Stanford University Urban Studies &
Urban Summer Fellowship
Student perspectives of community-engaged learning and research across the United States
Hello Again!
Wow! I cannot believe that my summer with the DeKalb Community Service Board has come to a close. It really seems like just yesterday I arrived. As a reminder, the DCSB is a community mental health platform that services low income individuals on the East-side of Atlanta. Specifically, I was working with PEIP (Prevention and Early Intervention Program) to build a platform to prevent those showing early warning signs of psychosis from transitioning into a first episode. Shortly after my last post, I got a chance to sit down with some leaders from a local community inpatient mental health facility. I will take a moment to mention that the DCSB offers outpatient counseling, psychiatry, and case work. Therefore, once patients are discharged from inpatient (live-in/overnight) facilities they depend on outpatient services such as our own to reintegrate into society and their old lives. In the past years, the connections between the inpatient and outpatient facilities have become strained or broken. It was really powerful to be present while these bridges are being rebuilt (especially when thinking of the positive outcomes continuity of care has specifically for mental health patients). I look forward to seeing this effort progress beyond the centers we are in contact with. I hope better patient outcomes in the future help to convey the positive results possible through collaboration and teamwork. I was also present for a drastic restructuring of PEIP as it moved from mainly Early Intervention (first-episode patients) to a Prevention (before first episode of psychosis) focused model. The prevention patients taken into the program averaged a few years younger than the first -episode patients and it was interesting to see the differences in their course of illness. This also offered me an opportunity to watch the progression of the illness from negative and cognitive symptoms (social anhedonia, lack of motivation, sudden drop in academic performance, and inattentiveness) to the onset of positive symptoms (often auditory hallucinations and delusions). One is only considered psychotic when they loose perspective on the positive symptoms and begin behaving in reaction to them. Over the last couple weeks, I was also able to complete my academic project on the sex based presentation differences in schizophrenia. Before starting the project, I was honestly unaware of how common sex based mental health presentation differences are. Interestingly enough, women often experience a less severe course of illness than their male counterparts. From fetal durability to hormonal imbalances and societal expectations, researchers far and wide have attempted to explain why this complex illness has such pronounced sex differences. Personally, I was a big fan of the estrogen hypothesis which states that natural estrogen production can lead to greater regulation of neurons in the central nervous system (even in men). I was also very interested in the ways that expected gender-roles can impact the recovery from first episode of psychosis. For example, in many Western individualistic societies, men are expected to be independent and accomplished while women are more welcome to depend on their families for help. Therefore, when a man turns to his family for long-term support, the family is less likely to be receptive than of a female counterpart requesting the same assistance. It was honestly just a treasure chest of really interesting stuff. Of course Dr. Shapiro was working alongside me the whole way, helping me to grow and ask more questions about the topics I was researching. Looking back, even though the summer had some pretty stressful moments, it was very fulfilling. I know I will not be able to follow the patients I met to the completion of their treatment, but I can find some solace in the fact that I was part of their journey. The question now becomes; how do we increase to number of people willing to come through the doors of the CSB? How do we de-stigmatize mental health so more people are willing to come forward and say they need help? Some illnesses are easy to see, others, such as mental illness, are not always so obvious. This position really helped me to look forward and think about where I want to go next in life. I definitely do not want to leave the community health field without a warrior to protect its clients. The structure as a whole was completely new to me, and I am glad I got to see it up close and personal. I hope everyone else had a summer as enlightening as my own! In Peace, Mauranda Upchurch
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AuthorThis blog is authored by Stanford University students engaged in summer fellowships through the Cardinal Quarter and the Program on Urban Studies. All writings and thoughts belong to the Fellows and do not represent the opinion of the sponsoring programs. Archives
September 2018
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