When Dr. Raper spoke about questions pertaining to how we might talk about suicide, it reminded me of my role as a crisis counselor at the Crisis Text Line. During training, we learn to utilize a ladder-up approach concerning conversations surrounding suicide. Every individual who seeks help from the platform is asked the following questions:

• Are you having thoughts of suicide?
• Do you have a plan for how you would do it?
• Do you have access to the means to carry it out?
• Do you have a time planned for when you would do it?

At first, it felt weird to be asking individuals what their plan was to kill themselves because I thought it would exacerbate thoughts of suicide. However, there is a plethora of data demonstrating that this is not the case. Moreover, as I had more conversations, I realized that these questions instead helped individuals feel like someone was listening to their concerns and not avoiding their immediate troubles. They felt that someone was genuinely helping them through their struggles, rather than being scared to address their concern head-on due to the stigma surrounding mental health issues. Thus, talking about suicide actually reduces suicidal ideation, and enables improvements to be made in treatment. 

Dr. Raper further spoke about self-stigmatization, or the internal shame, that people with mental illness carry within themselves. However, per my experience, within the South Asian community, it seems that mental illness is something viewed as a collective issue, in which the mental illness reflects poorly upon the family, rather than simply the sufferer. A lot of the stigma comes simply from a lack of understanding or fear. 

Furthermore, although there is conflicting evidence, there seems to be a decline in the stigma of mental illness, especially amongst young people. Many of us students are very vocal regarding how we are feeling mentally, yet there seems to be a disconnect between us and the older generation who are in positions of power running mental health departments at academic institutions (as I talked about in my post two weeks ago). 

Similar to Dr. Raper’s points about stigma, there is a need for a safe and trusted environment to speak about mental health. Without such an environment, mental health illness, which was significantly exacerbated during this pandemic, cannot be addressed properly. 

Because of the pandemic, a lot of us saw increases in our own mental health symptoms and conditions, enabling an increase in knowledge on mental health. As a result, I saw a change in mental health stigma at a classroom level after online learning had started. Professors became more agreeable with mental health excuses from class and extensions for assignments for mental health issues–something that professors would often want proof for (I’ve actually had a professor ask for proof that my cousin died my freshmen year when I requested an extension based on my mental health :/) beforehand. 

The universal experiences many of us have shared, coping with the uncertainties of the pandemic–whether baking banana bread, making dalgona coffee, or going on walks–have enabled us to focus on mental health, and, unconsciously or not, reduce the stigma. These shared social connections have further led to increased resilience within our communities and emotional acceptance of others, which is incredibly valuable in an increasingly divided world. 

What do you think could be done to reduce stigma related to mental health issues in academic settings or in the workplace? Because it seems that any attention being brought up about mental health in these settings is due to a fear of a “lack of productivity,” rather than an emphasis on people’s well-being.

Dr. Thompson spoke about the importance of community engagement, and the need to empower each other’s voices. And, as the narrative that the pandemic is over drones on and community engagement dwindles, I am reminded of the times during the height of the pandemic in which people did come together as a community.

Emory highlighted collective responsibility as an important component of ensuring students’ safety on campus. That individuals, whether on campus “to live, work or visit,” should follow COVID-19 guidelines to support the community. Those who were off-campus during this peak time were still a part of this campaign, and I vividly remember being sent a sweater and a sticker (now on my laptop) with the message: take care of each other. Albeit not the end-all answer in COVID relief, students from multiple organizations came together to sew masks, fundraise supplies, and write letters of encouragement to those going through a rough time.

For you. For Us. For Emory.

https://studenthealth.emory.edu/other/COVID/stay-healthy.html

In my community, a block away from one of Emory’s hospitals in Atlanta, my Desi-American neighborhood came alive at 7 pm every day in a communal outburst of clapping for the essential workers putting their lives on the line. While initially a demonstration of appreciation for frontline workers, those five minutes, hanging outside our windows, were an important reminder to us of our co-dependent existence in this world–that albeit long hours of isolation, we were not alone.

But, it was still hard for us with family members back in India and other South-Asian countries. While neighbors were having summer get-togethers and had vaccination appointments lined up, doctors in India were struggling to acquire treatment drugs and open ICU beds. It evoked a jarring feeling of helplessness from a place of immense privilege. So, despite the narrative of WhatsApp COVID cures, Desi communities across the United States came together to raise money for supplies, such as oxygen concentrators, to send to physicians on the ground.

Moreover, regarding support during the United States’ COVID surges, Desi communities took care of others–religious events were done virtually or socially distanced; neighbors made food for the elderly; family and friends met via zoom–knowing that it would ensure a safe community. In Atlanta, we made food satchels for the homeless, who may not have felt safe at shelters filled with individuals sick from the virus.

However, I know that in all communities, there were individuals who may not have felt at ease with the vaccine/treatment measures because they believed in alternate sources for a cure. How best should one go about navigating this conversation? And, why is it that this hesitation came about so headstrong during this pandemic as compared to the hesitancy surrounding mandatory vaccines for school-aged children?

Dear Students,

I was walking across the Quad a few days ago, and I happened to overhear a fragment of a conversation between two Emory students. “I just feel so anxious right now,” one student said. Those words stayed with me.

…But you have something my generation didn’t–the strength to speak eloquently and openly about mental health…that is a gift, and I’m proud about how you support each other.

-PResident fenves, october 10, 2021

Last year, I remember receiving an email from President Fenves on World Mental Health Day. He recounted a story of overhearing two Emory Students speak on how anxious they were. He said those words stayed with him. Moreover, he spoke about how eloquently and openly we are able to speak on mental health. While he had good intentions, and it is true that as a society we are more open about mental health, there’s only so much that speaking can do. Students want change. 

Although there was a significant increase in mental health concerns during the pandemic, this is just a continuation of a trend, which researchers and clinicians have been pointing out for years. In fact, it’s getting worse with American Indian/Alaskan Native students taking the brunt of the increases in mental health problems. 

A huge part of this stems from the disconnect between university administration, faculty, and students. Researchers Wendy Fischman and Howard Gardner from Harvard University assessed over 2,000 interviews with students, parents, faculty, administration, and alumni over a five year period and across ten campuses. They discuss in their book that faculty members and university administrators believed students’ main mental health issues were due to an increased workload compared to high school or being in a new environment away from home. Yet, students were actually concerned with the pressure to succeed and get a perfect 4.0 GPA. In HLTH 100, a class I teach as a Peer Health Partner, we are told to harp on strategies to combat the transition into a new space; however, when I speak to the first-year students, they echo Fischman and Gardner’s research.

Thus, as Dr. Glass stated, there is a systemic issue of students quantifying their worth because of a college environment and society based so heavily on doing well. Emory, especially, tends to glorify the concept of being busy, and students feel the need to fill up every moment of free time. Personally, I see this amongst students with post-graduate plans and/or are in pre-professional programs where there is a prominent narrative that there are only a few spots that will be given to the top students. Consequently, grades no longer become feedback, as faculty hope them to be, but rather are currency that have the potential to make or break a potential career path. 

The disconnect continues within the classroom and varies faculty member to faculty member. Some professors have assigned me exams that open and close on the weekend, while others have graciously granted me extensions due to health concerns. I have had lecture quizzes open right after lecture and due at 7pm the same day, ignoring the fact many students work late at their jobs, or extracurriculars, making this an impossible deadline. Though, I’ve also had professors kindly post all assignments, materials, and quizzes a week in advance, enabling me to be able to work ahead of time and accommodate for my job. 

Given these variations, there needs to be consistency between professors and a more transparent process with regards to student feedback. Administrators also should be keen to hear student advice and faculty experiences. Moreover, there is a dire need for more mental health resources on campus. Dr. Weeks spoke about the amazing advice he gave professors, and the immense work that went into making sure student learning was worth our tuition during the pandemic year(s), but not all professors applied and continue to apply these recommendations. Furthermore, I was delighted that Dr. Rickard spoke about CAPS, and its work to aid students, especially during isolating pandemic semesters. However, CAPS is not meant to be a long-term solution, only provides eight sessions focusing mainly on students’ academic stress, and has a bad rap amongst students due to its long wait times. 

Ask any student about the atmosphere on campus, and they will tell you that mental health is not being adequately addressed on campus. And, it seems that any steps that have been taken are inhibited by the underlying disconnect.

So, what do you all think should be done to address these mental health issues and disparities spoken about in class? And, what can be done to address the disconnect?

While Maria Gilberta Reyna may have received her COVID-19 vaccine information, for many individuals in the Brown and Black communities, this is not an easy feat. Others, like Maria Sousa, are pressed about their address to confirm their legal status, even though proof of legal residency is not necessary. The risks and fear of deportation or racial profiling have perpetuated the already large quantities of vaccine hesitancy and inequities. 

In 2019, a new supervillain arrived in the world names Sars-Cov-2. Having claimed more than six-million people, the virus, which causes COVID-19, takes refuge within our bodies, and continues to wreak havoc using its shape-shifting abilities, finding novel ways to grow its reach. However, awaiting the challenge, were multiple scientists who provided the world with COVID vaccines that were dubbed to be one of the top 100 inventions of the year 2021. These miracle workers gave the world bottled hope. 

But, has everyone received a drop? 

Despite calls for action by organizations, such as the Centers for Disease Control, World Health Organization, and the UN Development Programme, vaccine equity remains an immediate issue, not only amongst lower-income countries, but also amongst the marginalized here in the United States. As of May 2021, counties in the United States with a large population of Blacks were less likely to serve as COVID-19 vaccine facilitation centers compared to counties whose Black population was lower than the national average, even though Black and Latinx individuals have a higher likelihood of being infected, becoming severely ill, and dying from COVID-19. Globally, only 9.9% of individuals in low-income countries finished the initial COVID-19 vaccination protocol, which is a stark contrast to the 73.7% of individuals in high-income countries. This disproportionate access to vaccines is adding enormous strain to already fragile economic and health infrastructures in low-income countries. 

The burden of the Sars-CoV-2 virus on the marginalized is a theme in the HIV/AIDS epidemic as well. In 2018, 5,000 HIV infections emerged each day, and 61% of them were from sub-Saharan Africa. Moreover, there are significant inequities with HIV/AIDS antiretroviral treatment with countries outside of western and central Europe having less treatment. When considering countries like those in sub-Saharan Africa that are compounded with both COVID-19 and HIV/AIDS, vaccine equity becomes an even more pertinent topic.

How do we fix these health disparities to achieve vaccine and treatment equity?

Sandy Thurman spoke about community engagement, and how local leaders and spokespeople were utilized to power efforts. She discussed bringing people with power to the sites most affected. Thus, there needs to be an emphasis on investing in marginalized areas, organizations, and networks, leading to a greater emphasis on decreasing health barriers. Disregarded communities, and lower-income countries should have a spot at the decision-making table because only they truly understand what policies will be effective in their communities. Likewise, resources for treatment, knowledge to build strong health infrastructures, and research centers should be localized in affected areas. In this manner, there is less influence from organizations swayed by the agenda of higher-income countries.

Furthermore, health must be treated as a right. Yes, in our society, economics does play a role. However, when higher-income countries centralize the wealth, health no longer remains for everyone, rather it becomes a commodified good only available to the rich. 

-Sriya Karra, 9/20/22 1:01AM