.

The third principle is that the right to health is a broad concept that can be divided up into more specific rights. For example, there are some aspects of health that are specific to people who are assigned female at birth, and those aspects are associated with specific rights. The right to mental health (and the rights associated with it) is one of the many rights that make of the right to health.

Mental Health Impacts Your Overall Future Health

According to the World Health Organization’s Constitution, health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Based on this, taking care of your mental health is not simply making sure that you are not actively going through a crisis. Being healthy is more than just surviving. Taking care of your mental health involves taking daily steps to care for yourself that not only improve your health in the present, but also protect your health in the future.

Having poor mental health puts you at a greater risk for physical health problems. According to the American Psychological Association, having a mental health condition reduces men’s life expectancy by an estimated 20 years and reduces women’s life expectancy by about 15 years. This is in part due to the fact that nearly two-thirds of people with mental health conditions do not seek any form of treatment.

Mental Health is a Key Part of Accessing Many Other Rights

In addition to being a right on its own, maintaining good mental health is also a key part of being able to meaningfully access many other human rights. For example, even when given all the necessary tools that are directly related to education, struggling with mental health issues can impede a person’s ability to receive a truly meaningful education. This is reflected by the long-term effects of depression. In one study, scientists found that individuals who faced depression during mid-adolescence and continue to deal with it as young adults are at an increased risk of educational underachievement and unemployment. One’s mental health can also impact their access to other rights such as the right to participate in the cultural life of their community, the right to rest and leisure, and the right to work.

Scrabble pieces spell out the words "mental health." — Mental Health. Source: Kevin Simmons, Creative Commons

You Have to Help Yourself Before You Can Help Others

You’re probably familiar with the concept of putting your oxygen mask on before assisting others on a plane. If you are struggling to breathe yourself, not only is your ability to help others inhibited, but you’re putting your own health and well-being at risk of harm. This can be applied to mental health as well. If you are facing serious struggles with your own mental health, it is important to focus on helping and support yourself before taking on responsibilities related to other people’s mental health.

For this reason, the maintenance of good mental health is especially important for people who work in fields such as human rights advocacy. The world of human rights is full of issues and topics that can be emotionally draining, so one can easily become overwhelmed by it all. It is vital that advocates make their mental (and physical) health a priority, even if their main concern is helping others. Self-care needs to be a part of any human rights advocate’s tool kit.

The Basics of Self-Care

Self-care can be defined as “any activity that we do deliberately in order to take care of our mental, emotional, and physical health.”

Raphailia Michael, a licensed counseling psychologist, suggests that there are three golden rules to starting self-care:

“Stick to the basics.” This makes it easier to include self-care into your schedule, make it a part of your regular routine, and figure out what works best for you.
“Self-care needs to be something you actively plan, rather than something that just happens.”
“Keeping a conscious mind is what counts…if you don’t see something as self-care or don’t do something in order to take care of yourself, it won’t work as such.”

Michael also gives a basic checklist of self-care tasks that can apply to pretty much anyone. This list includes things such as eating a nutritious diet, getting enough sleep, following up with medical care, and looking for opportunities to laugh every day.

It is so easy to get caught up in the hustle and bustle of everyday life and forget to take care of oneself. We all do it sometimes. It is important that we set aside time to properly take care of ourselves and pay attention to our own needs. Mental health matters just as much as everything else that is going on, and that’s something we need to remember.

The Criminalization of Mental Illness

Prison cell block. Source: Bob Jagendorf, Creative Commons.

It is no secret that the United States has an issue of overcrowding prisons, which can lead to many issues regarding quality of life in prisons. Overcrowding in prisons is not just a problem in the United States; over 100 other countries also have this issue. In many countries, the criminalization of mental health is a factor that is compounding the issue. Individuals with severe mental illnesses not only need treatment that prisons don’t provide, but also can be put in dangerous situations when they are in prison. Despite this, they are more likely to end up in prison than in treatment.

Up until the 1960s in the United States, when someone had a severe mental illness, they were typically placed in a mental institution or asylum. In an effort to provide patients in mental institutions better community-based care and reduce government spending, the process of deinstitutionalization began. However, that is not how it played out. While the movement gave those with mental illness more rights and turned society away from locking them up, it released some that would have benefitted from long-term care that community centers could not provide. However, with many patients moving out of long-term treatment facilities, many of these facilities were shutting down. This left community mental health centers to try to treat illnesses they were not originally intended to. Another issue arose when insufficient funding was allocated for the community mental health centers, further overwhelming the new system. Because the difficulty of the transition from institutionalization to community care was underestimated, many—then and today—have gone without treatment. The lack of treatment for serious mental illness, like Schizophrenia, has led to the incarceration of many people with mental illness who should instead be treated.

Not Guilty by Reason of Insanity

Another issue that has contributed to the criminalization of mental illness is the difference between the clinical definition of mental illness and the legal definition. The diagnosis of mental illness is dictated by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The law, however, sees mental illness as symptoms that impair mental functioning. The main diagnoses that fits into the legal definition are psychotic disorders, such as Schizophrenia. Even if someone has been diagnosed with a psychotic disorder, when pleading not guilty by reasoning of insanity, their lawyer must show that they were having symptoms at the time of the crime that contributed to said crime. This can be a difficult task as some states require that the symptoms are so severe that the defendant didn’t know that the crime was illegal. Even in cases where the defendant has shown this to be true, some juries will give a verdict of guilty to ensure that someone is held accountable for the offense.

Some states have gotten rid of the insanity plea altogether, while others have changed it to “guilty because of mental illness” meaning after treatment, they must serve their sentence in prison. This can sometimes put the progress a patient has made in jeopardy, as prisons are not a suitable environment for maintaining a newly achieved healthy mental state. In states where not guilty by reason of insanity is still in effect, those found not guilty by reason of insanity are supposed to be released after sanity has been restored. Yet, this is rarely the case; due to fear they will go off their medicine and commit the same violent crimes, many are held in treatment facilities indefinitely. With the threat of this outcome overhead, many opt out of the not guilty by reason of insanity plea and are instead place into a prison where they will not receive the appropriate care.

Because of the law’s strict definition of mental illness, many are being placed in already crowded, underfunded prisons. Because of the lack of mental health professionals, prisoners in some states, including Nebraska, may not receive medications for mental illnesses or have access to talk to counselors. This can cause the reemergence of once-controlled symptoms, making the prisoner with a mental illness a danger not only to himself, but also to others. Additionally, many with severe mental illness are put in solitary confinement for long periods of time. Psychologists who have studied the effects of solitary confinement have seen a pattern of increased mental health problems in people who were originally neurotypical. If this is true, the effects on prisoners with mental illness could be devastating. Not only are people being sent to prison when they should receive treatment, they are also being put in situations that make their symptoms worse and make it harder to reenter into society if their sentence allows.

Substance Use Criminalization

In addition to violent crimes committed because of mental illness, many nonviolent acts associated with mental illness are criminalized; Substance Use Disorders are recognized by the DSM V and are therefore diagnosable and treatable, but the law instead criminalizes it. While at any given time there are more convictions for violent crimes, more people are sent to prison a year for drug-related crimes than violent crimes. Studies have shown that those imprisoned for drug-use are unlikely to receive treatment and often return to using drugs once released because they lack the resources that treatment would have given them. Sending people with Substance Abuse Disorders to jail does not improve their illness.

Not only those with Substance abuse disorder are affected by this criminalization; those diagnosed with another mental illness are five to eighteen times more likely to have a comorbid Substance Use Disorder. This can further prevent someone who needs treatment from receiving it. Most prisons don’t have adequate resources to treat prisoners with mental illness, so imprisoning people for crimes that are directly tied to mental illness can be detrimental to their treatment and future.

Current solutions

Some states are trying to combat the increasing proportion of prisoners with mental illness not receiving treatment. With our corrections system slowly catching up with our understanding of mental illness, states—like California—are beginning to consider replacing their old jails, not with new ones exactly like them, but instead with centers focused on rehabilitation. They are not calling for moving all criminals with mental illness out of prisons, but instead treating those with mental illness while they serve their sentence. Additionally, they do want to increase the diversion from jails, but that will be done on a case-by-case basis and only for those who have committed a crime because of mental illness.

Stigma

Ultimately, the criminalization of mental illness has a lot to do with the stigma surrounding it. The general population connects mental illness with violence, which leads to harsher punishments. As a society, we need to reduce stigma before any change can happen. If we continue to see those with mental health problems as inherently violent, they will continue to be prosecuted and sentenced unjustly.

Young Activists and the Burden of Change

Two girls smiling and holding up peace signs. — Children. Source: Shazron, Creative Commons

What would you do if you felt like the whole world was on your shoulders before you were even old enough to vote? Many children have faced this exact question, some of which have been acknowledged for their extraordinary efforts to make the world a better place. Malala Yousafzai. Greta Thunberg. Emma González and David Hogg. These are only few from a long list of young activists who have made great sacrifices in hopes of creating a better future for themselves and future generations.

For many, seeing children give up so much for something they are passionate about is greatly motivating. Children’s willingness to put themselves at risk for the greater good often make adults feel like they should be doing more to make a difference or that they have been underestimating the problem the entire time.

That being said, why should children have to make sacrifices in order to convince adults to change? Should the burden of change ever be placed on a child’s shoulders?

Why do they feel the need to get involved?

When discussing this issue, it is important that we consider what is causing so many young people to feel the need to take on the serious responsibilities that come with activism. It may speak to the severity of an issue when the members of society with the least responsibilities for the problems we face are the ones leading the charge for progress or, possibly, because they are the ones dealing the brunt of the impact of change.

Greta Thunberg, a sixteen-year-old environmental activist, skips school on Fridays in order to “protest outside Swedish parliament buildings, pressuring the government to pass legislation that would reduce carbon emissions in line with the Paris Agreement”. These efforts interfere with her right to an education which is recognized in Article 26 of the United Nations Universal Declaration of Human Rights and Article 28 of the Convention on the Rights of the Child). When asked about her message for world leaders at the UN Climate Action Summit, said, “You are failing us. But the young people are starting to understand your betrayal. The eyes of all future generations are upon you. And if you choose to fail us, I say: We will never forgive you. We will not let you get away with this. Right here, right now is where we draw the line. The world is waking up. And change is coming, whether you like it or not.”

Personal Connections to the Issue

For many child activists, their membership in a community that is particularly or uniquely impacted by an issue contributes to their involvement whether it is by participation or choice. Consider the activists from Marjory Stoneman Douglas High School in Parkland, Florida. Their activism began as a response to their experiences as survivors of a school shooting. Many of the activists have attributed much of their drive for promoting gun-reform to their feeling that adults are not doing enough (or are even making the problem worse). Cameron Kasky, an 11th grader at the school, said, “The adults know that we are cleaning up their mess.” Emma González added onto this, stating, “It’s like they’re saying, ‘I’m sorry I made this mess,’ while continuing to spill soda on the floor.”

In other cases, children carrying the burden of change are from marginalized groups who are disproportionately impacted by a given issue. Malala Yousafzai grew up in Pakistan, where her father was a teacher who ran a school for girls. In 2008, the Taliban overtook the town she lived in and put many harsh restrictions in place, one of which was declaring that girls could no longer attend school. Yousafzai spoke out against this and in support of girls’ right to an education (which is recognized as a right in Article 10 of the Convention on the Elimination of All Forms of Discrimination Against Women). In 2012, at the age of 16, Malala was shot in the head by a masked gunman in response to her activism. She knew that speaking out was dangerous but took the risk, because she knew, firsthand, how girls are affected when refused their right to an education.

Children should not have to lead the fights for their own rights and well-being, especially when it involves risking their lives.

Greta Thunberg sitting in a chair and being interviewed. — Greta Thunberg at the Parliament. Source: European Parliament, Creative Commons

Harmful Responses

One way in which heavy involvement in efforts for change has been harmful for children is the way people who disagree often begin to treat them. While Ruby Bridges was not an activist at the time, she still faced serious backlash when she became the first African American to attend a school that had previously only enrolled white students. Throughout her first year at her new school, there were mobs of people in front of the building every day protesting her attendance. People were angrily pointing and shouting at her as she was escorted into school every day. In an interview for NPR, she shared that some people would bring a baby-sized coffin with a black doll inside, and she would have to walk by it every day. This frightened her so much it gave her nightmares. She was simply a little girl going to school, but it was as if people stopped seeing her that way.

With the rise of social media in recent years, children who are part of social change or activism are more aware of people’s responses to them than ever before. Some adults, angered by the actions of these children for one reason or another, flock to websites like Twitter to air their grievances, seemingly without any consideration for how their words might impact the children involved. As her work has become more well-known, Greta Thunberg has faced much cruelty from adults. In August, Thunberg was traveling across the Atlantic Ocean on a high-tech racing yacht (to decrease her contributions to greenhouse emissions) to spread awareness of climate change. Arron Banks, multimillionaire and co-founder of Leave.EU, tweeted her picture with the caption, “Freak yachting accidents do happen in August…”. Others have mocked her for having Asperger’s syndrome or for displaying its symptoms.

The long-term negative impact that internalizing these kinds of harsh words and actions can have pose a threat to a child’s mental health. Article 25 of the United Nations’ Universal Declaration of Human Rights states that all people have the right to live in an environment that supports their health and well-being.

What Do We Do?

How do we deal with this issue? It is not so simple as to say that kids should be kept out of political conversations altogether. Many children live with certain aspects of their lives that require political conversations. If a child’s parents are a same-sex couple, the parents need to be able to talk to their child about the way some people treat the LGBTQ+ community. This conversation cannot be had without at least some political themes. People of color need to be able to talk to their children about certain topics which are considered political in order help keep them safe.

These conversations should not be limited to parents and children who are directly impacted by political issues. Children with privilege should not be kept ignorant of these serious issues, as gaining knowledge about marginalized groups can help them develop empathy. Additionally, children who are impacted by political issues should not be alone when having to face the difficulties of learning about these issues.

It is also important to recognize that exposure to conversations about political issues at an early age can lead to increased political engagement as an adult. Hearing their parents/guardians talk about different topics communicates to children (whether directly or indirectly) that these issues matter and have value. Political discourse that highlights the importance of such issues can, therefore, teach children to value political engagement.

One thing that we can do is spread awareness about how heavy participation in political activism can impact children, particularly their mental health. We can hold ourselves and our peers accountable for the things we say online (or in-person), hopefully decreasing the amount of mocking and bullying that children experience through the actions of adults. We can also respond to their cries for action by working toward progressive social change so that they do not have to do our job for us.

Barriers to the Mental Health Care of Sex Trafficked Victims.

This blog uses direct quotes from survivors that may be explicit for some readers.

What is Sex Trafficking?

The U.S. Department of State defines sex trafficking as “the recruitment, transportation, provision, or the obtaining of a person for a commercial sex act. The commercial sex act is induced by force, fraud, or coercion, where the survivors are pushed to perform such acts while under 18 years of age”. Sexual trafficking relies heavily on the control of the victim’s vulnerability. According to the Trafficking Hotline, about 10,949 cases of human trafficking were reported in the year 2018 alone. Among those cases, 7,859 account for sex trafficking (approximately 71.78%). Those who are survivors of human trafficking report experiencing severe cases of abuse and extortion sex practices. As a result, these individuals’ lives are continuously exposed to physical and sexual trauma.

So how does sex trafficking occur? After individuals are lured by their traffickers, victims are absorbed into the underground and uncontrolled sectors of the economy where wage, health, and safety law violations routinely happen. In these sectors, individuals are hooked into prostitution, pornography, and other forms of the commercial sex industry. Those who have survived human trafficking explain how hard it is to escape the trafficker. For example, in an interview with Kristina Kuzmic, Oree describes her experiences as a victim of human trafficking,

Warning Explicit Content.

“And he grabbed me by my hair and drugged me down the street. My knees was scraping the floor. There was other women out there, nobody did anything. When you have been forced to sleep with 7 to 15 men and be raped and be 11 years old, I was like slowly dying. And after the first night, you suppress those feelings because any inch of hope that you have, any sense of “I can get out,” any feeling of “There’s a God,” any feeling of “I don’t deserve this,” you get beat, You ain’t going to survive out there. By the time I was 12 years old within a year, I was already raped over 4,000 times.”

In Oree’s case, she explains that she was not able to get away from her trafficker until a man named Jim Carson came to her rescue when she was 14 years old. In her interview, Oree emphasizes, “It was never a choice. It’s not a choice for these kids…they are children whose dreams and innocence was stolen and snatched from them.” Regardless of the form of their exploitation, trafficked victims suffer extreme abuse that often results in physical and mental trauma.

Traffickers use various means, such as pregnancy, to coerce trafficked victims, This ensures that the individual is emotionally bound and remains dependent on the trafficker to meet her own and her child’s needs. In an interview, Rebecca Bender, another survivor of sex trafficking narrates her experiences as follows,

“When you have a trafficker that’s at home with your child and says, if you don’t bring home $1500, you’re going to find your daughter out on the corner. I think I was probably more frightened to go home than I was to be in the room because if you got robbed, it was your fault for being stupid. If you get raped, it was your fault for not watching your back. Anything that happened to you was typically your fault, and you incurred more punishment for allowing these things to happen.”

Trafficked victims, like Bender, often blame themselves for their situation, therefore making it even harder for them to escape their traffickers. Some other reasons victims find it hard to leave include:

Threats of violence against the victim’s family and loved ones.
Traffickers requiring their victims to repay all debt (real or not real) before they can be liberated.
Traffickers manipulate victims to believe they love them.
Victims may be unfamiliar with the language of the country they are in and often do not know how to get around.

Sex Trafficking and Mental Health.

Prolonged captivity has been found to cause psychological trauma and contribute to the development of post-traumatic stress disorder (PTSD). This is because traffickers instill psychological trauma through terror, helplessness, and continuous destruction of the victim’s self-esteem. Constant death threats and physical abuse, followed by inconsistent and unpredictable outbursts of violence, results in significant mental health consequences for trafficked victims. For PTSD, symptoms either present themselves within the first three months after a traumatic event or can go for months to years without showing any symptoms, making it harder to detect and diagnose. In addition to PTSD, victims of human trafficking have been found to suffer from other anxiety and mood disorders, including panic attacks, obsessive-compulsive disorder, generalized anxiety disorder, and major depressive disorder. There is also an increased risk for the development of dissociative disorders.

Substance abuse disorder is also at the top of the list. While some victims of trafficking may report prior substance addictions, the majority of victims who reported alcohol and drug use said they began using drugs after they were in their trafficking situations. Other victims report being forced into drugs by their traffickers or using drugs as a coping mechanism.

Types of Treatment.

Understanding the effects of human trafficking on the mental health of victims requires long-term comprehensive therapy. Some of the evidence-based treatment options for PTSD include:

Cognitive Therapy
- Challenges dysfunctional thoughts based on irrational or illogical assumptions.
Cognitive-Behavioral Therapy
- Combines cognitive therapy with behavioral interventions such as exposure therapy, thought breathing techniques.
Exposure Therapy
- Aims to reduce anxiety and fear through the confrontation of thoughts or actual situations related to the trauma.
Eye Movement Desensitization and Reprocessing
- Combines general clinical practice with brief imaginal exposure where a client is asked to imagine feared images or situations, and cognitive restoration. Rapid eye movement may be induced.
Stress Inoculation Training
- Combines psycho-education with anxiety management techniques such as relaxation training, breathing retraining, and thought stopping.

Barriers to Treatment.

Language barriers and transportation issues may hinder adequate treatment. Service providers express that clients who speak other languages have difficulty receiving care or even seeking care. More importantly, transportation barriers may result in missing appointments, which interferes with treatment. When looking at language, culture also plays a role. Just because someone speaks the same language as the victim, does not necessarily mean that services offered will be culturally appropriate. While speaking the same language as clients can help with service provision, other pieces of one’s culture are often overlooked. For example, some cultures may require that women only see women providers, and therefore it becomes difficult when the only provider available is male. In addition, some victims may also fear talking about their experiences because of fear of stigma and shame. Traumatic events may also affect the memories and may negatively influence the individual’s ability to recall events. Lastly, longer wait times for psychotherapy and funding cuts continue to be a challenge to both mental healthcare professionals and patients.

How Can Treatment be Improved?

I believe it is important to offer trafficking-specific training to professionals. This will help increase awareness of trafficking as well as inform the staff of available resources. Acknowledging the gender of patients when writing out assessments is also important because it will lead to better practice by providing more treatment options for victims. There is also the need to examine both social and psychological factors when responding to mental health needs. This will help improve communication between services as well as offer more insight into what type of treatment one should receive. Furthermore, there is a need for more research to help explore the ways in which healthcare professionals identify victims and determine what kind of care one receives. This will allow for the generalization of mental health practices and procedures into other disciplines. While there is still plenty to improve, it is important to note that there is work being done to enhance the mental health care of trafficked individuals.

The information above does not fully cover what victims of human trafficking experience before, during, and after they escape their traffickers. If you see something suspicious, call the Blue Campaign with your tip and be sure to include the car tag and vehicle description.

Call: 1-866-347-2423

Rape Hotline: 1-800-656-4673

Trafficking Hotline: 1-800-373-7888

Suicide Hotline: 1-800-273-8255