Barriers to the Mental Health Care of Sex Trafficked Victims.

A woman with her eyes closed and hands on her cheeks
Source: Mental Health, Yahoo Images

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:

  1. Threats of violence against the victim’s family and loved ones.
  2. Traffickers requiring their victims to repay all debt (real or not real) before they can be liberated.
  3. Traffickers manipulate victims to believe they love them.
  4. 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

Monstrous Misrepresentation: Disabilities in the Horror Genre

Empty seats in a movie theater.
Movie Theater. Source: Matthew Berggren, Creative Commons

Far too often popular media, particularly horror movies, paint people with disabilities as monsters.  Scary movies are notorious for taking completely real health conditions and distorting them into what appears inevitably dangerous.  In some cases, they create villainous characters with physical appearances that are seen as abnormal based on real conditions that have physically visible symptoms, like acromegaly.  In others, they create characters based on real mental health conditions, like dissociative identity disorder, and depict them as if they have the powers and the thirst for evil of a comic book super-villain.  These dangerously inaccurate depictions of disabilities dehumanize entire groups of people in one fell swoop, often without any clear recognition from the creators of the damage they have done.  

Acromegaly in Gerald’s Game 

In Stephen King’s novel and film Gerald’s Game, Raymond Andrew Joubert is a grave robber, necrophiliac, and serial killer.  He is also a character with acromegaly, a disorder that occurs when too much growth hormone is produced due to benign tumors (adenomas) on the pituitary gland.  Acromegaly is associated with many serious health problems, such as type II diabetes, high blood pressure, an increased risk of cardiovascular disease, arthritis, and, if not treated, even death.  The most visible and easily recognized symptoms of the condition are unusual growth of hands and feet, a protruding brow bone and lower jaw, an enlarged nose, and teeth that have spaced out.  The condition does not make a person any more dangerous than any other.  It seems that King only chose to create this character with this condition because of the physical appearance that is associated with it.  This is a problem, because it perpetuates the common, preexisting belief that people who look different from what is deemed “normal” are dangerous and should be feared.   

With the right lighting and camera angles, anyone could look terrifying.  There is no reason to use people with real health conditions in a way that only makes life and society’s understanding of them more difficult. 

Dissociative Identity Disorder 

Dissociative identity disorder (DID) is one of many mental health conditions that has experienced significant harm due to failed representation in the media.  It is far too common to find that fictional media depictions of DID lack any presentation of the true facts of the disorder.  The Entropy System is a DID system who posts educational videos about DID on YouTube.  Their series on DID in the Media does a thorough job at analyzing the quality of different examples of representation of DID in films.  They use four main criteria in assessing each work.   

First, does it “communicate proper diagnosis and treatment”?  Many attempted depictions of DID fail to even name the disorder accurately and call it “Multiple Personality Disorder”, its name prior to 1994.  These works also often suggest that all systems (the collective term for one’s alters/identities) with DID are working towards the same goal with their treatment: to integrate all the identities into one.  Some systems are not interested in integrating.  The Entropy System points out in many of their videos that an important part of treatment, regardless of the system’s level of interest in integration, is establishing strong communication between the different alters. 

Second, does the work address the cause of DID?  The disorder is a result of repetitive, severe trauma that occurs during childhood. According to the theory of Structural Dissociation, no person is born with a fully integrated personality.  This means that, when we are children, we are made up of multiple individual personalities or “ego-states,” which integrate and become a single personality between the ages of six and nine.  Each of these ego-states is responsible for performing a different role.  DID occurs when trauma prevents these ego-states from integrating.  The ego-states develop into individual identities known as alters. 

Third, are the alters shown as part of a unit, or as extra bits for a central/main identity?  It is important to recognize that no single alter is more real or significant that any of the others.  They are all parts of the same whole. 

Fourth, is the character relatable?  Are all the alters well-rounded and realistic? 

DID in the Media 

One of the most common and most serious misconceptions that the horror genre frequently perpetuates about DID is the idea that there is such a thing as a “bad alter.”  Within a DID system, each alter has a role that it performs to help protect the person with DID.  One alter is responsible for day-to-day living, while another might be responsible for holding on to certain trauma memories that would make day to day living extremely difficult.  One alter, called a persecutor, may mimic abusers or other people who have caused trauma to the system in an attempt to keep the system from re-experiencing the abuse.  When horror movies depict a person with DID as being dangerous to others, they typically do so with a severe misrepresentation of what persecutor-alters are and what they do.  The vast-majority of the time, if persecutors cause harm, it is towards the person with DID themselves and not other people.  DissociaDID, another system that posts education videos about DID on YouTube, has a video that is helpful in understanding alter roles, persecutors, and how they function within a DID system. 

Films like Split and Glass are extremely harmful to the DID community, because they glamorize the idea of a “bad alter” and depict people with DID as being villains or monsters, which is far from the truth.  These two movies involve a character with DID named Kevin Wendell Crumb, who has a bad alter named “The Beast” that has super-human abilities and wants to get rid of the “impure” people of the world.  In Split, the other alters in the system kidnap girls and watch over them until The Beast comes out.  To say that DID is depicted in an unrealistic way is quite an understatement. 

For many people in the general population, their only exposure to disorders such as DID is through the media.  When so much of the representation is riddled with harmful, fear-inducing inaccuracies, people who see that representation start to view people with those disorders in real life as being inherently dangerous or violent.  This is why quality and accurate representation is so important. 

The symbol for handicap parking in yellow paint on black pavement.
handicapped zone parking spot symbol on asphalt New Zealand. Source: Mr. Thinktank, Creative Commons

The Connection to Human Rights 

As we continue to push for more representation in popular media for marginalized communities, we must also make sure that that representation is accurate and not harmful to those communities.  When horror movies use people with disabilities in their attempts to scare their audience, they create/reinforce a belief that people with these disabilities in the real world are dangerous and scary.  This is a human rights issue, because prejudice, discrimination, and violence are fueled by fear.  Fear impacts who parents will let their children play with, and how children treat their classmates. This can interfere with one’s access to their right to an education, which is established in Article 26 of the Universal Declaration of Human Rights (UDHR). Fear affects how we interact with people we pass by on the street and people’s willingness to help find ways to improve people’s life experiences.  This can impede one’s access to their right to be an active part of their community (Article 27) and their right to seek employment and have favorable working conditions (Article 23). 

Non-disabled people need to use the privilege they have to advocate for those without it, and a person is less likely to want to advocate for someone who they are afraid of.  In order to have the basic human rights of all people fulfilled, we need to all be able to look at each other as members of humanity, and fear, especially unjustified fear, inhibits that. 

Conclusion 

I’m not going to lie or try to pretend that I have never let these kinds of portrayals of people with disabilities change the way I look at them.  Thankfully, I know better now, but there are still moments where I catch myself briefly slipping back into old ways of thinking.  It is important that we as consumers of media recognize the harm that these failed representations of an already marginalized group have caused and that we do our best to avoid supporting them monetarily.  We need to increase awareness of this harm, in hopes that, one day, the horror genre will no longer be made up of so many destructive stereotypes.   

Rather than the same stereotypically use of people with disabilities as the antagonists in film, why not increase their representations as protagonists?  Imagine, a horror movie where the protagonist is a person with DID, whose alters all work together to survive while also dealing with the memory loss that often comes with the switching of identities.  The film A Quiet Place is a brilliant example of positive and constructive disability representation.  One of the main characters is a young deaf girl, and her disability ends up saving her family.  In a world where making noise is a deadly act, their knowledge of sign language allowed them to communicate without risking their lives.  This is in complete opposition of the stereotypical idea that people with disabilities are burdensome for their loved one.  The makers of the film clearly did their research and were able to help spark important conversations about disability representation. 

Postpartum Depression Needs Serious Attention

by Marie Miguel

a picture of a new mother and her sleeping newborn
Mother & newborn sleeping. Source: David J Laporte, Creative Commons

Maternity leave is necessary because it helps with postpartum depression 

In the United States, maternity leave is almost non-existent. New parents in the U.S. get an average of three months of maternity leave, and some only get the twelve unpaid weeks of leave that employers are now required to offer under the Family Medical Leave Act. https://www.dol.gov/general/topic/benefits-leave/fmla  Depending on where you work and how long you’ve worked for a company, you may not receive any paid maternity leave at all, which can cause a high level of stress for low-income parents and families. According to a study at the University of Maryland, longer maternity leave decreases the risk of postpartum depression. It’s suggested that this is because women can spend more time with their infants, and this is not surprising; if you don’t have the bonding time with your child that you need, it’s going to be depressing for you. You feel like you have to leave your child preemptively, and that’s not fair. Healthcare providers and policymakers need to think about how we can foster a more positive experience with maternity leave and help women get the care that they need. It’s essential that we think about maternity leave as being a preventative measure for postpartum depression.

Postpartum depression is serious

Postpartum depression is a severe mental health condition. Many women go undiagnosed with this mental illness because they unknowingly downplay their emotions to their mental health providers or general practitioners. Postpartum depression is a severe condition, and it needs immediate attention from a medical provider. It’s normal to be emotional after having a baby. But, there’s a difference between feeling down and having PPD. When you have a baby, it’s a huge life transition. You’re now responsible for taking care of a new life. Many moms have a difficult time with this change, and if you’re feeling overwhelmed, sad, or a variety of emotions after giving birth, that’s understandable. It’s when your feelings feel out of control that you need to worry whether or not you have Postpartum Depression. We’ll go over the symptoms of the condition, and you’ll see if you relate to them. 

Postpartum Depression is not the baby blues

Postpartum depression is not just “the baby blues,” which affects up to 80% of new mothers. Postpartum depression affects childbearing individuals more severely. When you have PPD, it makes it nearly impossible to function. You feel severely depressed, hopeless, and scared. When a baby is born, you can have extremely intense emotions as a mother, which are frequently caused by changes in your hormone levels. Hormones make your experiences feel more powerful than they would ordinarily.  You may be prone to crying or insomnia that occurs even after your baby is asleep, for example. Symptoms that can be considered part of the “baby blues” include mood swings, irritability, anxiety, and trouble sleeping. Postpartum depression, on the other hand, is a diagnosable disorder that exists as a potential side effect of giving birth. Unlike the baby blues, which is categorized by minor dips in mood, postpartum depression can be severely debilitating. Postpartum depression requires treatment, so if you have this condition or think that you might have it, don’t ignore it. 

Symptoms of postpartum depression

The symptoms of Postpartum depression leave a mother feeling like she can’t cope with everyday life. You may be wondering what they are. The signs and symptoms of postpartum depression include severe mood swings, depression or depressed mood, feeling overwhelmed, not being able to sleep, feeling hopeless, fearing that you aren’t a good mother, restlessness, severe anxiety, inability to focus or think clearly, feeling worthless, thoughts of death or suicide, and intrusive, disturbing thoughts of harming yourself or your baby.

Postpartum psychosis is another condition to look out for and seek treatment if you think you have it. With postpartum psychosis, you may experience excessive thoughts about the baby, hallucinations or delusions, excessive energy or agitation, paranoia, and self-harm. If you believe that yourself or a loved one is experiencing postpartum psychosis, it’s vital that you seek treatment immediately. 

What can we do as a society?

We need to take a stand as a society to help new mothers, and if we can prevent Postpartum depression, One of the things that we can do to help new mothers is to advocate for longer maternity leaves. Allowing new mothers to spend more time with their babies can prevent postpartum depression. In a society that’s so focused on productivity and getting back to work, one of the most important things that we can do to prevent postpartum depression is to push for employees to offer additional time for maternity leave. We want to spend time with our children; that’s only natural. If we’re not able to do that, of course, we’re more likely to experience postpartum depression, but it’s important to note that no new parent is immune to developing it. It’s nothing to be ashamed of, and it’s not your fault. Certain risk factors, such as family history or personal history of mood disorders, financial problems, unwanted pregnancy, and more, can increase a person’s likelihood of developing postpartum depression

Getting help for postpartum depression

If you feel that you may have postpartum depression or if you’ve been experiencing symptoms of postpartum depression for over two weeks, it’s essential to schedule an appointment to talk to your doctor. Treatment for postpartum depression most often includes medication, if you need it, and most importantly, therapy. You can choose to see a traditional therapist or work with online therapy. New mothers can have the added challenge of trying to get out of the house, making it hard to get mental health treatment. Online therapy provides a forum to get therapy in the privacy of your home. A new mother may not have the energy to get out of the house to go to therapy. Online therapy can be an excellent resource for new mothers to get mental health treatment, prevent PPD or treat it. You can see a counselor with your partner or has individual therapy. Whatever your preference, it’s essential to seek treatment for PPD.

 

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

Asking For Help When You Have A Mental Illness

** The mental health relationship between public health and human rights is often misunderstood. Humanity can begin to see the underlying and overarching interconnections among poverty, its relation to lack of health insurance and untreated mental health issues, and individual and public safety. This blog seeks to provide insight and resources that help bridge the gap and offer solutions that remove stigma and shame. – AR

by Marie Miguel

a picture of someone reaching out to help
Help. Source: Leo Hildago, Creative Commons

It’s difficult to ask for help when you’re suffering from the symptoms of mental illness, whether that be depression, PTSD, Schizophrenia, Bipolar Disorder, or Anxiety. Sometimes, mental illness can leave you feeling hopeless and at the mercy of your symptoms. Some people have a great ability to see outside of their symptoms and ask their support system for help, but there are challenges when getting help for mental illness. We will explore what it takes to acknowledge that you have an issue and get the help that you need in this article. 

Acknowledging that you need help

It’s difficult to admit that you need help when you have a mental illness. Here’s an example of where someone with mental illness Let’s say that you’re living with Bipolar Disorder, and you’re in an episode of mania. You’re spending lots of money, engaging in risky behavior, and you find that your life is out of control. Your friends are put off by your excessive spending habits and your wild behavior that’s out of control. You know that you have a problem and you don’t know how to ask for the help that you need because you’re in the midst of a manic episode. What do you do? Well, you reach out to a loved one first, and say: “I need help.” they might not know how to help you, but at least you’re admitting that there is a problem, and trying to get the help that you need starts with talking about the issue. They might not have a solution, but it’s time to admit that there’s something that you have to address. Next, maybe you and your loved one go to your doctor and discuss the issues. That’s assuming that you have health; this is all the optimal scenario. Then, your doctor refers you to a psychiatrist, who can treat your symptoms, and you find a therapist that works together with your psychiatrist. So, this is an ideal scenario in which you have insurance, you have a support system, and you find the mental health providers that you need. Not everybody is so lucky, and we need to see how those who don’t have access to good healthcare fare in our system. 

When you don’t have resources

Let’s examine the same scenario when you don’t have appropriate resources. So, let’s say that you have Bipolar disorder, you’re going through a manic episode, and you’ve alienated your friends and family. There’s nobody to reach out to for help, and you don’t have insurance. How might you feel? Isolated. You don’t know what to do or who to turn to for help. These are the things that we have to think about in terms of getting people with mental illness help because sometimes, the symptoms of mental illness are destructive and you end up alienating those who can help you. So if you notice that a friend or family member is doing something self-destructive, it’s one thing to be angry with them and another thing to have compassion. If you can, even if they’re acting in a way that’s not kind, try to get them the help that they need because, in a way, the person may be crying out for it even if they’re cruel in the process. Now, don’t put yourself at risk or in harm’s way – there are times to draw boundaries with people if somebody is acting in a that is unsafe and they intend to harm themselves or others. If somebody is suicidal, for example, it’s time to get them to a hospital because you won’t be able to provide them with the help that they need. Many times, it’s about finding the right resources. Some people don’t know where to find the right resources for their problems. The problem is that sometimes there aren’t enough resources available.

The resources need to be there

If you have insurance, use it. One of the things that we have to remember is that even if you have a mental illness, it doesn’t make you powerless. You can, if you have insurance, look for a provider to help you with your mental illness, whether that’s PTSD, Bipolar Disorder, Schizophrenia, or Anxiety. Find a psychiatrist who’s able to talk with you about your symptoms and get you help. So, that’s one thing that you can do, and speak with your psychiatrist and find a treatment plan that works for you. Have your psychiatrist and therapist work together and understand that a treatment plan takes time to develop. You’ll be able to figure out what your treatment plan is over time and get better. 

Creating resources when there are none

There are instances where people cannot get help because there’s overcrowding in hospitals or they can’t find a provider that takes their insurance that doesn’t have a five-month-long waitlist. It can happen to people that have “good” insurance. So what do we need to do as a society to create more resources so that people can get the help that they need? Well, one thing is, we need to train more therapists. So, we need to understand that and value the jobs of mental health professionals. One resource we can use is online therapy. It is affordable, and it is accessible to many people. Some people don’t have the luxury of choosing from a plethora of therapists. 

Online therapy

One alternative to traditional face-to-face therapy is online therapy. Online therapy is an excellent space for people that have a mental illness to get the support that they need affordably from the privacy of their own home. Companies like BetterHelp are an excellent place for people to find a therapist that they can talk to and feel comfortable sharing their problems with so that they can get better. Our world is changing, and technology can be used for good. Let’s try to make space for people who have a mental illness to get the support that they need. Everyone deserves access to quality healthcare, which includes their mental health.

 

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

PTSD is Not Just for Veterans; It’s A Trauma Disorder

by Marie Miguel

a photo of a man, on a train, wiping tears from his eyes
Sadness. Source: Matthias Ripp, Creative Commons

Some people believe that PTSD is only a mental health condition that affects those who have come back from war, but this isn’t the case. People who have Post Traumatic Stress Disorder aren’t just veterans. Individuals with PTSD have experienced severe trauma. It’s not only people that come back from combat, but that’s how many of us associate the disorder. PTSD can happen to anybody who experiences trauma such as a sexual assault, a natural disaster, or many things that would prompt someone to have a traumatic reaction, so let’s stop talking about PTSD as though it’s something that only war veterans experience. Anyone who has been through a traumatic experience can develop PTSD. According to the National Alliance on Mental Illness (NAMI), PTSD affects 3.5% of the U.S. adult population. That works out to eight million American people living with the condition. Approximately 37% of people diagnosed with PTSD display serious symptoms. Women have higher rates than men. Later in this article, we’ll discuss the gender divide.

What is Post Traumatic Stress Syndrome?

Post Traumatic Stress Syndrome happens after a person experiences trauma, and it’s something that sticks with a person. Symptoms can include flashbacks, night sweats, insomnia, panic attacks, and isolating from friends and family. We need to understand that people with PTSD aren’t dramatic; they’re traumatized. When you experience trauma first-hand it changes your brain. According to the U.S. National Library of Medicine – National Institutes of Health, Several areas of the brain are involved when a person experiences PTSD. A stress response includes the amygdala, hippocampus, as well as the prefrontal cortex. PTSD and trauma can cause lasting changes in those areas of the brain.

What causes PTSD?

The cause of PTSD is that a person experiences trauma and never adequately deals with the issues because it sticks with them. People think that PTSD is caused by being in combat because combat can be a traumatic experience, especially if you see someone die in front of you. The cause of PTSD is when an individual has difficulty adjusting after a traumatic event; their brain changes and the memory of the traumatic event gets stuck in their brain. These intrusive memories make it difficult for an individual to function. The root cause of PTSD is a traumatic event, but the symptoms are what overwhelm people to the point where it’s diagnosable. People with PTSD often have recurring distressing and upsetting memories of the trauma, and when you continually have upsetting memories and can’t stop them, it makes you want to shut down, which is a problem that many people face when living with PTSD, and it can seriously impact your relationships.

Causes of PTSD

  • A stressful experience
  • Trauma
  • Mental Illness
  • Predisposition to mental illness or family history of mental illness

Risk factors for PTSD:

  • Long lasting trauma
  • Childhood sexual abuse
  • Other childhood trauma
  • A job where you’re exposed to trauma such as a military position
  • If you don’t have a sound support system
  • Seeing someone get hurt
  • A history of substance abuse

Types of trauma

When we think of PTSD, we might think of combat, but it’s not just that. Anyone who has experienced trauma is at risk of developing PTSD. Whether you witnessed a violent act or you were physically attacked yourself, you’re at risk for PTSD. In addition to combat, types of trauma that can induce PTSD include but aren’t limited to:

  • Childhood sexual abuse
  • Other childhood trauma
  • Sexual assault or violence
  • Physical assault
  • Natural disaster
  • Being attacked with a weapon

Symptoms of PTSD

Symptoms of PTSD can range from mood symptoms to physical symptoms. These symptoms can include but aren’t limited to nightmares, irritability, being easily startled or frightened, trouble sleeping or concentrating, or even feeling completely emotionally numb. These symptoms occur after a traumatic event and are only some of the possible signs that an individual could experience. Everyone reacts to trauma differently. And it’s understandable that someone may shut down, lash out, or break down crying. These are all responses that could happen.

How intense are your symptoms?

Depending on the person, the intensity and type of PTSD symptoms will differ. If you have suicidal thoughts or ideation, it’s incredibly crucial to reach out to a friend, loved one, or to contact the national suicide prevention hotline (1-800-273-8255 or 1-800-273-TALK in the United States.) It’s essential that you talk to your doctor if you’re experiencing difficulty functioning.

Complications of PTSD

PTSD can impair someone’s function to the point where they’re unable to engage in normal life activities. Someone might develop substance abuse issues, an eating disorder, or other comorbid mental health conditions. PTSD can be debilitating. It can lead people into a state where they can’t work. It can make it so that they’re unable to attend social functions, and it can severely impact a person’s life. If you’re diagnosed with PTSD, you need to have the following symptoms:

One avoidance symptom – Avoidance is where you’ll stay away from things that remind you of the trauma. Avoidance symptoms include avoiding places and situations that remind you of the trauma, and avoiding thinking about upsetting thoughts connected to the event

At least two arousal symptoms– Arousal symptoms of PTSD make a person extremely anxious. Arousal symptoms include:

  • Getting startled easily
  • Feeling tense
  • Having problems sleeping
  • Angry outbursts

At least two cognition/mood symptoms – Cognitive symptoms of PTSD can rob people of things they once enjoyed. Cognitive symptoms include difficulty remembering the trauma, distorted emotions including guilt, and loss of interest things you once enjoyed

One re-experiencing symptom – Re-experiencing a key marker of PTSD, and it sounds exactly like what it is; re-experiencing. Re-experiencing symptoms include flashbacks or reliving the trauma, nightmares, or scary thoughts.

a lone little boy sitting on a platform
Source: John Smith, Creative Commons

Children vs. Adults With PTSD

Children can have different responses to trauma in comparison to adults. They might wet the bed or have selective mutism, they might start acting out during play time, or they might begin experiencing separation anxiety. According to the National PTSD center, seven or eight out of every 100 people experience PTSD at some point during their life. Not every person who has PTSD has been through a dangerous incident; some people experience it after a loved one has suffered harm.

According to The U.S Department of Veteran Affairs Studies, approximately 15% to 43% of girls and 14% to 43% of boys experience significant trauma. Of the children and teens that experience trauma, 3% to 15% of girls and 1% to 6% of boys go on to develop Post Traumatic Stress Syndrome.

We can see that females seem to develop PTSD more than men do. What is the reason for this? Many women are survivors are sexual assault, try to speak up and aren’t believed. According to the National Sexual Assault Resource Center, one in five women and one in 71 men will be raped at any given point during their lives. Yet, we as a society do not believe survivors as we should. We need to start believing women when they come forward. When we do they can get treated for what happened to them appropriately.

Why do some people get PTSD and others don’t?

You may be wondering why some people develop PTSD while others do not. Part of it has to do with having the risk factors listed above, but there’s nothing wrong with you if you have PTSD and someone else in the same situation did not. There are other disorders that can go along with PTSD. An individual with PTSD can have additional mental health conditions. They may also struggle with suicidal ideation and may attempt to take their life. Here are some mental health conditions that people with PTSD also manage:

  • Generalized Anxiety Disorder
  • OCD
  • Depression
  • Borderline Personality Disorder
  • Substance Abuse

How to prevent PTSD

PTSD isn’t necessarily preventable because you can’t control when trauma happens, but you can deal with the trauma after it happens. After experiencing a traumatic event, it’s vital to seek mental health treatment in the form of therapy and, if you need to, a psychiatrist. You can reach out to people in your network and find someone to treat your symptoms. Whether you see someone online or in your local area, PTSD is treatable and even preventable if you address trauma right away. If you develop PTSD, it’s okay, and there’s no need to feel shame. It’s a treatable mental illness, and you’re not alone. Many people live with PTSD, and with support, you will get through this. It starts with getting help from a mental health professional, whether that’s working with someone in your local area or finding the help of an online counselor, like one at BetterHelp, you can find a treatment plan and get the help that you need to health from PTSD. You’re not alone, and remember that millions of Americans live with the condition. By going to therapy, you’re doing something incredibly brave, which is taking charge of your mental health. You will get better, but it’s going to take time. Be patient with yourself. Healing from trauma can be difficult, but it’s worth it.

 

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

Mindful Learning: Adding Meditation to Education

A girl sitting outside and meditating.
Girl Meditation. Source: Best Picko, Creative Commons

If you have ever struggled to fall asleep or dealt with significant anxiety or stress, you may have tried to calm down and relax yourself by listening to a guided meditation or yoga practice.  Data from the 2017 National Health Interview Survey (NHIS) found that 14.2 percent of American adult and 54. Child participants had practiced meditation in the previous 12 months.  The survey also found that 14.3 percent of adults and 8.4% of children had practiced yoga in the past year. Some schools have now seen the positive impact that meditation and yoga can have on children’s behavior and mental health and have decided to integrate these practices into their procedural structures.  Instead of sending children to detention or the principal’s office for traditional disciplinary methods, these schools have rooms designated for mindfulness and meditation.  This results in a complete shift in how both educators and students cope with behavioral issues and emotional struggles in the classroom. 

What Is Meditation? What Are the Benefits? 

According to the National Center for Complementary and Integrative Health (NCCIH), meditation is, “Meditation is a mind and body practice that has a long history of use for increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being.”  While there is no single method or rigid guideline for how to meditate, there are four main elements that most meditation methods include: an environment with minimal distractions, a comfortable posture (such as sitting or lying down), a focus of attention, and an “open attitude (letting distractions come and go naturally without judging them).”  In this context, yoga combines meditation with specific physical postures and breathing techniques. 

While there is still much research to be done on meditation and its impact on people, studies thus far suggest that it can help reduce blood pressure, aid in coping with anxiety and depression, improve sleep, reduce pain, improve ability to focus, and much more.  There is also research that suggests practicing meditation could lead to physical changes in the brain which support numerous aspects of mental and physical health.  For example, one study that was performed in 2012 compared brain images of 50 adults that did not regularly meditate and 50 adults who had been doing so for years.  The results suggest that the brains of those who had been practicing meditation had undergone gyrification, which means the outer layer of their brains had more folds, potentially increasing their ability to process information.  Another study from 2013 suggests that regularly practicing meditation may slow, stall, or reverse certain changes in the brain that typically result from aging.   

It should be noted that every individual’s relationship with and response to meditation can differ.  One person may work well with a certain meditation strategy, while another person might find that strategy extremely difficult or uncomfortable.  Some people who suffer from mental health issues, such as anxiety, may find that certain forms of meditation make them more anxious.  Some people may have physical limitations that prevent from sitting on the floor, which is a common posture for many meditative practices.  It is a very personal experience and should not be treated as one-size-fits-all. 

Children learning yoga outside.
Learning Yoga. Source: Amanda Hirsch, Creative Commons

How is Meditation Being Implemented in Schools? 

In 2013, Robert W. Coleman Elementary School of West Baltimore created the “Mindful Moment Room,” a space used for meditation and yoga.  This is where students are sent when they are being disruptive in class or aggressive with their classmates.  The space is warm and inviting, smelling of essential oils and decorated with pillows and yoga mats.  Here, students who are feeling angry or frustrated can have an opportunity to breathe and do activities like yoga and meditation to calm down.  The Holistic Life Foundation is the nonprofit that helped the school to establish and run the Mindful Moment Room.  The staff helps students talk about why they had to leave class and guides them through mindfulness exercises.  Mindfulness in not limited to being encouraged when students are misbehaving.  Students listen to a 15-minute guided meditation over the intercom at the beginning and end of every school day and can practice yoga both during and after school. 

Not only is this beneficial in helping kids work through problems at school, but it also helps them build skills that can help them to cope with strong negative emotions in the future.  The students themselves have been able to recognize the benefits they have experienced from practicing mindfulness.  Dacari Crawford, a third-grader at Robert W. Coleman, said, “When I get mad at something or somebody, I just take some deep breaths, keep doing my work and tune everyone out.  It gives you good confidence when you need to do something important.”  Inspired by the impact mindfulness practices have made on the elementary school, Patterson High School has started its own Mindful Moments Room. 

A Mother’s Testimony 

Dana Santas, a yoga trainer to many professional sports teams, was invited write an article for CNN discussing her experience of guiding her three children (the youngest of which being on the autism spectrum) through yoga.  In her experience she has found three main reasons why mindfulness-practices like yoga and meditation should be taught in school:   

The first is “teaching breathing as fundamental to well-being.”  She points out that the impact that breathing has on us is not as simple as the fact the we cannot live without breathing.  Our breathing patterns, our postures while breathing, and the way we breathe in general impacts both our mental and physical health in ways that are hard to notice if we do not know to look for them.  This be related to things like the basic mechanisms of breathing or using breathing to calm down when one is overwhelmed.  Santas developed a breathing exercise called “peace palm exhaling” to help her son with Asperger’s syndrome when he becomes overwhelmed.   

The second reason is that yoga can help children “move with control and confidence” because it can help them gain self-control and respect for their own bodies and improve their balance and movement abilities. 

The final reason she discusses is that yoga can promote the power of mindfulness, helping children to learn skills that they can use to cope with anxiety and stress. 

How Does Mindfulness Impact Human Rights? 

One significant impact that the use of meditation and mindfulness in schools has on human rights is that it helps to improves students’ ability to access and fully utilize their right to an education.  The right to an education is recognized in Article 28 of the Convention on the Rights of the Child (CRC) and Article 26 of the Universal Declaration of Human Rights (UDHR).  Article 26 of the UDHR also recognizes the right of every person to an education that works towards the full development of their personality, and that right is also supported by meditative practices.  With fewer class disruptions, an improved ability to focus, and a calmer school-environment, students can spend more quality time learning and gaining knowledge that they can use in the future.  Practicing mindfulness also helps to create an environment that supports one’s health and well-being, which is recognized as a right in Article 25 of the UDHR and Article 24 of the CRC.  The impact that meditation and mindfulness can have on education and personal development can help a person better prepare for future experiences, helping them have better access not only to these rights, but also to their other rights as well. 

Our Rights Under Fire

by Pam Zuber

a photo of a gun store rack
and more guns. Source: Patrick Feller, Creative Commons.

The grim timeline:

  • On December 14, 2012, a gunman entered Sandy Hook Elementary School in Newtown, Connecticut. He killed twenty children, six adults, and then himself. The gunman also killed his mother earlier in the day.
  • On March 15, 2019, another gunman traveled to two mosques in Christchurch, New Zealand and opened fire. As of April 2019, he killed fifty people and wounded fifty more.
  • On March 21, 2019, New Zealand Prime Minister Jacinda Ardern announced that her country would ban sales of assault rifles beginning April 11, 2019, and reimburse people for returning rifles that they already owned. The country has also reclassified guns to make them more difficult to purchase.
  • On April 11, 2019, the United States still did not have substantial legislation against many types of weapons, even assault weapons that were once banned but were now legal.

Two countries, two tragic events, two very different approaches to gun ownership and legislation. What do the differences say about the two countries? What do the differences say about human rights? The shootings represent an egregious attack on human rights. Many victims in the Newtown attack were children. Many victims in the Christchurch attack were refugees and members of a religious minority. The attacks targeted some of the most vulnerable members of society. The shootings were also attacks on the greater society charged with protecting these vulnerable members.

Both shootings occurred in what should be safe spaces: schools and religious buildings. Advocates of gun ownership say that the Second Amendment of the U.S. Constitution supports their stance. It states: “A well-regulated militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed.” One can argue, though, that the Christchurch and Newtown victims experienced violations of the First Amendment of the Constitution. The mosque worshippers in Christchurch were expressing their religion, a First Amendment right. The children and adults in Newtown were exercising the “right of the people peaceably to assemble,” according to the words of the First Amendment.

While the dead and wounded people in New Zealand were not obviously U.S. citizens, they definitely experienced a violation of their human rights, if not technically a Constitutional one. Could the banning of assault-type weapons in that country help protect the rights of future New Zealanders? If the United States government does not issue such bans, is it violating its own citizens’ rights? Maybe. After all, commentators often cite that the National Rifle Association (NRA) is one of the major reasons why U.S. legislators cannot or will not pass major legislation against guns. The NRA is a U.S. organization that finances the campaigns of many U.S. politicians who oppose gun control. The NRA also encourages voters to vote for such candidates, making it a well-organized effort that exerts consistent pressure in favor of gun rights.

Wouldn’t it be better to divert our resources elsewhere? Money and time that the NRA and other organizations spend on campaigns to support gun ownership would arguably be better spent on mental health screening, treatment for drug and alcohol abuse, and other forms of preventative health care. Time and money that could be better spent on law enforcement efforts that look for potential trouble instead of reacting to it after it occurs. This is not to say that all shooters struggle with their mental health and that governments should track our every move. But, “weaknesses and lapses in the educational and healthcare systems’ response and untreated mental illness” contributed to the “deterioration” of the shooter in the Newtown attack, according to the Connecticut Office of the Child Advocate. The shooter in the Christchurch attack live streamed the attacks and may have posted his intentions on social media before he carried out his plans.

a photo of a large gun
gun. Source: skyandsea876, Creative Commons

New Zealand’s new laws are in line with regulations in other countries. Well-known for not participating in armed international conflicts, Switzerland also has strict rules about gun ownership. The country requires its male citizens to serve in its military. Sometimes Swiss men keep their weapons after their service, but this number has been decliningSwiss laws do not allow people to own firearms if they are struggling with drug or alcohol abuse or have been convicted of a crime. The country has laws that require people to obtain gun permits and typically only grant concealed weapon permits for police or security officers. Authorities in Swiss regions known as cantons determine if people are fit to own guns. They may talk with psychiatrists or authorities in other cantons to make such decisions. They also keep records of who owns guns in their cantons, although some semiautomatic long guns and hunting rifles are exempt from such records.

Switzerland had a population of approximately 8.5 million people and twenty-six cantons in a country of about 16,000 square miles in March 2019. The United States had a population of approximately 329 million people and fifty states in a country of about 3.8 million square miles in March 2019. It also has a federal district and various territories. Gun laws already vary widely in the fifty U.S. states, territories, and the federal district. Given the large population and geographic size of the United States, delegating the states to create and implement new gun laws may not be possible. Federal legislation would be more feasible to regulate weapons in the United States.

Another country, New Zealand’s neighbor Australia, may be a good example of federal weapon legislation. After a gunman killed thirty-five people in the Australian island state of Tasmania in 1996, the federal and state governments of Australia implemented a number of weapons ban from 1996-98. Under the Australian laws

  • Licenses and registrations are required to own weapons.
  • Police must determine whether people have satisfactory reasons for owning weapons.
  • Private firearm sales are prohibited.
  • People may not own weapons for self-defense and very few may own handguns.
  • Semiautomatic weapons are banned. Like New Zealand, the Australian government bought such weapons from private owners.

Australia’s gun control laws have produced dramatic results. While there were thirteen mass shootings in Australia from 1979 to 1996, there were none from 1996 to 2006. In 1979 to 1996, Australia witnessed an average of 627.7 firearm deaths every year. From 1996 to about 2003, Australia witnessed 332.6 firearm deaths annually. The country also experienced declines in firearm suicides, firearm homicides, and unintentional firearm deaths after the passage of the laws.

Limiting semiautomatic and assault weapons and passing stricter gun control legislation may mean fewer deaths. Australia and Switzerland know this. New Zealand may learn this. Given the reluctance of U.S. authorities to take such measures, it doesn’t look like the United States will learn this any time soon. If it doesn’t, more senseless firearm tragedies like Newtown (and Parkland, Las Vegas, Orlando, Christchurch, and so many other places) may occur. Until the United States limits and legislates guns, its citizens’ rights to peace and safety are in peril.

 

About the author: Pamela Zuber is a writer and an editor who has written about human rights, health and wellness, business, and gender.

Getting a Mental Detox in Rwanda

This Sunday 7 April is the International Day of Remembrance of the Victims of the Rwandan Genocide. 

Photo by Carmen Lau.

I decided to study the Rwandan genocide after attending the  Institute for Human Rights conference entitled, “Bystanders and Complicity in Nazi Germany and the Jim Crow South.”  Rwanda, viewed as a trophy of the African “mission field” by many in Western Christianity, shocked many onlookers in the period during and after the genocide as it became obvious that Christians had killed Christians.  Moreover, many estimate that most Rwandan Genocide victims were killed in churches, an assertion that stimulated my interest.  The Rwandan Genocide differs from other genocides because religion did not serve as a demarcation to target victims as “other.” Most people in Rwanda identified as Christian, and the religious affiliation did not coincide with ethnic identity.

Last summer, I tagged along with a group of teachers and professors who were passionate about using education to prevent genocide.   This was a first step in developing my thesis:  Stories from Rwandan Churches Priot to the Genocide: A Collection of Oral Histories. The travel group knew one another from collaborating with the Holocaust Museum, and they held great affection and esteem for  Carl Wilkens, our group leader. Wilkens backstory, as described on his website, is this:

As a humanitarian aid worker, Carl Wilkens moved his young family to Rwanda in the spring of 1990. When the genocide was launched in April 1994, Carl refused to leave, even when urged to do so by close friends, his church and the United States government. Thousands of expatriates evacuated, and the United Nations pulled out most of its troops. Carl was the only American to remain in the country. Venturing out each day into streets crackling with mortars and gunfire, he worked his way through roadblocks of angry, bloodstained soldiers and civilians armed with machetes and assault rifles in order to bring food, water and medicine to groups of orphans trapped around the city. His actions saved the lives of hundreds.” 

With this experience, one might not be surprised that Wilkens has chosen to position himself as a force for peace and as a catalyst to stimulate people to seek to become integrated beings with emphasis on respect, empathy, and inclusion.

I had expected to cultivate empathy and understanding and to gather context and information, but I had not considered the idea that this trip with teachers would provide space for some mental detox. I had heard Rwanda described as a country with gorillas and genocide, but I saw a place where the government exceeded expectations in the context of health care and infrastructure.  Ranking among the 20 poorest countries in the world, Rwanda is a place of paradox. When our group gathered in the small white bus outside the Kigali Airport, I first sensed that this would be different than I had expected. Carl Wilkens presided over our discussion as we rode to the hotel that would be our home for the next 11 days. Wilkens urged us to harness the power of gratitude to rewire neural circuits and reminded us that since negative thoughts stick like Velcro, one must intentionally attend to the task of noting the positive.

Photo by Carmen Lau.

Early on the first day, to fulfill Wilkens’ charge, our designated facilitator, a teacher from Nebraska, urged us to think about “The Good Life,” the motto for her home state. As the group shared visions of a good life, I noticed that already, just twelve hours in Rwanda, we had erased default notions of acquisition or competitive achievement as core building blocks in “The Good Life.” Instead, people cited nature, learning, and human connectivity as the essence of a good life.

Gratitude underpins the curriculum for Mindleaps, a thriving multinational NGO designed to empower children who come from the most impoverished homes. Mindleaps collaborates with the Gisimba Training Center, a repurposed orphanage that was featured in Wilkens’ book, I’m Not Leaving. This was our first stop on the Carl Wilkens Tour. Once a child is accepted to Mindleaps, she has the opportunity to have a noon meal, wear a special uniform, receive school supplies, learn digital literacy (as an enticement to learn English), attend academic enrichment classes, and have her mother participate in a parenting-strengthening program (fathers are often away seeking work). Oh, and the best part is the child learns to dance very well. Dancing gives the children confidence and a sense of personal achievement that will be key to developing skills to thrive.

I visited the home of a seven-year-old student who regularly walks alone to Mindleaps — a three-quarter mile jaunt down a hilly tangle of dirt roads that are jam-packed with huts. Her home has no electricity or plumbing and only a patchy tin roof. Her mom comes to the parental-enrichment class regularly. The strategies used by Mindleaps are being tested by a tracking software program to provide a nuanced evaluation of the children in the areas of memorization, language, grit, discipline, teamwork, self-esteem, and creativity. For me, the visit to the Mindleaps gated compound was a transcendent experience. I saw excellence, bright colors, simple food, and a tidy vegetable garden. A swarm of smiling students wanted to touch and thank each one in our group.

Holistic, abundant living combines heart and head. So far, this time in Rwanda has allowed me to peel off barnacles of language and worldly possessions and notice feelings of gratitude and love. Watching the children and teachers leap in grand plié’s to Leonard Cohen’s “Hallelujah” consolidated my embrace of Rwanda’s Mental Detox. Rwandans have embraced the ethos of gratitude. The security detail at the entrance to the parking lot of Hotel Des Mille Collines paused from the task of pushing mirrors on long handles under incoming Land Rovers (to check for bombs) and greeted our group of pedestrians on foot.  He said, “Thank you for visiting our hotel.” Street merchants, airport personnel, gardeners, cooks, and administrators said variations of “Thank you for visiting our country.”

As the old saying goes, “You won’t remember what they said, but you will remember how they made you feel.” In Rwanda, I feel loved and appreciated.

 

 

 

Health Care Is a Human Right

by Pam Zuber

a photo that reads "Save the ACA."
“Save the ACA”. Source: Creative Commons.

Being sick or struggling with a chronic medical condition can harm health, emotions, and finances. Sickness can hurt various aspects of a person’s life and impact society as well. It causes people to miss days of work. It creates financial costs if people have to cover medical expenses for uninsured people. Isn’t it better to help treat and prevent illness in the first place? One would think so, although some people don’t believe that health care is a fundamental right. But, restoring and maintaining health improves the quality of life and so much more. Ensuring proper health care can produce a healthier, happier, and more productive society.

What are some federal government attitudes about health care?

Attitudes about health care are different in different areas. There are many diverse opinions and proposed solutions regarding health care in just the United States alone. The Patient Protection and Affordable Care Act (also known as the Affordable Care Act, the ACA, and Obamacare) represents a microcosm of this diversity. Although it became law in 2010, the Affordable Care Act has garnered considerable controversy before its creation and continues to generate controversy after its passage. Much of this controversy has coalesced around party affiliations. Some members of the Republican Party have decried the ACA a form of socialism because it’s a federal government program that works with state government programs. In this view, the ACA is un-American because other countries sponsor their own state-funded health care programs.

While not a socialist state, Canada is one such country. According to a Canadian federal government website, “Canada’s publicly funded health care system is best described as an interlocking set of ten provincial and three territorial health systems. Known to Canadians as ‘medicare,’ the system provides access to a broad range of health services.” Canada’s federal government funds, administers and sets policies for this system under legislation known as the Canada Health Act (CHA). The goal of the CHA is “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers,” according to the Government of Canada. The CHA thus features complex interactions between federal and provincial governments and the Canadian health care system. This is reminiscent of how the U.S. federal government administers and funds government programs in U.S. states as part of the Affordable Care Act.

How is New York approaching health care?

Federal governments aren’t the only government bodies that feel strongly about health care. In January 2019, the administration of New York, New York mayor Bill de Blasio announced that the city would offer health care for uninsured residents. City residents would pay for health services on a sliding scale. Known as NYC Care, the initiative would provide mental health care and substance abuse care. “We recognized that obviously health care is not just in theory a right,” de Blasio said. “We have to make it in practice a right.” “Health care is a right, not a privilege reserved for those who can afford it,” stated the mayor. “While the federal government works to gut health care for millions of Americans, New York City is leading the way by guaranteeing that every New Yorker has access to quality, comprehensive access to care, regardless of immigration status or their ability to pay.”

Stories about the de Blasio proposal highlighted that this health care would be available to all New Yorkers, even undocumented immigrants. This proposal occurred at a time when immigration was a hotly contested topic. In fact, immigration was so contested that the topic helped spark a partial shutdown of the U.S. federal government in December 2018 and January 2019 because of debate over funding for a wall between the United States and Mexico to prevent illegal immigration. The de Blasio administration’s decision to fund health care for undocumented immigrants reflected the view that health care should be universally accessible to all, regardless of financial cost or political repercussions. In this view, health care is a human right and the right thing to do.

Why is healthcare a right?

Health care is a human right in part because health – or more accurately, bad health – can permeate every area of a person’s life. It can even have repercussions far beyond a single individual. Say a person is struggling with depression. Depression is a mental illness. It’s also physical one since depression can cause pain, other physical symptoms, or conditions such as substance abuse. (Pain and other conditions can cause depression as well, which underscores the importance of treating mental and physical illnesses so they don’t influence each other.) Depression is more than mental and physical pain. It can wreak havoc on other areas of people’s lives. For example, conditions such as depression may prevent people from going to work. If people take frequent absences, their coworkers may have to perform work extra work to compensate for their absent coworkers. Or, taking frequent absences could lead depressed people to lose their jobs. Losing their livelihoods means people may have trouble paying for food and shelter. People without jobs may not be able to support their families. People who are depressed may lack the physical and mental energy to attend parent-teacher organization meetings, to vote, to run for office, to manage their lives, or to contribute to the lives of others. They can’t fully exercise their human rights because they’re struggling to meet their basic needs. Basic access to mental health care could prevent these struggles and ensure basic rights.

What is the status of current health care initiatives?

It’s clear that spending a little money early may prevent future health problems (and possibly save money) in the long run. But, it appears that some entities don’t want to spend money on such purposes. Others have reluctantly, grudgingly accepted health care initiatives. In 2017, the U.S. Congress passed the American Health Care Act (AHCA). This legislation would have prevented Medicare expansion and other aspects of Medicare funding and would have reduced taxes for some insurers and higher income people. The legislation never took effect, so the ACA remained intact. Commentators have noted that despite efforts to reverse the Affordable Care Act, the ACA is “gaining in popularity – despite the repeal-and-replace rhetoric Trump and fellow Republicans have voiced for years.” The commentators note that politicians realize this and are using the increasing acceptance of the program to bolster their own political fortunes. They recognize that gutting a popular program could hurt their own popularity. The administration of U.S. president Donald Trump issued rules regarding the implementation of health care programs in U.S. states in 2018, for example. This acknowledged that the programs exist, serve many people, and are well-liked and well-used by voters who could determine the political future of the administration and its members. The administration’s rules vividly illustrated the old adage, “If you can’t beat ‘em, join ‘em.”

What is the future of health care?

The future of universal health care is uncertain. On one hand, the Affordable Care Act continues. Conservative administrations and everyday voters have acknowledged the ACA and support it to various degrees. There is still considerable pushback to the ACA and similar initiatives, however. Not surprisingly, some of this pushback is from entities that could be affected by universal health care plans or other health care reforms. Private insurance companies often oppose universal health care reforms because they could affect their profits. The companies and other free-market supporters say that universal health care and other reforms are a direct rebuke to capitalism and the practice of small government. The Partnership for America’s Health Care Future is one such opponent. This organization includes a number of private insurance companies and health-related entities. Interestingly, though, it also includes a number of politicians from the Democratic Party and people affiliated with the party, such as workers from the presidential administrations of Bill Clinton and Barack Obama.

On the other hand, this organization is operating at a time when other Democrats are criticizing their fellow party members for not being progressive enough. A number of Democratic candidates running for the U.S. Congress in 2018 supported a single-payer health care system known popularly as Medicare for All to replace private health insurance. A Reuters poll in that same year reported that growing numbers of voters affiliated with both the Democratic and Republican parties also favored Medicare for All-type policies. A growing number of people and some politicians support universal health care. Other politicians and private corporations don’t. Given the increasingly divided political climate, it’s uncertain whether we’ll reach workable decisions about health care any time soon. But, given the far-reaching impact that good health can provide, aren’t they worth a try?

 

Pamela Zuber is a writer and an editor who has written about human rights, health and wellness, business, and gender.

 

The Impact of Child Abuse

A sad boy sitting outside and staring into the camera.
Sad. Source: tamckile, Creative Commons

Childhood is a time in life that should be filled with joy and imagination, and free of fear and any serious responsibility.  However, for many people, this not their reality, as abuse and trauma have warped their experience of it.  In 2014, about 702,000 children were found to be victims of some form of abuse in the United States – this number does not take into account situations of abuse that went unreported.  It is estimated that 1,580 children died “as a result of abuse and neglect” in that same year, though it is possible that this number is actually much higher due to “undercounting of child fatalities by state agencies.”  The general impact and potential trauma caused by abuse can have a significant harmful influence throughout childhood development and adulthood.

What is Child Abuse?

Child abuse is “when a parent or caregiver, whether through action or failing to act, causes injury, death, emotional harm, or risk of serious harm to a child.”  This includes many different forms of abuse, such as physical abuse, emotional abuse, sexual abuse, and neglect:

  • Physical abuse is “when a parent or caregiver causes any non-accidental physical injury to a child.”
  • Emotional abuse, which is recognized less often, is “when a parent or caregiver harms a child’s mental and social development or causes severe emotional harm,” and can include (but is not limited to) isolating a child, terrorizing, ignoring, and humiliating them.
  • Sexual abuse is “when an adult uses a child for sexual purposes or involves a child in sexual acts,” but it does not have to involve physical contact with a child. In addition to “contact abuse,” it can also include inappropriate sexual language, “making a child view or show sex organs,” and forcing a child to watch a sexual act.
  • Neglect is “when a parent or caregiver does not give the care, supervision, affection, and support needed for a child’s health, safety, and well-being,” and it occurs when an adult fails to meet even the most basic requirements for taking care of a child that they are responsible for. Neglect can physical, emotional, medical, or educational.
    • Physical neglect relates to reception of “care and supervision.”
    • Emotional neglect relates to reception of “affection and attention.”
    • Medical neglect relates to “treatment for injuries and illnesses.”
    • Educational neglect relates to a child’s “access to opportunities for academic success.”

Effects of Child Abuse

Experiencing abuse as a child can have serious, long-term effects on an individual.  Those who have experienced child abuse are at an increased risk for intimate partner violence, substance abuse issues, and mental illnesses.  Experiences of abuse also lead to children having an increased risk of exhibiting criminal behavior.  In the United States, “14% of all men in prison and 36% of women in prison” experienced child abuse.  Children who are survivors of child abuse are about “9 times more likely to become involved in criminal activity” than those who are not.  Many survivors must deal with intense negative effects of their trauma for the rest of their lives.

Trauma and Child Abuse

Trauma is “an emotional response to a terrible event, like an accident, rape or natural disaster.”  When considering the issue of trauma, people often think of veterans who suffer from Post-Traumatic Stress Disorder (PTSD).  Both PTSD and Complex Post-Traumatic Stress Disorder (CPTSD) are common in survivors of child abuse, but they differ in exactly what circumstances causes them.  PTSD results from a specific event, while CPTSD results from repetitive experiences of trauma.  In terms of child abuse, PTSD is caused by a specific incident of abuse, while CPTSD is caused by experiencing numerous incidences of abuse over a period of time.

The three main categories of PTSD symptoms are “re-experiencing trauma through intrusive distressing recollections of the event,” “emotional numbness and avoidance of places, people, and activities that are reminders of the trauma,” and “increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated or angered.”  In addition to the symptoms of PTSD, people with CPTSD also experience problems with forming and maintaining relationships, negative views of themselves, and problems with regulating their emotions.  These symptoms negatively affect the ability of individuals with PTSD and CPTSD, including child abuse survivors, to live their lives in normal, healthy ways.

Treatments for coping with PTSD and CPTSD include individual and group therapy, medications (such as antidepressants) that help with some symptoms, and the establishment of a reliable support system.  Dealing with trauma is a life-long process.  Healing is possible for survivors of child abuse, but the impacts of their experiences will never fully disappear.

A sad boy sitting next to a dog on a couch.
Nathaniel. Source: Tony Alter, Creative Commons

The Cyclical Nature of Child Abuse

The presence of abuse can be seen as a cycle with the potential to perpetuate itself throughout the generations of a family.  According to the Child Welfare Information Gateway, around one in three of all survivors of child abuse will “subject their children to maltreatment”.  This is because many survivors who become parents believe that the way they were treated as a child is the correct way to parent.  In other cases, parents believe that if they simply treat their children better than their parents treated them, then they are not being abusive.  This way of thinking is incorrect, because abuse is abuse, even if one example of abuse is not as overtly severe as another.  By spreading information and reporting incidences of child abuse we can help to interrupt the cycle.

Child Abuse is a Human Rights Issue

There are numerous ways in which child abuse can be clearly seen as a violation of human rights.  Article 18 of the Universal Declaration of Human Rights states that “everyone has the right to freedom of thought, conscience and religion,” and Article 25 states that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family.”  How can someone utilize these rights while living in fear (whether it be as an adult or as a child)?

The Convention on the Rights of the Child also deals with child abuse as a violation of human rights.  Article 19 calls for States Parties to “take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation…”  Article 24 states that children have the right to “the highest attainable standard of health,” which is a right that cannot be fully enjoyed in an abusive situation.  Article 27 describes the right “to a standard of living adequate for the child’s physical, mental, spiritual, moral, and social development,” and abuse is a known hindrance to childhood development.  Article 34 relates specifically to sexual abuse, stating that States Parties should do everything they can to “protect the child from all forms of sexual exploitation and sexual abuse.”

It is important that we remember that children are limited in what they can do to help themselves in any given situation.  It is the responsibility of the adults around them to protect and nurture them.  Adults should be attentive toward the well-being of the children they contact.  Adults need to be able to recognize and report abusive situations when they witness them and/or are aware of them.

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