Pedagogy

Global Mental Health INTL 467/567
FALL 2019
Class meeting: Mondays, 4-6:50pm; 255 Lillis Hall
SYLLABUS – DRAFT (subject to change)

Professor Kristin E. Yarris
Email: keyarris@uoregon.edu
Fall Office Hours: Wednesdays 12:00-2:00pm, PLC 313

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Global Mental Health INTL 467/567 (PDF)

Course Overview:

Global Mental Health has emerged as a priority for multilateral institutions like the World Health Organization, for international non-governmental organizations, and for academic researchers. This course examines global mental health from a critical, anthropological, and humanistic perspective, exploring issues from the foundational critiques made by anthropologists about the undue influence of universal diagnostic systems, to current debates over the expansion of psychopharmacological intervention in populations around the world, including in the United States. The course will explore several key issues in global mental health, including: the challenges of cross-cultural diagnosis, the social and cultural shaping of emotional distress and mental illness, and the historical role of power (politics, economics, and history) in shaping the identification (naming and labeling) of mental health problems. We will also engage with questions about what appropriate, person-centered, community-based, and culturally-relevant responses to mental health problems might look like. The aim of the course is to deepen students’ understandings of mental health in critical, historical, and global perspectives.

Addendum:

In the Fall 2019 term, “Global Mental Health” will be taught in tandem with a course offered by my colleague Prof. Mary Wood (UO English), INTL 407, “Madness, Place, Story.” Professor Wood and Yarris have received a UO-Mellon library-museum collaboration grant to further develop their research project on the history of American psychiatry and nation-state formation through examining the story of the Morningside Psychiatric hospital, which was open in Portland from 1903-1963. Thus, several activities during fall term will expose students to archival materials in UO libraries and artistic materials in the Jordan Schnitzer Museum of Art (JSMA) related to mental illness and mental healthcare. This term’s course is therefore somewhat experimental, so students should join in this class with a spirit of intellectual curiosity and open-mindedness. Additionally, students will have the option of working on class research projects (see below) related to Yarris and Wood’s ongoing research.

Required books (Available for purchase in Duckstore):

(1) Reyes-Foster, Beatriz. 2019. Psychiatric Encounters: Madness and Modernity in Yucatán, Mexico. Rutgers University Press.

(2) Stevenson, Lisa. 2014. Life Beside Itself: Imagining Care in the Canadian Arctic. University of California Press.

(3) Whitaker, Robert. 2010, 2015. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. New York: Broadway Books.

Additional readings and other materials will be made available on the course Canvas page or a course WordPress blog, currently under construction.

Course Activities, Expectations, and Assignments:

First, ENGAGING WITH GMH SCHOLARSHIP & WRITING RESPONSES PAPERS. As a class, we will read three books examining challenges in global mental health. We will read the works on our own (out of class) time, and use class time to discuss the books and their provocations and implications.

For undergraduates: In-class discussions of the readings are worth 10% of a students’ course grade (as presence in class is worth 1 point per class period). If you are absent for a class, you cannot make up this point (with no exceptions). Three short reflection papers (one written on each book read during the term) will assess students’ engagements with these books. For undergraduates: 15 points per paper, 45% of course grade; for graduate students: 10 pts per paper; total of 30% of course grade.

Second, SKILLS-BUILDING IN ACADEMIC RESEARCH AND WRITING. During the term, we will engage in a number of in-class activities, often with guest presenters, designed to enhance our skills as academic researchers and writers. For instance, one session will focus on library research skills, another on developing WordPress sites to share our work with broader publics. These sessions will happen in class, therefore, students must attend classes to benefit.

Third, GROUP RESEARCH PROJECT. Students will work in small groups throughout the term on a research project related to global mental health. Groups and topics will be established by week three of the term, in consultation with the professor. As part of the professor’s ongoing research project examining the history of psychiatric diagnosis and patient care at Morningside psychiatric hospital, possible group topics include: analyzing patient data for patterns in historical diagnosis and treatment of mental distress; researching the controversies over patient care and financial (mis)management at the Alaska Psychiatric Institute; examining best practices in patient-centered community mental healthcare (in Oregon, or elsewhere); conducting discourse analysis of historical materials documenting the decline of Morningside hospital, among other project topics, which the professor will distribute during week one of the term. Small groups will present their project findings to the class at the end of the term, using either oral presentations and/or web-based platforms.

For undergraduates: Group projects are worth 35% of overall course grade.

For graduate students: Projects are worth 30% of overall course grade.

Fourth, ENGAGE IN DEATES IN THE FIELD OF GLOBAL MENTAL HEALTH.

A) Sign up for the “Five on Friday” blog produced by Columbia University’s Global Mental Health program. See: http://cugmhp.org/five-on-friday/

B) Engage in discussions on a WordPress site currently under construction for this class at https://blogs.uoregon.edu/melloncourses/

C) Actively participate in discussions on the course Canvas page. All students will post at least one weekly discussion response either on Canvas or on the course blog site. Posts are worth 1 point per week, or 10% of the course grade for all students.

Note: The class has purposefully been scheduled for a three-hour, once-per-week, block of time in order for us to use our class meetings as a combination of discussion, skills-building, and project work time. Typically, students should come to class prepared to discuss the assigned reading for that week for the first hour-plus of class; then, after a short break, students will work in their project work groups for the second hour-plus of class.

Additional Graduate Student Expectations: Graduate students enrolled in INTL 567 have two

Additional requirements:

First, graduate students will facilitate in-class discussion of the assigned course readings during one week of the term (each graduate student will facilitate one class session). For this requirement, the graduate student will create a lesson plan for the class period, and will meet with the professor to discuss this lesson plan at least one week prior to the class period they facilitate. This requirement is worth 10 points of each graduate student’s course grade.

Second, graduate students will submit one paper (of up to 5 single-spaced pages, max.) related to their own research projects and interests. This paper may be any of the following: a research proposal, an annotated bibliography, a conference paper, a literature review, an empirical section of a thesis or dissertation in progress, or another project approved by the professor. This paper is worth 20 points of graduate students’ final course grade.

Grading Summary:

UNDERGRADUATES (INTL 467)

Class participation (being present and engaging in discussions based on the readings): 10 pts
Online Discussions (weekly posts related to current events on Canvas or course blog): 10 pts
Reading reflection papers (three short essays responding to assigned books): 15 pts x 3 = 45 pts
Final group project (based on collaborative research and presentation): 35 pts

Total pts possible = 100

GRADUATES (INTL 567)

Class lesson plan/facilitation of discussion during one class period based on readings: 10 pts
Canvas conversations (weekly posts related to current events on the course web page): 10 pts
Reading reflection papers (three short essays responding to assigned books): 10 pts x 3 = 30 pts
Final group project (based on collaborative research and presentation): 30 pts
Final research paper (based on individual research interests, in consult with professor): 20 pts

Total pts possible = 100

Grading Rubric:

The instructor will assign letter grades roughly corresponding to the table below. However, in some cases, the instructor will curve course grades, in order to more fairly distribute letter grades. Letter grades will always be curved in the students’ favor, e.g. a “92” might be an A or an A, but not a B+; similarly, a 70 might be a C- or C, but never a D+.

A+ 100

A 94+-99

A- 90-93

B+ 87-89

B 83-86

B- 80-82

C+ 77-79

C 73-76

C- 70-72

D+ 67-69

D 63-66

D- 60-62

F < 60

Learning Outcomes. Students Taking this Class Will:

1) Develop sophisticated understandings of the importance of social and cultural factors in shaping the meanings of mental illness and the appropriateness of responses and treatments.

2) Become aware of critiques of medical interventions, in particular psychopharmaceutical interventions, in global mental health.

3) Learn about alternative ways of responding to mental illness and distress, such as social support and community-based care.

4) Develop research skills in historical, textual, narrative data analysis, including reviews of secondary sources in academic literature and engagements with primary source materials (interviews, archival materials, and other data)

5) Be sensitized to the ethical challenges involved in social science and humanistic research related to global mental health.

6) Improve skills in academic writing – developing analytical arguments in written English.

7) Become familiar with academic blog sites as a means of sharing research with broader publics.

8) Enhance their group collaboration, teamwork, and presentation skills, through a collaborative research project and final presentation.

Course & UO Policies:

Attendance policy: Students are expected to attend all class meetings (especially as there are only ten meetings this term). It is students’ responsibility to attend all classes and to find out (from a peer or classmate) about material covered in any classes they may miss. Please do not contact me (Dr. Yarris) about class absences or to request that I “tell you what you missed in class”. If you miss a class, you should speak to a colleague or peer about what was covered during that class session, and you may come to office hours to ask questions about that class period, but there is no substitute for missing class.

Technology in the classroom: I (Yarris) accept the use of electronic devices (cell phones, ereaders, computers, I Pads, etc.) in the classroom when they are used for purposes related to class work (e.g. searching for information, researching, reading, note taking, engaging in inclass activities and assignments). Use of technology falling outside these uses (e.g. engaging with personal social media, watching YouTube videos unrelated to class, or shopping online) is not accepted. If your technology use becomes a distraction for you or your peers, you may be asked to leave the room out of respect for the learning environment. If you need to take a call during class time, let the professor know, and quietly step outside the room if needed. Speaking aloud into your smartphone or other device is distracting to others around you – it should be avoided, on campus, and in society generally.

Mental Health and Wellness: This course obviously covers issues related to mental distress and illness and psychiatric intervention and treatment. The course can be troubling for us, as we work through issues that often resonate in our personal lives. The professor encourages students to process these thoughts and feelings, through personal journaling, individual counseling, and/or group therapy. On campus at UO, students have access to mental health and wellness support through the UO Counseling Center, through the Ducknest and through UO Recreation. Students are encouraged to seek out these resources to support their mental health and wellness.

Equity and Inclusion: The instructor welcomes all students to this course, regardless of race, national origin, religion, immigration status, ability status, gender identity, or sexual orientation. If you have concerns about language, identity, or inclusion, please speak to the professor in office hours about your concerns, as she wants to learn with you about how to create a more welcoming and inclusive learning environment. As a member of the UO Dreamers Working Group, the instructor welcomes undocumented or mixed status students in this course. Students with precarious immigration status can seek needed support or information at this site: https://www.uoregon.edu/dreamers.

Writing and academic support: Students should seek out the Tutoring and Academic Engagement Center in Knight Library, see: https://blogs.uoregon.edu/engage/writing/

Accessibility: The Professor seeks to make this course accessible to all students, regardless of background or differential ability. Please let the Professor know if you need any accommodations in order to succeed in this class and she will do her best to accommodate you. Students can also contact the UO Counseling and Testing Center and the Accessible Education Center.

Academic Honesty: Students are expected to do their own work and any evidence of plagiarism or academic dishonesty will be handled according to UO policy.

Student Conduct: The UO Student Conduct Code can be found at https://policies.uoregon.edu/vol-3-administration-student-affairs/ch-1-conduct/student-conductcode

Basic Needs: Any student who has difficulty affording groceries, lacks a safe and stable place to live, or is experiencing other problems meeting basic needs is urged to visit this helpful UO specific website: https://blogs.uoregon.edu/basicneeds/ and to contact the Office of the Dean of Students Office (541-346-3216) for support.

WEEKLY SCHEDULE OF TOPICS, ACTIVITIES, AND READINGS

Week 1. Introduction to the Critique, Diagnostic Expansion and the “Epidemic” of mental illness

NO CLASS MEETING SEPT. 30 DUE TO ROSH HASHANAH HOLIDAY

Assignments:

1) Required: Reading Anatomy of an Epidemic, pp. 1-66. (chapters 1-4)

2) Required: Post on Canvas Discussion board (by 12:00pm Friday of each week)

3) Optional: Meet with Professor in office hours

4) Optional activity: Tom Cramer, museum talk, at JSMA. Meet Friday, Oct. 4 @ 2:00pm on the JSMA steps facing PLC for exhibit and artist talk.

5) Optional pre-museum talk, watch video: https://watch.opb.org/video/oregon-art-beatpainter-tom-cramer/

Week 2. Psychiatry’s problematic past; Diagnosis and its Limits; Laying out the debates in GMH.

CLASS MEETS MONDAY, OCT. 7th

Assignments:

1) Required Reading: Anatomy of an Epidemic, chapters 4-6 & 10 (pp. 47-125 & 205-215)

2) In class: review research project options and discuss

3) Listen to the Lancet Global Mental Health press conference at: http://www.thelancet.com/series/global-mental-health

4) Listen to Kathleen M. Pike, Director, Colombia Global Mental Health Program TedxTalk:

5) Post on Canvas under discussion (by 12:00 Friday)

6) Optional museum activity: Friday, Oct. 11th, artist talk with Elsa Mora “One Hundred and One Notions” and “Fading”. Meet at JSMA for 2:00pm artist talk. For background, see:

FRONTPAGE

Week 3. Rethinking Psychiatry, the Survivor and C/S/X movements, rethinking mental health care beyond psychiatry.

CLASS MEETS MONDAY, OCT. 14th

Class Visit by Victoria Mitchell, Global Health librarian, Skills-building session: conducting reviews of academic research using online databases and library resources

Assignments:

1) Required Reading: Anatomy of an Epidemic, chapters 13, 14, 16 & epilogue

2) By Friday of this week, form small groups for research projects

3) Watch Jim Gottstein’s “Psychiatric Adventures” talk at 2012 “Rethinking Psychiatry” conference at: https://www.youtube.com/watch?v=Q-ancdxr268 (9 minutes)

4) Review website: http://psychrights.org

5) Post discussion on Canvas or course blog site

6) Optional reading: https://www.nytimes.com/2018/02/27/books/review-blue-dreams-mentalillness- drugs-lauren-slater.html

7) Optional podcast: Interview with Lauren Slater: https://www.npr.org/sections/healthshots/2018/02/27/589081018/long-term-effects-of-psychotropic-drugs-are-cloaked-inmystery

RESPONSE PAPER on Anatomy of an Epidemic DUE FRIDAY, OCT. 18th

Week 4. Encountering Psychiatry and Coloniality in Mexico; Psychiatric medicine and the limits of modernity; inpatient psychiatric care in a context of scarce resources

CLASS MEETS MONDAY, OCT. 21st

Assignments:

1) Required Reading: Psychiatric Encounters pp. 1-82 (chapters 1-3)

2) In class: Skills building session: Mike Moresi, CASIT– WordPress workshop, developing academic blogs for distributing our work to broader publics

3) In class: Small group project work

4) Post on Canvas or course blog page (by Friday 12:00 noon) – this week, post questions for the author (see week 5)

Midterm Student Experience Survey available – complete by Friday, Oct. 25th.

Week 5. Structural violence and mental health, diagnostic uncertainties; Ethics in GMH research

CLASS MEETS MONDAY, OCT. 28th

Assignments:

1) Required Reading: Psychiatric Encounters pp. 83-164 (finish)

2) In class: Conversation with the author, Beatriz Reyes-Foster via Skype (post questions by Fri. Oct. 25)

**Prof. Wood’s class joins in this conversation

3) In class: Review feedback from midterm student experience survey

4) In class: Small group project work time

RESPONSE PAPER ON Psychiatric Encounters DUE FRIDAY, NOV. 1st

Week 6. The State in Mental Health “Care”; Rethinking state “care” from a critical, historical, and post-colonial perspective

CLASS MEETS MONDAY, NOV. 4th

Assignments:

1) Required Reading: Life Beside Itself, chapters 1-3 (pp. 21-102; Introduction optional)

2) In class: Skills-building session: archival research in psychiatric history and mental health

3) TBD: Visit to UO Special Collections and University Archives

4) In class: Small group project work time

Week 7. Public mental health care: community, prevention, and cultural considerations

CLASS MEETS MONDAY, NOV. 11th

Assignments:

1) Required Reading: Life Beside Itself, chapters 4-6 (pp. 103-170; Epilogue optional)

2) Optional Reading: Ramirez-Stege, Alyssa and Kristin E. Yarris. 2017. Culture in la Clínica: Evaluating the utility of the Cultural Formulation Interview in a Mexican Outpatient Setting. Transcultural Psychiatry 54(4): 466-486. [posted on Canvas page]

3) In class: Small group project time

Week 8. GMH and its Discontents; The limits of a global/local field

CLASS MEETS MONDAY, NOV. 18th

Assignments:

1) Required Reading: Summerfield, Derek (2012). Against “Global Mental Health.” Transcultural Psychiatry 49(3):519-530. [posted on Canvas]

2) Required reading: Somatosphere post at http://somatosphere.net/2012/global-mental-healthand-its-discontents.html/

3) In class: Small group project work time

RESPONSE PAPER on Life Beside Itself DUE FRIDAY, NOV. 22nd

Week 9. First-person experiences; Writing about “madness”; Preparing group projects, presentations, and final products

CLASS MEETS MONDAY, NOV. 25th

Assignments:

1) In class: Discussion with Prof. Mary Wood

2) Skills-building session: writing first-person experiences

3) Required Reading: Excerpt, Heart Berries.

4) In class: Small group project work time Week 10. Small group project presentations

CLASS MEETS MONDAY, DEC. 2nd

Project presentations – Groups 1-4

In class: End of term student experience survey (See: https://provost.uoregon.edu/revising-uosteaching-evaluations#m-ses)

Finals week. Small Group Project Presentations

FINAL EXAM PERIOD SCHEDULE

CLASS MEETS TUESDAY, DEC. 10th, 2:45-5:15pm

Project Presentations – Groups 5-10

Note: this is a required class meeting for all students.