Global Health Blogs with Professor Swahn

Student Reflections on Topics Covered in our Class

Global Health Blogs with Professor Swahn

The Mental Disease Hidden By Many Faces

March 7, 2021 · No Comments · Mental Health, Uncategorized

In the past year the big talks have been about COVID-19 and politics. Which is understandable seeing how both affect not only the U.S., but the entire world. Those however overshadow the multitude of diseases and aliments that affects millions on the daily, specifically one that many don’t like to talk about or don’t know enough about which are mental illnesses. Mental illnesses or disorders according to the W.H.O. are a wide range of conditions that affect mood, thinking, and behavior (World Health Organization, 2018). Mental disorders can include, but are not limited to; bipolar disorder, schizophrenia and other psychoses, dementia, developmental disorder (autism) and the main topic of our discussion depression. According to W.H.O. depression is the most common illness worldwide, affecting nearly 264 million people (World Health Organization, 2018). The hyperlink here illustrates the share of population with depression in 2016 No single type of population is excluded from depression, it can be seen in nearly all sexes, ages, and ethnicities (Ritchie & Roser, 2018). Depression can be defined as experiencing a depressed mood or loss of interest or pleasure in daily activities that can also be accompanied by problems sleeping, eating, energy concentration and self-worth (Statistics about depression in the U.S., 2020). 

Figure 1.

Now that we know kind of what depression is, it gets a little more complicated because there are different types of depression and just like how no two human beings are completely identical, neither is the case for how individuals experience and express symptoms of depression. The W.H.O. classify three different degrees of depression being mild, moderate or severe which can then be broken down by expressing manic episodes, chronic cases, recurrent depression, or a combination of bipolar and depression (World Health Organization, 2018). Persistent depression can be seen by having one major episode of depression over a course of a time period or chronic low-level depression over a long time period (Depression: Facts, Statistics, and You, 2018). On the flip-side bipolar depression or manic-depression involves manic, or energized moods or episodes (Depression: Facts, Statistics, and You, 2018).  Healthline also classifies another type of depression that can be seen in new mother, known as postpartum depression, accounting for 80% of new mother’s experiencing the “baby blues”, which include the symptoms of mood swings, sadness and fatigue, but in a very specific population. Figure 1. has a very interesting image of postpartum depression in the United States (Depression: Facts, Statistics, and You, 2018). Now that we have an idea of the variety of types of depression, how does one identify someone or yourself with depression.


As stated before, no two people are the same. However although there is a list of symptoms that can fall into the category of depression, the degree and variety of those symptoms varies from person to person. There are two types of symptoms that can be displayed by people with depression, emotion and physical and sometimes the person can have the combination of the two. The general emotion symptoms include; extreme irritability, anxiety, trouble with anger management, loss of interest, fixation on the past and thoughts of death or suicide (Depression: Facts, Statistics, and You, 2018). The physical symptoms include; insomnia or oversleeping, debilitating fatigue, major changes in appetite, major changes in weight, difficulty concentrating or making decisions, and unexplained aches and pains (Depression: Facts, Statistics, and You, 2018).  There can be a multitude of causes for someone to experience depression or be succumb to it and although their is now one answer risk factors for depression can include; low self-esteem, anxiety disorder, physical or sexual abuse, chronic diseases, alcohol or drug use, family history of depression, age, gender, race, and geography and could be simply genetics or hormone imbalances (Depression: Facts, Statistics, and You, 2018). According to both Healthline and W.H.O., if symptoms last more than two weeks that’s when its time to seek professional help. I’m not too sure there is a specific “time lapse” that should be waited before seeking help, but if you or someone you know expresses symptoms, talking and identifying the reality that, that person may have depression is a good first step upon seeking further care. 

Their are however treatment options for depression, although their are some controversy on the legitimacy on whether antidepressant drugs are effective or not. The two treatment options for depression are antidepressants and therapy. Therapy has shown to have a lower rate of relapse compared to being placed on antidepressants (Depression: Facts, Statistics, and You, 2018). Figure 2. illustrates the comparison of 21 different antidepressants in clinical trials, and has concluded that antidepressant drugs were more effective than placebo in reducing severity of depression in adults (Ritchie & Roser, 2018). The W.H.O. has a program in place known as the mental health Gap Action Programme (mhGAP) which aims to help countries increase services for people with mental and substance use disorders. The W.H.O. have created psychological intervention manuals and educational programs to help identify persons who may be depressed (World Health Organization, 2018). After all is said and done, depression like all mental illnesses, should be recognized and provided greater attention because it is one that if caught at early stages can be helped or monitored.  

Are antidepressants effective

Figure 2.

Side Note: The National Network of Depression Centers and Substance Abuse and Mental Health Services Administration (SAMHSA) are great resources that not only works with people who are depressed, but other mental disorders as well and they are very active. Here is the link with some key statistics depression has in the United States:–t0XekaAupyEALw_wcB 

Here is the link to SAMHSA:


Depression: Facts, Statistics, and You. (2018, June 29). Healthline.

Facts. (n.d.). National Network of Depression Centers. Retrieved February 25, 2021, from–t0XekaAupyEALw_wcB

Ritchie, H., & Roser, M. (2018, April). Mental Health. Our World in Data.

SAMHSA. (2014, May 14). National Helpline | SAMHSA – Substance Abuse and Mental Health Services Administration.

Statistics about depression in the U.S. (2020, June 6). The Checkup.

World Health Organization. (2018, April 9). Mental Disorders.; World Health Organization: WHO.


Are You Suffering from Mental Illness?

March 7, 2021 · No Comments · Mental Health

    Mental health is very important for every individual. What is mental health? Mental health refers to cognitive, behavioral, and emotional well-being. It is the state of mind of an individual expressing his thoughts, feelings, and behavior. Mental health is very important for every individual. What is mental health? In the present lifestyle, people are becoming more reserved. People have trust issues among themselves. No one wants to show their real personality out. There are various reasons behind this kind of change in nature. If we talk about the older times, people used to trust each other, they felt relieved by discussing their thoughts and feelings with their loved ones and friends. But now in this modern and advanced time, everyone competes with the other person. Earlier we used to say, your grief can be minimized if you share it with your loved one, but now people say it’s better to cry in front of a wall than a person. It’s the sad reality of our lives that we are lacking in trust. 

        The Internet plays a crucial role in our lives. It has made our life very easy, we have access to multiple opportunities. We are doing online studies, remote jobs and doing payments online, and many more. But everything has its pros and cons, social media which was initially a tool of connecting with friends and family living far away. But with time, I realized it’s becoming a hub for mental sickness. Everyone is showing off their fake lifestyle, showing how happy they are, how cool the lifestyle and they are living the best of their life. But it is the opposite, especially for adults. Adults like school kids and adolescents are the prime victims of this social media trap. They are more worried about how many likes and followers they are getting, they feel depressed if they get fewer likes than others. It’s a whole new world now. There is no privacy, where they are going, what they are eating and what they are doing is all over their social profile. This is the main reason that many kids become victims of cybercrime, where they are stalked and blackmailed. They are always thinking about what is next to post, instead of playing or doing some physical activities.

        Where is real interaction? There is no real conversation between people. It’s all texting and sending emojis to each other. These are the emotional language now, sending happy, sad, laughing, and angry emojis. This is the biggest reason that the families are parting apart, earlier in the family dinners like Thanksgiving, friends, and family sit together for dinner, share their feelings and laughter. But now, it’s all about posting pictures of dinner items and waiting for likes and followers. They are sitting at the dinner table and everyone on their cell phones. Kids no longer share their problems with parents, they are in their different worlds. 

     Suicide is the outcome of mental illness. In my experience, loneliness kills the person. Cases of suicide have increased exponentially in the past decade. The reason for suicide can be many, people commit suicide because of family abuse, sexual violence especially in those parts of the world, where law and order are always in favor of the rich and powerful party. People feel helpless and depressed, don’t know what to do, where to go. Especially poor girls who were victims of rapes and sexual molestation either by family members or by someone who had powers.

 Feeling of helplessness, physical trauma, and social pressure is a mental illness that resulted in suicides. Since I am talking about social pressure, it’s torture which had named as cultural pressure. There are many cases of honor killing witnessed all over the world. Why do people honor killing? It’s also a kind of mental illness, which has turned into violence and killing.


     COVID19 pandemic has shaken the world. Millions of people lost their lives and their loved ones. To stop the spread of this disease, the government had put some guidelines like stay at home, lockdown, 6 feet apart social distancing, and quarantine regulations. Although these were meant to control the situation as a result of this, more cases of mental illness were diagnosed during this period. Fear of getting infected from COVID19, fearing losing a loved one has caused anxiety in people. Many people had panic attacks and anxiety episodes, while they were waiting for their results for COVID19. Those who were the frontline workers like health care workers and essential workers like truck drivers, grocery store workers were also going through this fear of getting infected. Kids were also suffering from the same kind of depression, as schools were closed, with no interaction with their teachers and friends. Even for parents, it was hard to keep them engaged all the time. They missed visiting their grandparents and other close relatives due to the lockdown.  


     People who were exposed and under quarantine, for them it was so devastating. Completely in isolation away from loved ones and family at the risk of their life is another kind of mental trauma for them. Old people living in nursing homes were also subjected to depression as they can not meet with their kids and grandparents as they were in a high-risk category of getting infected. It’s like a pandemic within a pandemic. Many people lost their jobs, financial insecurities have led to so many mental related problems like aggression, depression, and violence in the families especially black households

       In the end, I would like to give some suggestions to improve mental health. During the time of COVID919, there should be tele counseling for patients regarding mental wellbeing for those who are waiting for test results, so that they don’t get panic attacks or anxiety attacks out of fear of getting infected. All the front-line workers and essential workers should be given some compensation in their salaries and proper personal protective equipment should be provided. Parents should monitor the activities of their kids on social media.





McLean Hospital. (2021, February 10). The Social Dilemma: Social Media and Your Mental Health. Retrieved from

Evangeline Elsa, D. S. (2020, April 27). India: Rape victim commits suicide in India after the accused were let off by the village heads, with five slaps each. Retrieved from


Chesler, P. (n.d.). Worldwide Trends in Honor Killings. Retrieved from


New Findings About Children’s Mental Health During COVID-19. (n.d.). Retrieved from


Mental Health Stigma: Reflections from a Jamaican

March 7, 2021 · No Comments · Mental Health, Uncategorized

I am a first generation American. My parents were born in the rural hills of Jamaica. Growing up their livelihood came from farming. They cultivated the land and sold their harvest at the local markets. It is no doubt that they have had to overcome tremendous challenges to succeed in that lifestyle to immigrate to another country and to thrive here. Growing up, we never spoke about mental health. In our household we championed strength and any sign of weakness was frowned upon. As an adolescent, I dealt with many issues including anxiety and depression. I had no skills or tools to deal with it and felt like a complete failure because I associated my issues with weakness. When I would try to go to my parents about it, they would say “hush”, or “pray about it.” I was left feeling weak, helpless and still anxious. 

As I’ve grown, mental health has become very important to me. I have experienced sound counseling and therapy and have unlearned the stigma that I was taught in my Jamaican household. Mental Illness is real, and resources to reduce stigma and increase care is urgently needed– especially in countries like Jamaica. In this blog, i’ll discuss the stigma that exists around mental health in Jamaica from being immersed in the culture as well as looking at the current literature. 

Jamaica is a small country in the Greater Antilles, known globally for their contributions like reggae music and phenomenal foods like jerk and oxtails. Jamaica is home to some of the most beautiful beaches and has the greatest hospitality in the world in my opinion. But how does Jamaica faire when it comes to prioritizing mental health and mental illness as a country? What is the current stigma towards mental health among the communities there? 

In Jamaica there is significant mental health stigma. According to some articles, Jamaican’s view mental illness typically as having to do with some sort of dark possession. An article entitled, “Mad, Sick, Head Nuh Good”, evaluates a community’s reaction to mental illness and many participants stated an acknowledged fear of people with mental illness. They cite religion and family members as places to receive guidance on mental issues and reported little knowledge of the limited mental health resources offered in Jamaica. Many Jamaicans noted that when facing “hard times”,  people may resort to alcohol and drug abuse. Marijuana use was also noted as a possible trigger for mental health episodes as well as a tool to help people cope. In 2016, there was a study done looking and the relationship between social and economic factors and mental health in Jamaica and Guyana. The results showed that the rate of depression was reportedly high for Jamaicans. The article called for an in depth analysis of social and economic factors that may influence mental health in these countries. As I combed through the literature this was true. It is very limited and from the looks of the outdated Jamaican mental health system, so are their policies. A systemic overhaul is necessary to help reduce stigma and to increase the accessibility and quality of mental health care in the country. 


In comparison, here in the United States, where I grew up we use  The Diagnostic and Statistical Manual for Mental Disorders (DSM). It is the guide used by healthcare professionals predominantly in the US, and in some other countries, to diagnose mental disorders. It includes the criteria for diagnosing over 150 mental disorders. America currently has a very complex mental health infrastructure and many other developing countries look to it for guidance as they expand their mental health services. Jamaica currently does not use the DSM-5 to diagnose mental health. They have one large mental health institution and a 1 in 100,000 psychiatrist. This country is clearly lacking in resources and has an urgent need for development to serve the needs  of its people. 


Is there a generational gap? 

One promising study was done comparing Jamaican adolescent views on help-seeking behaviors for mental health with African-American adolescents. They’re hypothesis was not supported as those Jamaican youth had similar and more positive attitudes towards seeking professional mental health. It was not as negative as they previously thought.  This is promising and asserts that formal mental health visibility could be integrated into schooling and could help in reducing stigma starting with younger generations. It could also help to have more positive outcomes in mental health help-seeking behaviors amongst the next generation of Jamaicans. 


As a Black, Jamaican- American woman who works in Public Health and as a future Global Health Educator, I am particularly interested in the development of this system in Jamaica. I have seen first hand how drug and alcohol abuse can ravage a community because of a lack of resources. I have seen how socio-economic factors lead to poor outcomes in education and health in Jamaica. I call on the governments of Jamaica both nationally and locally to invest into their communities’ mental health. With that they will certainly see more positive outcomes in mental health care and services. 



How do we address stigma around mental illness?

March 7, 2021 · No Comments · Mental Health, Uncategorized

           Mental Health issues are very common conditions that affect an estimated 44 million Americans. Most families are not prepared to accept that their loved ones have mental health issues. There is a stigma around mental health issues, and in some cultures, it is a taboo subject to discuss. In both developed and developing countries people suffer from mental health issues. Men are more likely to commit suicide than women, although women are more likely to have suicidal ideation. Worldwide an estimated 800,000 people die from suicide each year, including men and women ranging from ages 15 to 70+. For this reason, we need to address the stigma that surrounds mental health. We need to create an environment in which people with mental health issues can speak out and share their stories to create a positive impact and inclusion. This should be an environment in which a child can grow free of anxiety and stress; free of social factors that judge or make fun of other’s differences; and a place where there is professional help available if or when needed.

           I personally suffer from mental health issues that include anxiety, depression, and a compulsive disorder. Since I can remember, I knew that something was wrong with me. I was so young, yet I couldn’t figure out what the problem was. Thirty years later I was diagnosed with these mental health issues, which is in part the result of genetics and environmental factors. Growing up in El Salvador, Central America, there were so many taboos surrounding this subject. In El Salvador people do not believe that mental health issues are real, but rather something made up by the affected. I am now 53 years old and I am very well aware and educated about my condition. Physically having a safe environment is very important for the prevention of depression and anxiety in young children.  The environment encompasses the place of residence, the green areas a person has access to, the cleanliness of the home, etc. This is a big issue for developing countries because some of these countries may have civil unrest, violence or even different types of conflict. People living in the slums do not have a safe environment that can shield and protect them from the dangers of this world. This was the case for me. As a young child, I was left to fend for myself all day long because my mother was a single mother that needed to work full-time in order to provide for my necessities.   For that reason, a safe environment is essential for the development and the prevention of mental health issues. 

            Social factors are things that affect a person’s interaction with immediate family members and are important for good mental health. These social factors are physical or sexual abuse within the family environment; racism; sexism; homophobia; lack of social support etc. We humans need social support and the social interaction of other humans, for this reason isolation or rejection can do a lot of harm to our mental wellbeing. In my situation, I was left alone starting at a very young age for long periods of time without parents to give me love and protection that I needed in order to build a more secure environment. I was also sexually molested by a family member, someone that I thought I could trust. This person was an authority figure that was in charge of taking care of me. These are some of the potential experiences that many children, young women, and young men may have by simply growing up in a developing country. These are some of the factors that can affect the mental state of a person; these social factors could be the key to how a child/teenager is shaped into an adult.

           Professional support is also very important for the improvement of mental health issues. As humans we need other humans to thrive in life. Professional support has offered me different strategies to cope with my mental health struggles. One such strategy is learning that I am not the only one suffering with these problems, and therefore not alone. I have also learned to recognise when issues arise that trigger my anxiety and ways to reduce these triggers, so I can avoid these situations. Through the assistance of professional help, I have an outlet to express negative thoughts that tend to hurt me and now strive to turn that pain into helping others. Unfortunately developing countries lack many medical resources that can provide professional support for mental health issues. Professional support can give a person the tools to cope with their problems all while continuing to enjoy a normal life. Professional counselors provide empathy, love and trust which sometimes cannot be found elsewhere. 

           In conclusion, living with a mental health issue is a challenge. Some of these issues are the result of genetics or environmental factors or even both. We need to learn to interact with others with care and with respect. We need to reduce the stigma surrounding mental health issues because they are actual issues that greatly impact the lives of those who have them. Developing countries need to implement programs to teach their citizens how to create a safe environment at home and within their communities. Children need to be educated using social factors such as a family environment free of racism; sexism; homophobia; and other discriminative behaviours that can affect the life of a person in the long run. Finally, professional support should be more available for those in need. Having a mental health issue can limit a person’s ability to excel in many different ways; but if communities come together to support one another this issue can be reduced.


The Mental Health Stigma in Mexico – Where is it going?

March 7, 2021 · No Comments · Mental Health, Uncategorized

The Hispanic population has generally high level of underreported mental health issues and stigma compared to other population groups.  In Mexico, a major concerns it that many do not seek treatment for mental health, even when facing significant and debilitating issues According to the

Mexican Ministry of Health, mental health-related disability represents 9.8% of the country’s total burden of disability-adjusted life years. The system in Mexico has a long way, with health professionals explaining the need for a fortification of the identification and treatment of mental illnesses and raise general awareness regarding the problems stemmed from mental health in the whole country.

Currently, Mexico’s government does not have a set policy to address mental health in their plan. Mental health has been studied to correlate other issues found in the country, including but not limited to violence, inequality, and poverty. According to a mortality statistic, mental health has increased by 33% between 2008 and 2014. During the same time, both men and women have also increased in mortality due to mental health disorders. The beginning of the period was also a time of social unrest as the Mexican government began suffering financial crisis as the Mexican government began its war against drugs.

Depression is the most common mental illness recognized to negatively affect a person’s mood, cognition, and behavior. Mexico’s disability-adjusted years (DALYs) had 4.19% in depressive disorders. DALYs are a globally recognized indicator to see the gap between the country’s current health status and what would be the ideal health situation for those who may not know. In 2002, A survey was conducted using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) to assess the epidemiological profile of mental disorders in Mexico. The survey revealed that 1 out of 8 Mexican citizens suffered from some depressive disorder and half of the survey participants had a depressive disorder within the last year. It also found that those of lower-income had a stronger correlation with increased mental disorders and those who were widowed, divorced, or separated. Those over 60 years old had a prevalence of 12.3% depressive disorder and individuals over 80 years old with a 21.7-25.3% with a depressive disorder.Women in Mexico are at greater risk for depression than men. Source: Irais Esparza, Wikimedia Commons.

Even though there is already a high prevalence, there is still a large probability that more people are suffering from depression in Mexico than what is currently being accounted for. The reasoning behind this possibility of having a higher prevalence is that currently, studies are not accounted for indigenous people and the stigma against mental disorders and cultural differences. These stigmas can result in significant report biases and can lead to that underestimation in the population. A big stigma against mental health disorders is known as “machismo” or, in English, male chauvinism. The belief is so strong that many believe that depression can be cured if you just have positive thoughts and that these feelings are only in mind. It’s also believed that mental illness is only for weak-minded individuals and that strong, mature persons will not suffer from them. Since mental health is also not something that can be seen, what doesn’t kill you makes you a stronger mentality. There is also a strong sentiment that those who seek mental health treatment are simply trying to find an excuse or escape for their daily problems. Also, these sentiments result in individuals not seeking care and continuing treatment.

With these obstacles and challenges for there is not adequate diagnoses and treatment at all levels of income. In 2002, Mexico launched a “New Model of Care for Mental Health” to eliminate human rights violations caused by the old model, such as Why Is the Doctor-Patient Relationship So Important?inhumane care and also involuntary psychiatric treatment. An organization known as “Secretario Técnico del Consejo Nacional de Salud Mental “(STCONAME) to dedicate to establishing public policies and national strategies for mental health. Several mental health plans were placed in the health plan ministry to promote information and prevent mental illnesses. The plans also focused on getting a better quality of care and reducing the cost of care. The biggest part of these plans is implementing primary care level clinics and specialized clinic sites to improve the diagnoses and treatment for those with mental health.

Fortifying the fundamentals of accessible care and diagnosing mental illness is a big part of what the country will need to combat the stigma.

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COVID-19 and its impact on mental health

March 7, 2021 · No Comments · Mental Health

We are coming up on one year of quarantine as a result of the COVID-19 pandemic. In that time, quite a lot has changed for the everyday person. From eating habits, working at home, spending more time with one’s family, growing in one’s health journey or gaining weight, becoming depressed, and struggling with one’s mental health. 

In this blog post, I will be focusing on the impact COVID-19 had on the mental health of people, specifically in the United States. A year is a long time for one’s mental health to change. For example, according to the Commonwealth Fund, Los Angeles has seen an 8000% increase in calls to suicide and mental health hotlines.

Chart: Covid-19's Widespread Impact On Mental Health | Statista

Source: Statista

The graphic above gives an insight as to which countries have experienced the most impact from mental health struggles and it shows that the United States is the one to have a 33% increase compared to the rest of the world. What has caused such a rapid increase to occur? 

By exploring the social determinants of health, we may gain some answers. First, employment- many people were let go from their jobs or had lower pay thereby reducing the chances of staying busy or driven and having the added stress of financial maintenance that may not have been there before. With that comes the added insecurity of access to food, housing, and healthcare resources. The stress of the uncertainties that came with the pandemic itself has also caused a rise in mental health struggles. People have gotten sick, gone to hospitals, and even died during the pandemic due to the virus and that added emotional stress has caused a toll on people. 

The pandemic has helped in the growth of telemedicine, especially the availability of mental health counselors, therapists, social workers, and more. Preston Kadleck, a therapist who was written about in National Geographic, stated that there are now enough social workers or people licensed to give counsel in the United States to help everyone. The issue that arises is access to these experts. He brings up a valid point that volunteers are a vital part of hotlines and help people step back from the edge of whatever volatile emotion they may be feeling, but they are not licensed and do not have the right resources to help a person understand what it is they are experiencing, how to cope with it, and build healthier habits to combat negative emotions that could result in negative actions. The link here provides a wonderful graphic that I was unable to add to the blog due to copyright issues. It shows the access to mental health resources by state and how they fare due to the lack of said resources. 

The next question that arises is then how do we increase access to mental health providers to reduce the struggle of mental health? Something like telehealth is a great start. Yet for some people, telehealth coverage is not included in their insurance. Therefore, one solution would be to expand health insurance coverage to include mental health providers. And the coverage should not have outrageous copays, especially during a pandemic. You know, if it is telehealth, why does a provider network matter for certain insurance carriers? By asserting more control over the health of people, it causes more stress, anxiety, depression, and more to increase and start in a vicious cycle. 

This bar graph comparison shows a clear increase in anxiety and/or depression in 2019 compared to 2021. 

This article by the KFF does a great job of breaking down the percentages and changes of anxiety and depressive disorder development in the United States before the pandemic and during the pandemic. The article does well to address the people that already had mental health issues in their life before the pandemic and how their situations were exasperated during the pandemic. It specifies per section an age group that has been impacted. For example, it focuses on young adults who are ages 18-24 who have experienced pandemic-related stress which has increased mental health struggles. Some of that stress is from schools closing and transitioning to 100% online education. Other stress includes losing one’s job or reduced hours as well as the risk of working during the pandemic and being distrustful of people who may not be taking protective measures properly. 

The stress of wearing a mask and covering one’s face is another huge factor that is not discussed often. Our society functions on interactions with one another which includes facial expressions and socializing in close circles or going out. By wearing masks, we have closed ourselves off to a major source of interaction which is reading one another’s facial expressions and interacting based on the reactions one has with the other. Something so small was not even realized until the pandemic and makes one question if we, as a society, took it for granted previously. The isolation that comes with putting a mask on and feeling alone along with the literal isolation during the pandemic really caused the rise in anxiety or depressive disorders to increase substantially. Will we go back to being “normal” after the pandemic? 

East Asian countries such as China, Korea, and Japan include masks as part of their daily lives. Some of it is due to air pollution, fashion, being respectful of people around them if they are sick, and for some, it’s to be a bit more protected against smoking. Therefore, would people be completely opposed to keeping the masks even after the mandates subside? Personally, I don’t think so. An element of that has to do with being worried or nervous about what germs or illnesses someone else may have. While that may make our society less trusting of one another at the beginning (which is another mental health concern), it would provide a sense of security to everyone in knowing that they are looking out for their own health and the health of others. 

It’s clear to say that the mental health status of Americans has steadily deteriorated over the last year, but it makes Americans that much more determined to persevere in the face of difficulties. I look forward to the positive changes this pandemic may possibly bring, even if it takes a while. Until then, if you need someone to talk to, hotlines are great for a conversation, but please reach out to someone who is able to give you professional guidance without any judgement; someone who wants the best for you. 


Mental Health in America: A Real Cry for Help

March 7, 2021 · No Comments · Mental Health

What comes to mind when you hear the words “mental health?”  Suicide? Abnormalities? People who have too many feelings or do not know how to handle the world? According to, Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is as important to our bodies and minds as physical health. In fact, I think that without good mental health, you will never obtain good physical health. Mental health issues vary from eating disorders, to anxiety and depression, to phobias and addictions. While some of these issues are rooted in our genetics, the environment and social atmosphere we surround ourselves in also play a crucial part in our mental health. 

In her TedTalk video, Heather Young Sarkis explains why it is important to discuss mental health. 43.8 million adults experience mental illness each year. This number is actually four million less than the 2019 population of the entire state of California. AN ENTIRE STATE OF PEOPLE, and the third largest state at that, all diagnosed with mental illness and there is still a large stigma around ‘mental health.’ She brings up a very good point; we have specific months and fundraisers for other health related topics but we are still scared to promote mental health. The entire month of October is dedicated to Breast Cancer awareness. You can sign up to run 5k’s for specific diseases, like pulmonary fibrosis, but what about supporting mental health, or even bringing awareness to it? Especially when it effects so many people.

I did a Google search for mental health awareness and was introduced to a new name; NAMI aka the National Alliance on Mental Illness. According to their website, NAMI joins the national movement to raise awareness about mental health every May. While many people are familiar with breast cancer awareness in October, the Susan G Komen foundation, is anyone aware that May is dedicated to mental illness? As someone who suffers from mental illness myself, this is news to me. The AHA, or American Hospital Association, also advertises May as Mental Health Awareness month. The National Council also shares this information, yet this is still the first time I am hearing about this. 


The first thing that comes with mental health awareness is simply an understanding for what it actually is, an illness out of someone’s control. From the perspective of a 20 something year old female who has been diagnosed with mental illness and sought treatment for almost 10 years, it still irks me to hear people say mental illness is in my control. That I can control my feelings, my moods, emotions, and the way the world makes me feel. That I can “let go,” or “move on,” or “stop letting it bother me.”  The simple truth of the matter is simply this; I cannot. I may seek help through a therapist or psychiatrist, I may take medication to even the chemicals in my brain, but it is still an ongoing issue I deal with everyday. Mental illness is an illness that follows you for life. Changing surroundings and the way our brain thinks can only do so much for certain people.  This article outlines six things NOT to say to a depressed person, and gives alternative ways of communicating.


Just like with anything else in life, it takes a specialized professional to diagnose mental health disorders and an even bigger professional to treat or cure them. Speaking from experience, it takes a lot of courage to open up to someone about how you are feeling. Now make that person a licensed professional in a closed room — speaking about your problems becomes almost impossible. When I say it takes a specialized professional, I do not mean someone who went to medical school and interned at different psychiatry offices. Often times it takes an empathetic individual to truly understands where we are coming from to make us feel comfortable. As mental illnesses continue to grow and occur, the need for mental health professionals is also growing. This article takes a closer look at what might be a shortage of mental health professionals in our country. With the ongoing pandemic, I can only imagine these numbers will steadily increase.



In 2017, a rapper known as Logic released a song titled with The National Suicide Prevention Lifeline, 1-800-273-8255. The song has over 1 billion streams on Spotify at the time of writing this (February 2021). For the first time in maybe forever, suicide and mental illness were trending in music charts. This song not only helped people suffering with mental illness and thoughts of suicide, but also brought awareness to the issue. While mental illness does not stop at suicide or depression, the song still made headlines and woke many people up, especially young adults and teenagers. I strongly encourage you to watch this video, where Logic explains the meaning behind his lyrics and the truth behind the song.  After the praise he received from the songs release, and all the fans who wrote to him saying he saved their life, he specifically states “I wasn’t even trying to save your life, now what could happen if I actually did?” He then went onto preform the song at the 2017 Video Music Awards (VMAs). After the performance, which included attempted suicide survivors, calls to the National Suicide Prevention Lifeline increased by 50%.




I hope more artists and people in the spotlight can continue to bring awareness to these issues. Mental illness does not stop at suicide and depression. We must also advocate and support those suffering from OCD, ADHD, schizophrenia, bulimia, and everything else included in mental health. Mental health should be prioritized over everything else, and maybe once it is, the rest of our health and social behaviors will change as well. When you break your leg, you have a cast. When you have cancer, you might get chemo and experience hair loss. When you’re sad and your mind is racing, there is nothing to show. That does not mean there is nothing to see, it just means mental illness shows itself in different ways than other diseases, illnesses, or injuries. 


When Isolation becomes Isolating: the COVID-19 Pandemic’s Impact on Global Suicides

March 7, 2021 · No Comments · COVID19, Mental Health, Uncategorized

Around the world, many people have become isolated due to COVID-19 restrictions. During the pandemic, we have socially-distanced from those we love – with many people not seeing close family and friends for over a year – stayed-at home, socialized less, and have consigned to talking to people primarily through electronic devices. I appreciate platforms like Microsoft Teams and Zoom that allow me to stay in touch with people, but to be honest, I miss being around people in-person. Hugs. Handshakes. Feeling socially connected. I miss the spontaneous lunches with co-workers where we caught-up on our favorite television shows. Have you stopped to examine how this has affected your mental health over the past year? Have you been sad, depressed, anxious or lonely? I have! I have felt isolated due to isolation! However, when I think about this in the global context, I am thankful, and realize how privileged we are, because unlike many around the world I have technology to allow me to still interact with others and an Employee Assistance Program (EAP) that pays for mental health services. For many around the world this is not the case and I can’t imagine how truly isolating this pandemic has been for them. Can you imagine living in a remote village with no technology to stay in contact with loved ones or access to mental health services? For myself and others, the pandemic has highlighted the importance of investing in innovative global mental health initiatives and technology.

Suicide in the Global Context

Suicide is a public health concern. Around the world, approximately 800,000 people lose their life to suicide each year. In 2016, suicide accounted for 1.4% of all global deaths, making it the 18th cause of death (Reference). Suicide knows no boundaries and cuts across race, ethnicity, sociodemographic level and all regions of the world. A suicide attempt is a crucial risk factor for subsequent suicide. Silence and stigma prevent those in need from seeking help. During the COVID-19 pandemic shelter-in-place policies and stay-at-home orders may increase the number of unrecognized suicide attempts or suicide attempts resulting in loss of life due to an individual being alone for a longer period of time before someone intervenes.

Globally, suicide remains the second leading cause of death in 15-29-year-olds (Reference), after road injury, and the second leading cause of death for females aged 15-29 years, after maternal conditions. In males of the same age, suicide was the third-leading cause of death, after road injury and interpersonal violence. However, more men died from suicide than women with 13.7 deaths per 100,000 compared to 7.5 deaths per 100,00, respectively (Reference). The only countries where the suicide rate was estimated to be higher in women than men were Bangladesh, China, Lesotho, Morocco, and Myanmar.

Most suicides (79%) occur in low- and middle-income countries (Reference), where resources for identification and management are scarce; however, high-income countries have the highest rate of suicide at 11.5 per 100,000 population. Nearly three times as many men as women die by suicide in high-income countries, in contrast to low- and middle-income countries, where the rate is more equal.

Suicide Rates during COVID-19

Currently, there is limited data on suicide rates during the COVID-19 pandemic or associated factors. However, as many countries implemented shelter-in-place policies and stay-at-home orders, many healthcare professionals were concerned for a potential increase in suicide rates, attempts, and ideation. Previous infectious disease-related public health emergencies, such as SARS and Ebola, have been associated with an increase in suicide rates and suicide attempts. There is evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS and Ebola exposure and increased suicide attempts (Reference). Additionally, several factors, which I talk about below, reinforce these concerns.

Widely reported studies modelling the effect of the Covid-19 pandemic on suicide rates predicts increases ranging from 1% to 145%, (Reference) largely reflecting variation in underlying assumptions. A particular emphasis has been placed on the effect of the pandemic on children and young people, who based on WHO’s previous statistics, are most at risk for suicide. Numerous surveys have highlighted that their mental health has been disproportionately affected, relative to older adults, (Reference) (Reference) and some suggest an increase in suicidal thoughts and self-harm. (Reference)

Specific COVID-19 Threats to Suicide Risk

Addressing global suicide rates during the COVID-19 pandemic will require considering specific suicide risk factors (e.g. increased social isolation, personal and economic losses), but also pre-pandemic risk factors (e.g. the increasing service gap between mental health needs and effective health care). Importantly, these factors may interact in previously unexplored ways. For example, an established suicide risk factor (e.g., access to lethal means) has increased during the pandemic. (Reference)

Based on the growing body of science informing our understanding of suicide, there are several risk factors linked to the pandemic and ensuing public health measures, which suicide expert consensus views as threats that could lead to an increase in suicide rates if the proper mitigation steps are not employed.  These threats to population suicide risk include the pandemic’s potential to lead to deterioration in mental and/or physical health; social disconnectedness, loneliness, or diminished social support; fears about or realized job or financial losses; remote work or school and the related disruption in social, academic, and basic structure to daily life; loss of loved ones or anticipated milestones; increased alcohol consumption in some regions of the world; and increased availability of lethal means such as firearms, opioids, and other toxic substances, especially with more time spent at home sheltering in place. (Reference)

Beyond COVID-19: Suicide Intervention Programs

Currently, only 38 countries have national suicide prevention strategies. As the COVID-19 pandemic continues and countries plan to address the mental health effects, it is imperative for countries to develop innovative prevention strategies to address suicide rates-specifically in women and youth. Suicide prevention strategies should be intersectional and include plans to address stressors that could lead to poor mental health (e.g. unemployment, food insecurity, etc.) The World Health Organization offers guidance on national suicide prevention strategies.


Information in the Nepal Graphic (Reference)

Information in the Japan Graphic (Reference)

Information in the Japan Graphic (video)







Screen Time and Mental Health Outcomes

March 2, 2021 · No Comments · Mental Health

               There has been a dramatic increase in the use of technology over the past decade. I occasionally witness, or even find myself involved in, discussions about the social and environmental changes youth today find themselves obliviously engaging in. In the 2000’s and early 2010’s, my peers and I were much more engaging with our physical environments. We enjoyed playing outdoors, having playdates at one another’s house, and using our imagination to create fun activities for ourselves. There was even a “Worldwide Day of Play” on one of the popular television networks (Nickelodeon) that encouraged children to go outside and play by halting their regular programming for a majority of the day.

Unfortunately, times are very different for today’s youth. With technological devices being overly accessible, children and adolescents indulge in “screen time” at unhealthy and alarming rates.

Before You Blame Screen Time For Teen Mental Health Issues, Read This

According to a 2018 study on Screen Time and Psychological Well-being, adolescent’s psychological well-being decreased after 2012. I distinctly remember this time period as there was an emphasized shift to using social media platforms among my peers, more specifically Instagram. There were social media apps and sites (Facebook, Myspace, Tumblr etc.) that previously existed before this year, however Instagram was in a lane of its own. I witnessed, and was a part of, the steadily growing dependence on smartphones. Retrospectively speaking, this was also the time I began to experience significant disruptions in my mood which affirms this study’s findings. According to the authors, adolescents that spend more time on electronic communication and screens (social media, the internet, texting, television, and gaming) and less time on non-screen activities (in-person social interactions, extracurricular activities, sports, and homework) have a lower psychological well-being. In contrast, adolescents that spend a small amount of time on electronic communication and screens were more content and happier. The rapid uptake of smartphones significantly contributed to the shift in adolescent’s use of time on non-screen activities to the extreme amounts of screen time we witness today.

Screen time and use is of significant importance today due to our current circumstances. The Covid-19 pandemic has caused laws and policies to be created (school closures, shelter-in-place orders, and social distancing implementation measures) to best promote citizen’s well-being and reduce the spread of the virus. However, the global lockdown orders have incited an increase in screen times and usage. In addition to the physical health risks (obesity, high blood pressure, and diabetes) this may cause, there may also be some mental health risks such as an increase in depression, anxiety and even suicide within youth and young adults. Having to socially isolate and be unable to physically connect with friends and family members could result in negative mental health outcomes. There are free mental health educational resources and support services individuals can utilize to combat any of these issues, which is a positive screen time benefit. Georgia State University actually offers some of these resources at the counseling and testing center. Fifteen free counseling and therapy sessions are offered to students but only via telehealth, which is a contributing factor to screen time.

Virtual mental health support services are a great example of all screen time not being negative or yielding the same outcomes. Due to there being various types of screens (televisions, computers, tablets, cellphones) that can be used in a variety of different ways (watching films, playing games, reading books, using social media) the effects of screen time and screen use can be a bit conflicting. Each of these screens can have a different, unique impact on children and young adults. For example, using screens to communicate and connect with friends and family members can have a positive effect on one’s mental health. Though social media use has been reported to cause unhealthy comparisons, enable bullying, and increase exposure to negative content it can also have positive influences on youth. Some children have stated that it is a significant help to them in keeping in contact with their loved ones, strengthening their friendships, and allowing them the opportunity to explore new information, opinions, and perspectives.

However, numerous studies have reported that if used excessively screen time has been associated with negative mental health outcomes. In their 2018 article, Twenge and Campbell found that after 1 hour a day of screen time, any additional hours were associated with lower psychological well-being (less curiosity, lower self-control, increased distractibility, more difficulty making friends, less emotional stability, decreased ability to finish tasks). For adolescents aged 14-17 years old, users that had a screen time of more than 7 hours of day were more than twice as likely to receive a diagnosis of depression, anxiety, receive treatment from a mental health professional, or have taken medication for a psychological or behavioral issue in comparison to those adolescents that had a screen time of 1 hour or less a day. They also reported that adolescents that even had a moderate screen time of 4 hours a day also displayed an association with lower psychological well-being.

There are also age and gender differences in the effects that screen time have on mental health. For example, the associations between screen time and lower psychological well-being are more salient among adolescents than younger children. In a recent (2020) article Jean M. Twenge conducted with Eric Farley, it was reported that girls demonstrated stronger associations between screen media time and mental health indicators than boys. This finding validates Barthorpe’s article that also reported a greater amount of time spent on social media was associated with an increased risk of self-harm, depression, and lower levels of self-esteem in females.

Due to the significant negative mental health effects screen time has on youth, there are a few suggested ways to limit screen time to promote a healthy mental well-being.

For children:

  • For children under 18 months old, no screen time.
  • For children 18 to 24 months old, parents should choose only high-quality media and watch it with their child.
  • For children 2 to 5 years old, less than one hour per day of high-quality programming is recommended, with parents watching along.
  • No screens 1 hour before bedtime, and remove devices from bedrooms before bed.

For adults:

  • Use phone apps to remind you when it’s time to stop using the phone
  • Turn off the majority of your notifications
  • Delete your social media apps

Future guidelines and screen time plans could include virtual activities that promote physical activity, education, and socialization while still setting time limits to decrease the risks of mental distress. Credible, trusted organizations should implement policies that guide individuals and families on the optimal amounts of screen time to indulge in daily.


HealthCare Systems: U.S. VS UK

March 2, 2021 · No Comments · Health Care Systems

I was oblivious to the importance of health care, and how access to it is almost a privilege, until last semester in my Fundamentals of Health Systems, Leadership and Policy course. Our discussions on health care costs, access to care, and quality of care were quite eye opening. It was in this course that I learned of the United Kingdom’s healthcare system and how they granted their citizens universal coverage. Comparing the United States and the United Kingdom’s healthcare systems is helpful in identifying the pros and cons of each system. Each country has its successes and challenges in regards to the relationship between its citizens and the healthcare services they receive.

The Organization for Economic Cooperation and Development Average (OECD) is an international organization that consists of 34 countries to compare and discuss government policies to “promote policies that will improve the economic and social well-being of people around the world”.  I used some of its statistical findings to compare and contrast the US, UK, and a few other countries healthcare outcomes. It is widely known that the US spends an overwhelming amount of money on healthcare. In 2018 we spent 16.9 percent of gross domestic product (GDP) on healthcare, which was almost twice as much as the average OECD country. Other countries such as New Zealand and Australia spent almost only half of that, with 9.3 percent of GDP being spent.

Interestingly enough, the United States public spending on healthcare is comparable to its peer countries. It is the citizen’s private spending on health insurance that is drastically higher than its peers. About half of health care spending derives from private funds with most working adults being covered by an employer funded health insurance plan.

The average US residents pays $1,100 out of pocket for health care because of copayments for doctor’s visits, prescription drugs, or health insurance deductibles. In contrast, residents of the United Kingdom do not have to personally afford any of these things because they are all covered under their universal healthcare that is implemented by the National Health Service. Like the UK, the US does have government assisted health care programs such as Medicare, Medicaid and the Veterans Administration which cover 36.5 percent of the population’s health insurance. However, despite employer funded and governmental coverage there is still an overwhelming amount of citizens (32.9 million) that do not have health insurance. This is due to low-income citizens being likely to not visit a doctor when sick, receive a test/treatment/follow-up care that was recommended by their physician, get a prescription filled, or visit a dentist. I can personally attest to being extremely hesitant on receiving a test my primary care physician recommended I get due to abnormalities detected within my heart rate. Once I inquired with my insurance on how much I would have to pay out of pocket for the test I was discouraged on getting it done. I triple-checked with my physician to make sure it was something I needed before scheduling my appointment to receive the heart scan. Due to it being my heart that needed to be examined I went forth with the test and requested to be placed on a payment plan to pay for it.

 I am sure my experience and hesitance on seeking the treatment I needed is a common one among US citizens, and is a significantly contributing factor to our countries unfavorable health outcomes when compared to other countries. The life expectancy in the U.S. was 78.6 years in 2017, which is two years lower than the OECD average. This life expectancy can be further broken down by racial and ethnic groups; African-Americans have a life expectancy of 75.3 years, which is 3.5 years lower than whites who have a life expectancy of 78.8 years. Hispanic Americans have the longest life expectancy of 81.8 years.

The United States lower life expectancy can partially be attributed to its higher suicide rates. When comparing these rates with the UK, it is observed that their suicide rates are half of what ours is.

 This could be due to the UK including mental health care within its universal coverage and offering a full range of services to its citizens. Mental illnesses such as depression and anxiety are typically treated by general practitioners, and illnesses requiring more advanced care are treated by mental health specialists. America’s steadily increasing rates of suicidality, and substance use, could be caused by a high burden of mental illness and individuals finding relief in substances, instead of seeking proper treatment.

Along with mental health care, the UK’s National Health Service (NHS) covers preventive services, inpatient and outpatient care, maternity care, physician services, inpatient and outpatient drugs, clinically necessary dental care, rehabilitation, home visits, and even assistive devices such as wheelchairs and hearing aids. All of England’s citizens are privy to its universal health care however some residents opt to obtain their own private policies. Choosing to receive private insurance offers more rapid access to care, personally selecting health care specialists, and better amenities. One would choose to deny free health care provided by the government and fund their own policy due to the oftentimes insufferable waiting times patients experience. Individuals seeking emergency care experience long wait times due to the overwhelming amount of patients ER doctors see on a daily basis. General practitioners can only see their patients for an average of 10 minutes for this same reason. If an individual needs to seek treatment from a specialist, they will likely be placed on a waiting list because of the overwhelming demand of services needed and shortage of specialists available to provide them. Opting for private insurance alleviates these wait times and is a major reason why about 11 percent of UK residents choose to obtain private insurance. Contrastingly, America’s quality of care is quite commendable. The average length of a hospital stay in the U.S. is 5.5 days, which is significantly lower that the OECD average.

 On a positive note, both the United States and the United Kingdom have outstanding rates of implementing preventive measures.

The United States has one of the highest rates of breast cancer screening among women ages 50-69, and the second-highest rate (after UK) of flu vaccinations among people age 65 and older. While both countries have their respective strengths and weaknesses within each of their healthcare systems, perhaps they could adopt certain qualities from each other to improve them. For example, the United States could begin working toward lowering healthcare costs to increase citizen’s accessibility. Doing so could improve our populations overall health outcomes. In contrast, the United Kingdom could seek to improve their quality of care by either hiring more physicians and specialists, or including more services covered in private health insurance policies so that this option is more appealing to citizens that can comfortably afford it. It is my hope that our country can begin to make sincere, efficient efforts to remediate our current healthcare crisis.


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