Mental Health Recovery in Different Contexts: Lessons Learned from the Field

Jessica Maria-Violanda Spagnolo

The mental health recovery movement emerged in order to counter the overly biomedical view of mental illness that littered the era before deinstitutionalization (Anthony, 1993). After this era, community-based services for people living with mental illness were strongly encouraged, as illness is not merely the absence of disease, but a state of holistic well-being that goes beyond physicality (WHO, 1948). Therefore, mental health recovery includes ways of “living a satisfying, hopeful, and contributing life even with limitations caused by illness”; as well as finding “new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness” (Anthony, 1993, p. 527).

I have always been interested in understanding how this concept is seen and understood around the world. This post will report on examples of the cultural representation of mental health recovery in local communities where I worked.

Picture 1 (McGill Blog)

Photo 1

At a shelter in a small village in the Caribbean, mental health recovery meant developing new skills by learning how to plant vegetables, pineapple, and flowers, as well as care for chickens. This manual labor encouraged the presence of a daily routine, which can easily falter when one is affected by illness; learning through trial and error, which promotes patience and perseverance; as well as interacting with others, which can often be a limitation caused by illness. Photo 1 shows the chickens that the residents took care of until they were either sold to local community members or were used to feed the residents at the shelter. These same residents highlighted the importance of religion in their lives, which helped them find new meaning after illness. For example, when asked what inspired them, the majority of the residents said “God.” This reality is also apparent when visiting the shelter, as the walls are painted with religious images and symbols by local artists (Photo 2).

Picture 2 (McGill Blog)

Photo 2

In a small village in Central America, where many refugees sought protection after experiencing hardships in another country, often showing signs of post-traumatic stress, mental health recovery was seen through the development of new social ties. Arriving as strangers, women leaned on each other for support as well as hope for the future. Their children, through play, would do the same (Picture 3).

Picture 3 (McGill Blog)

Photo 3

The beauty of the mental health recovery movement is that it ensures the focus is not solely on mental disorders or symptoms. Not once during my work in these 2 communities did the residents mention the word “sick” or “ill,” but spoke about what was important in their own, unique, personal recovery journey from illness: developing new skills; generating hope for the future, creating social support and networks. These things are what innately make us human, and are anchored in what can help people living with any type of illness enjoy a satisfying and fulfilling life, despite symptoms.

 

Jessica Spagnolo is a Doctorate Candidate at the School of Public Health at the University of Montreal. Her research focuses on building system capacity for the integration of mental health at the level of primary care in Tunisia. Jessica is funded by les Fonds de recherche du Québec – Santé (FRQS) and MITACS Globalink. Jessica holds a Bachelor and a Masters of Social Work from McGill University.

Cooking with solid fuels, household air pollution, and health in the Tibetan Plateau, China

Sierra Clark

Background and research:

Almost half the world’s population cooks with biomass fuels in inefficient stoves that emit high concentrations of toxic pollutants (Bonjour et al. 2013). The resulting household solid fuel combustion is thought to be a major contributor to ambient pollution with regional and global climate impacts and is a leading environmental health risk factor (Lim et al 2013, Amann et al 2008). Notably, use of solid fuels in China is the leading environmental health risk factor and contributes to an estimated 37% of the country’s total ambient Particulate Matter (PM2.5)emissions (Amann et al 2008). Ambient air quality in China and the surrounding regions have rapidly deteriorated in recent decades with high concentrations of ambient PM and other health and climate-relevant air pollutants (Zhang et al 2011, Heald et al. 2006). Further, black carbon aerosols from household solid fuel use in the Tibetan Plateau are thought to significantly contribute to glacial melting (Xu et al 2009).

Cleaner-burning stoves and fuels can potentially reduce household air pollution concentrations and exposure (Ezzati 2002). My research measures the potential environmental and health benefits of transitioning households to low-polluting semi-gasifier stoves and processed biomass fuels in a study site located on the eastern edge of the Tibetan Plateau, China.

Photo 1

Photo 1: Water is heated on a traditional chimney stove in Shanxi Province, China. Coal is used as fuel which, when burnt, can release a large amount of toxic air pollution into the home through inefficient combustion.

Photo 2

Photo 2: A traditional chimney stove in a rural village in Sichuan Province, China. These traditional stoves use biomass (wood and/ or crop residues) as fuel for burning in an open chamber which release smoke into the kitchen.

Photo 3

Photo 3: A woman in a small village in Sichuan collects wood (fuel) to burn in her traditional stove. Harvesting and collecting firewood can put an additional burden on households as it requires time that could have been spent doing other things.

Photo 4

Photo 4: Myself and another researcher go into homes to talk with women about their household cooking practises. Above me, smoke is being partially vented out of the kitchen by a chimney, but the unvented smoke remained in the kitchen with the cook.

Photo 5

Photo 5: Household burning of solid fuels for cooking and heating contributes to about 30% of China’s ambient air pollution.

Photo 6

Photo 6: A woman participant is having her blood pressure taken by a member of our field staff. Research shows that chronic as well as acute exposure to air pollution is associated with both short and long-term changes in blood pressure, which is a known risk factor for adverse cardiovascular events.

Photo 7

Photo 7: A woman participant is having her pulse wave velocity taken by a member of our field staff. Some research indicates that exposure to air pollution is associated with increases in pulse wave velocity, which is an indicator of cardiovascular health.

Photo 8

Photo 8: A woman participant in our study is wearing a waist pack with a Personal Exposure Monitor (PEM) inside. The PEM actively collects 48hrs of PM2.5 mass on a filter which is later analysed. Woman are often the most exposed to household air pollution, particularly in this setting, as they spend the most time near the sources of pollution (i.e., cooking-heating stoves).

Photo 9_1

Photo 9: Young children are particularly vulnerable to the health impacts of indoor air pollution. Not only are they biologically more vulnerable than adults, but they may also spend more time near the sources of pollution – indoors and alongside women in the household who are cooking.

 

 

sierra clark

Sierra Clark is a second year Master’s student in Epidemiology and an Institute for Health and Social Policy graduate intern at McGill University. She is currently in rural China collecting data for her thesis on the air pollution and health impacts of a clean cook stove intervention which is aimed at reducing household sources of pollution. Sierra received her BA (Hon) in Geography from McGill, focussing her research on climate change and infectious disease in rural Uganda. Sierra is currently a National Geographic Young Explorer and a Mitacs Globalink International research award holder, and she is an active member of the Baumgartner Research Group at McGill. 

 

Ethics and consent for photos: Ethics approval was granted (10-05-2016) in a REB amendment for a consent procedure which gave participants the opportunity to give oral informed consent for their photo to be used in presentations or media pertaining to this research project (REB A01-E01-14A). All identifiable person’s featured in this photo journal have provided informed oral consent.

Acknowledgements: Much thanks to all of the subjects in my photos who graciously agreed to allow me to use their images to help highlight and translate my research findings. Funding for my research this Summer was provided by McGill Global Health’s “Norman Bethune Award’, The National Geographic Societies “Young Explorers Award Program” and Mitac Canada’s “Globalink Research Award Program”. Funding for the larger project was provided by the US Environmental Protection Agency (EPA) STAR program.

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