18 Jun HOW DID CULTURE PLAY A ROLE IN THE CRISIS THAT OCCURRED IN THIS COMMUNITY?
As a member of a team of Native American mental health professionals and traditional spiritual leaders (hereafter called “the Team”), I have had the opportunity to respond to community crises in Native communities. Often these responses have come after communities have experienced clusters of youth suicides. The following is a description of one of those responses. The health director of a remote tribal community of approximately 2,500 contacted and met with the Team leaders (one of the community’s traditional spiritual/cultural leaders and me, a clinical psychologist). She described the occurrence of 17 youth suicides in the community, all by hanging, over a 2-month period. Most members of the community had been affected directly in some way, and some families had lost more than one child. Service providers and first responders in the community were overwhelmed and exhausted as suicide attempts were continuing almost every day. Community leaders had sent the health director to request that the Team respond as soon as possible to help stop the suicide attempts and help the community begin a healing process. Team Activities The Team prepared itself through spiritual ceremony and then traveled to the community within 3 days. The following are some of the activities of the Team over the next several weeks. Meeting with first-line service providers (FLSPs). The Team spent the first day meeting with a group of service providers and first responders from the community, providing training on the effects of traumatic stress and using talking circles to give the FLSPs a chance to talk about the ways they had been affected by the suicides. The FLSPs became the lead group for all the following work and worked closely with the Team for the remainder of the visit. Community meeting. The Team conducted an open community meeting to hear the perceptions and ideas of community members about what had been happening. Meeting with tribal government. The Team met with the tribal government to ensure that community members recognized that the Team had been authorized to be in the community, and to present a report and recommendations to tribal leaders at the end of the visit. The Team maintained contact with tribal leaders as recommendations were implemented over the next several years. Meeting with spiritual leaders. Traditional Native spiritual leaders and church leaders had never met together before but were able to come together to provide united spiritual support to community members. Working with schools. All of the schools serving the reservation children (public, church-based, tribal) were visited. This was facilitated by school counselors who were part of the FLSP group. Team members working with members of the FLSP group held talking circles with children in every grade, all teachers, and all administrators to educate (in grade-appropriate formats) about the effects of traumatic stress and to identify high-risk children. Meeting with affected families and relatives. Team members traveled to families’ homes or met them in places they felt comfortable. In some cases, families had not yet reentered the homes where their children had died. Spiritual leader members of the Team conducted the appropriate ceremonies that would allow them to go into their homes or enter their children’s rooms. Mental health members of the Team worked with the children, adults, and families to help them express their grief, honor their loved ones, and support one another. Meeting with representatives of the judicial system. Some children whose siblings had died were afraid to return to school because they were afraid someone else in their families would die. The schools had started to press charges against the parents for truancy. Team members met with representatives of the judicial system and were able to work out solutions that included in-home schooling for affected children. Building a context. Meetings with the tribal health director over a 2-week period revealed a broader context that included 4 years of massive flooding on the reservation, basements that held 3–4 feet of standing water, increases in respiratory illnesses, deaths of elders, occurrence of hantavirus, and washed-out roads requiring school buses to detour 70 miles (resulting in children going to school in the dark and not returning until dark). Many families had moved to the central district of the reservation, where services and schools were centered, but a severe housing shortage required them to live with friends or relatives. Families were separated, with members scattered among multiple households and their possessions somewhere else. Federal funding cuts meant that service providers were overwhelmed. Overcrowded living conditions led to increases in substance abuse, domestic violence, and gambling. Preexisting racial tensions between the reservation residents and people living in the nearby town were exacerbated. There was a single half-time mental health professional for the reservation, and when the suicide attempts started, young people who attempted to harm themselves were sent off the reservation to hospitals more than 100 miles away for evaluation. Often, their families did not have access to transportation and could not go with them. When the young people returned, their families were not informed about diagnoses, medications, or warning signs, and there was no aftercare in the community. This was the case for many of the young people who had died. People started to believe that when their children were “sent away,” they were put on medicine that contributed to them killing themselves, so now there were many more suicide attempts that went unreported. The young people who had died were actually seen as the youth leaders in the community. Sharing the context. The Team worked with the health director and tribal governance to build the context for the current crisis situation. The tribal chairperson called a mandatory meeting of all community members so that the Team could share the context with community members. People in the community had not connected the long-term stress brought on by the flooding to the suicides. The tribe did not think of the flooding as a “disaster” because it was a part of the natural world (there actually is no word for disaster in the tribal language). Team members had also been working with the young people, developing a new set of youth leaders. These youth shared their grief, feelings of loss, and need for adult guidance at the community meeting. Sharing this context allowed community members to get a “big-picture” view of what had been happening and allowed them to come together and mobilize community resources to support each other and begin a healing process. Developing a community crisis team. The Team worked with the FLSP group to develop a community crisis team with an emergency plan and connection to needed resources. The Team had discovered a pattern of suicide attempts, and planning was done for the community crisis team to use time periods when no suicide attempts were happening to do community education and outreach. Engaging in advocacy. The Team was able to advocate with FEMA to get needed resources to the community. Acknowledging the relationship. The Team maintained contact with the community and its leaders. Follow-up visits focused on further development of the crisis team, the youth leadership, community education, and advocacy for resources. It was important for the Team to acknowledge that its relationship with the community did not end at the end of the crisis. Engaging in self-care. The Team met at the end of every day so that members could debrief and check in with each other. Even when the Team worked late into the night, this meeting was important to make sure that everyone remained healthy. In a situation where children have died and everyone in the community has been affected, it is difficult for helpers not to be overwhelmed as well. Throughout this intervention and the several years that followed, the Team maintained a supportive presence, stayed in the background, and empowered community leaders and service providers to shape and implement their plans. Community members who had felt helpless in the beginning became active leaders for change in their own community. The suicide attempts stopped, the youth leadership asked for representation in tribal governance, and needed resources (including mental health professionals) were received in the community.
What are some of the reactions to traumatic stress seen in the community described above? Would you describe the community above as resilient? Why or why not?
How did culture play a role in the crisis that occurred in this community?
How do the IASC guidelines apply in this setting? How do they serve to protect a community during a crisis response?
Case Study of Jeanette – Chapter 17
Jeanette, a 54-year-old married African American woman, presented at a community mental health center in rural Georgia with symptoms of depression (weight gain, irritability, social isolation, crying spells). Jeanette’s husband is an independent contractor, but construction jobs have been few and far between with the economic downturn, and Jeanette herself is currently unemployed. Jeanette has one adult daughter with whom she describes a “distant” relationship because her daughter identifies as a lesbian and lives in Atlanta with her girlfriend. Jeanette states that she garners the majority of her social support through her women’s group at church, though she notes feeling “guarded” around friends who “don’t know too much” about her past. As a child, Jeanette experienced severe physical and psychological abuse from her mother and sexual abuse from her older brother. Despite having been raised in the 1960s, Jeanette grew up in a childhood home that had no indoor plumbing or heat, and she states that she was too embarrassed to make friends for fear they would find out about her poverty. She dropped out of high school in the 10th grade in order to get a full-time job as a line cook that enabled her to move away from her abusers and support herself. Jeanette entered therapy at the prompting of her husband, who claims that she “overeats away her pain” rather than facing her past trauma. Jeanette has a history of severe drug abuse, but she indicates that due to Narcotics Anonymous, raising her daughter, and her Baptist faith, she has been able to remain substance-free for 17 years and has instead shifted her coping method to food. Since her daughter moved away and came out as lesbian, Jeanette reports feeling that she has lost her identity as a mother and homemaker. Jeanette completed her GED after her daughter was born and has since enrolled in a few classes at the community college, but she has little desire to earn her associate degree. To pass the time, she is currently seeking employment, but because of her past involvement with narcotics, she has a criminal record and has been unsuccessful in securing even a minimum-wage position. Jeanette indicates that she would like to work on her anger toward her family of origin, her feelings of helplessness, and her lack of a sense of purpose. In sessions, she explores the context of her traumatic experiences. Growing up in the rural and racially segregated South, she felt as though she could not report her abuse or rely on law enforcement for support or intervention. Moreover, as a Black woman, she describes feeling pressure not to bring negative attention to her family and community by reporting these assaults. Through therapy she begins to process how these early traumatic experiences may have contributed to her feelings of hopelessness and disempowerment, which eventually led to substance abuse and overeating. Jeanette feels “trapped” and discouraged by her inability to find employment and notes that her present disempowerment is triggering her to relive past trauma. At the end of her fourth session, Jeanette expresses the desire to set concrete goals for reestablishing her sense of personal mastery while allowing for a more healthy release of anger toward her mother and brother. Jeanette also notes that she would like to work on her relationship with her daughter but feels “stuck” because of her spiritual beliefs that same-gender romantic relationships are immoral. She fears that if her friends in the Baptist women’s group find out that her daughter is a lesbian, she and her husband will be marginalized by their community, and they might also lose the sporadic economic support they receive from religious leaders and food banks run by faith-based organizations.
Jeanette’s presenting concerns emerge at the nexus of several poverty- and racism-related factors. How would you describe the influence of these systemic forms of oppression in her life and in her presenting concerns?
ORDER THIS PAPER NOW AND GET AN AMAZING DISCOUNT.
Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteDemy. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.
Fill in all the assignment paper details that are required in the order form with the standard information being the page count, deadline, academic level and type of paper. It is advisable to have this information at hand so that you can quickly fill in the necessary information needed in the form for the essay writer to be immediately assigned to your writing project. Make payment for the custom essay order to enable us to assign a suitable writer to your order. Payments are made through Paypal on a secured billing page. Finally, sit back and relax.
About Writedemy
We are a professional paper writing website. If you have searched a question and bumped into our website just know you are in the right place to get help in your coursework. We offer HIGH QUALITY & PLAGIARISM FREE Papers.
How It Works
To make an Order you only need to click on “Order Now” and we will direct you to our Order Page. Fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.
Are there Discounts?
All new clients are eligible for 20% off in their first Order. Our payment method is safe and secure.