BEHS 320 – Applied Final Project – Interview

Applied Final Project

Mental health and disability continue to be a genuine concern for individuals, communities, and governments. Unless people with such challenges are understood, it would be challenging to provide them with appropriate support. To understand depression and what living with it entails, I interviewed David, a 37-year-old African American of low socioeconomic status. Health statistics show that approximately 7.1% of American adults experience at least one depression episode annually (Kalin, 2020). Experiences vary with age groups, support available, knowledge to cope with the condition, and accessibility to healthcare services and resources. As the leading cause of disability in people aged between 15 and 44 years, depression continues to be misunderstood despite its profound impacts on people’s health, relationships, and productivity (Anxiety & Depression Association of America, 2022). The purpose of this paper is to discuss the interview’s major findings and how laws like the Americans Disabilities Act (ADA) and concepts like the Universal Design have been pivotal in protecting and empowering special populations.

Challenges Living with Depression and the Role of Disability Laws

I asked David to recount his experiences and the main challenges he experiences living with depression. He stated, “it is sad that many people do not understand depression and overlook its impacts.” Failing to understand depression implies that people with major depressive disorder and related health conditions do not get timely and appropriate support at homes, schools, and workplaces. David’s assertion is correct. Lack of knowledge about depression and public misunderstanding of people with depression are among the leading barriers to supporting people with depression (Yokoya et al., 2018). Many people do not recognize depression, the need for treatment, and how to help those in need. David blamed inadequate public education as the main cause of the low public knowledge. He suggested that “the situation could be different if there was adequate health education and awareness of mental health as with lifestyle diseases and substance abuse.” In this case, the situation can improve, but a better approach is needed.

David also narrated about stigmatization and discrimination as common challenges he faces regularly. He stated: “I am a victim of stigmatization due to fear and misrepresentations of disability, depression and other mental illnesses from people and the media.” David’s primary concern is how mental illnesses are misunderstood and whether the negative views will end soon. He noted that disability and mental illnesses are represented negatively, which is the main cause of public, self, and institutional stigma. Health research provides a similar perspective to David’s observations and concerns.

Yokoya et al. (2018) suggested that negative public beliefs about depression are the main cause of stigma, discrimination, and related behaviors. Stigma worsens depression and deters people from seeking help. Over 50% of people with mental illnesses do not seek help since they fear being treated differently (American Psychiatric Association, 2022). They fear because stigma and prejudice are widespread, and opening up about depression can make them lose their jobs and livelihoods. As a result, an educational campaign to reduce stigma is crucial to improve public knowledge and beliefs about depression.

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To protect David and others from the damaging effects of stigmatization and discrimination, ADA promotes equality in the workplace by ensuring people with special health conditions have the same rights and opportunities as everyone else. ADA is a civil rights law prohibiting discrimination against individuals with disabilities in all public and private places (Bowman, 2021). Through ADA, people with special needs cannot be discriminated against based on their ability. Accordingly, they get similar civic rights protections accorded to sexual and racial minorities. The ADA was amended into the Americans with Disabilities Act Amendments Act (ADAAA) in 2008 to better deal with workplace discrimination based on abilities. ADAAA defines a disabled person as anyone with physical or mental incapacitation limiting one or more major life activities (National Center for Learning Disabilities, 2022). Under ADAAA, David and others are protected since depression limits thinking and concentrating, which the law recognizes as major life activities.

Coping Mechanisms

David has accepted his condition and views life positively. To understand how he reached this point, I asked him to describe how he copes with his condition to avoid its development to unmanageable levels. David stated: “reducing stress and promoting a positive mindset is instrumental to avoiding stressors that increase depressive thoughts.” As a result, “I engage in activities that boost my self-image and make me feel better about myself.” According to David, it is common to have low self-esteem when living with depression. Hence, adapting effectively and finding strategies to feel better is a crucial coping mechanism. David further noted the importance of positive thinking since it enhances positivity.

Living positively and spending time with friends promote positive identity and inclusion. Disability identity implies connecting positively with the disability community (Dunn, 2019). The identity is better developed when people with special needs accept their condition, share their challenges with others, and overcome labeling. David understands the importance of such an approach to life. When I asked what makes him happy overall, he said that “spending time with encouraging friends and family members surpasses everything else.” Unfortunately, they are not always available hence the need for other adaptations. When people with special needs socialize positively, their peers understand their potential. Hence, they are not labeled negatively or subjected to inclusion. Over time, their ability becomes a non-issue when working and engaging in social practices.

David is adequately informed about the importance of high spirits as a coping mechanism. When I asked him about his thoughts on the importance of social connections, he noted that they are instrumental in reducing depressive thoughts. David is right, and such an approach to depression should be encouraged. Santini et al. (2020) advised people with depression to avoid isolation since it intensifies depressive moods. If not socially connected, people with depression should stay active always. Productive activities include watching movies, walking, and catching up with a friend. Jointly or independently, such activities lift a person’s spirits and reduce the probability of spiraling downward into unmanageable depression.

The other thing that was encouraging with David’s overall lifestyle is how he has prioritized sleep and exercise. When I asked him whether he gets adequate sleep, David said: “although it is common for us to struggle with sleep, I ensure that I sleep at the right time and follow a regular schedule.” The importance of quality sleep among people with depression cannot be underestimated since people with sleep problems are more prone to depression and anxiety problems. Sleep problems also make depression unmanageable since depressed people with sleep problems have more severe symptoms and treatment challenges (Fang et al., 2019). Regarding exercises, David believes that exercising makes him stronger and forgets about his problem for a while. Hu et al. (2020) also underlined the importance of regular exercise when coping with depression since it makes depressed patients feel emotionally and physically better. It is instrumental in relieving stress and boosting self-esteem.

David exemplifies what positive living when someone is sick entails. Commonly, patients suffer since they do not understand their illness or do not embrace it as part of life. It is encouraging to see that David has accepted his condition and is determined to address it holistically. He also understands barriers to healing, including stigmatization and lack of social support. David’s coping mechanisms are centered on positivity. Exercising, active living and socializing are highly effective stress relievers. Health outcomes could be better if all patients understood the importance of coping and adopt appropriate coping mechanisms depending on the severity of their illnesses.

Depression-Socioeconomic Conditions Intersection

The other core element of the interview was the influence of socioeconomic conditions on depression. Health research shows a strong link between socioeconomic status and depression. The primary finding is that low socioeconomic status intensifies depression and hampers coping since it limits access to resources, treatment, and appropriate social support (Schlax et al., 2019). People’s knowledge of mental health varies with socioeconomic status. Kim and Cho (2020) found that depressed patients from low socioeconomic backgrounds are at high risk of neglect or abuse. They are also more likely to develop trauma and not seek early treatment. Since these setbacks affect their recovery, it was important to explore how David’s socioeconomic status shapes his experiences with depression.

Patients from low socioeconomic backgrounds are the most disadvantaged. David believes “a lack of money to afford daily basics when coping with depression hampers recovery.” Considering that people from low socioeconomic settings have low incomes, getting timely and comprehensive treatment for special needs is always a challenge. The other problem that amplifies the situation is low education levels among low-income earners. Besides their inability to access timely treatment, low education levels among patients of low-economic status adversely shape their beliefs about mental health. Like David, most patients from such settings opt for complementary and alternative medicine (CAM). Since most CAMs are not scientifically proven, there is a high probability of slow or no recovery when using them.

Solutions from a Healthcare Provider/Aide Perspective, ADA, and Universal Design

Like many other conditions, depression can be easily overcome with the right approach and reliable support. The patients also need to have a positive mindset, open up, and be willing to seek help when necessary. David believes “mental health problems disturb patients due to a wrong approach.” As a result, we explored the most practical solutions to enhance healing, promote holism, and prevent the recurrence of the condition. The first intervention that we explored from a health perspective was accommodations. Despite understanding many elements regarding depression, David does not adequately comprehend workplace accommodations and how the Americans with Disabilities Act (ADA) protects him. People with mental health problems should request workplace accommodations to enable them to perform their roles more effectively (Mental Health America, 2022).

David also needs such support, and I explained to him about the available accommodations and how to make a written request. Essential accommodations to help depressed people to manage their conditions and job responsibilities include a support person, flexible work schedules, and a private space (Mental Health America, 2022). When requesting accommodations, patients should identify their issues, specify problematic job tasks, outline accommodation ideas, and state that they are requesting support under the ADA. Such a formal approach will ensure that David gets appropriate support.

The concept of Universal Design demonstrates how workplaces can protect and support the growth of people with special needs. Universal Design is centered on social inclusion as a process for enabling and empowering people’s performance, health, and social participation (Maisel & Ranahan, 2022). David is adequately aware of the importance of inclusivity and why organizations should design environments that accommodate everyone. He believes “ensuring an equal playing field benefits people with functional limitations and reduces workplace discrimination.” For Universal Design to thrive, workplaces should have environments, rules, and systems that empower all individuals to be fully usable. The built environment should be friendly, safe, and not limit people’s movement due to their disabilities.

The other intervention that we explored is support groups. I first asked David whether he is a member of a support group and the motivations behind it. He said: “I have joined a mutual support group where members inspire and encourage each other.” Through such platforms, patients can encourage each other and improve their coping skills. Sharing problems also makes people not feel alone. After David explained his position, I explained other options, including therapy and online support groups and the benefits of membership. Through support groups, patients gain a better self-understanding and more knowledge to handle challenging situations (Solari-Twadell & Ziebarth, 2019; Cascella & Stones, 2021). Unlike mutual support groups, therapy groups help patients to receive professional advice. Although a fee is involved, David should enroll in a therapy group for better outcomes.

We also explored the importance of self-care and the most effective strategies. Pilkington and Wieland (2020) defined self-care as individual activities for health management that include complementary and alternative approaches. When explaining coping mechanisms, David mentioned that he engages in exercises and prioritizes adequate sleep. Such interventions are crucial self-care strategies to empower patients to overcome depression. I advised David to consider reading health blogs, try art and crafts, and play creative games as part of self-care. Individually or jointly, these interventions will help David to reduce negative thoughts and think more about self-improvement and recovery. Importantly, he will minimize the risk of engaging in risky behaviors such as alcoholism and drug abuse.

David believes “online resources can be helpful to patients with mental illness, but they need expert advice for effective use and evade the security and privacy risks.” Guided by this view, I explained the importance of online support groups, mobile apps, crisis helplines, and reliable options. A suitable option for David is the ADAA Online Support Group since it facilitates members’ connection and information sharing (Anxiety & Depression Association of America, 2022). With the widespread use of smartphones, information for depression management can be accessed through mobile apps. David’s concern for security risks is genuine since patients can be tricked into sharing private information by malicious users (Tangari et al., 2021). As a result, healthcare providers should help patients to choose mobile apps correctly. An effective mobile app for David is Headspace, which guides patients in conducting meditation practices to relieve stress. Another valuable platform is Crisis Text Line which offers timely responses to mental health victims during crises. The helpline also refers patients to the right healthcare professional depending on the severity of their conditions.

Conclusion

Healthcare professionals should be committed to understanding diverse patient problems and offering creative solutions. An interview is a reliable qualitative method for exploring a patient’s views, knowledge, and fears about a health condition. The interview with David helped me understand his condition in light of common challenges, coping mechanisms, and the link between depression and socioeconomic status. From the interview, David understands his illness and uses multiple management approaches to suppress depressive thoughts and feelings. However, other interventions can be used to improve health outcomes; hence, I offered advice from a healthcare professional dimension to enhance David’s recovery.

BEHS 320 – Applied Final Project – Interview References

Anxiety & Depression Association of America. (2022). What is depression? https://adaa.org/understanding-anxiety/depression

Anxiety & Depression Association of America. (2022). Where can I find support? https://adaa.org/find-help/support

American Psychiatric Association. (2022). Stigma, prejudice and discrimination against people with mental illness. https://www.psychiatry.org/patients-families/stigma-and-discrimination

Bowman, K. L. (Ed.). (2021). The Oxford handbook of US education law. Oxford University Press.

Cascella, M., & Stones, M. J. (Eds.). (2021). Suggestions for addressing clinical and non-clinical issues in palliative care. BoD–Books on Demand.

Dunn, D. S. (Ed.). (2019). Understanding the experience of disability: Perspectives from social and rehabilitation psychology. Oxford University Press.

Fang, H., Tu, S., Sheng, J., & Shao, A. (2019). Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. Journal of Cellular And Molecular Medicine, 23(4), 2324-2332. https://doi.org/10.1111/jcmm.14170

Gondek, D., & Lereya, T. (2018). What are the challenges involved in the prevention of depression in schools?. Contemporary School Psychology, 22(4), 395-400. doi: 10.1007/s40688-017-0136-z

Hu, S., Tucker, L., Wu, C., & Yang, L. (2020). Beneficial effects of exercise on depression and anxiety during the Covid-19 pandemic: A narrative review. Frontiers in Psychiatry, 11, 587557. https://doi.org/10.3389/fpsyt.2020.587557

Kalin, N. H. (2020). The critical relationship between anxiety and depression. American Journal of Psychiatry, 177(5), 365-367. https://doi.org/10.1176/appi.ajp.2020.20030305

Kim, Y. M., & Cho, S. I. (2020). Socioeconomic status, work‐life conflict, and mental health. American Journal of Industrial Medicine, 63(8), 703-712. https://doi.org/10.1002/ajim.23118

Maisel, J. L., & Ranahan, M. (2022). Beyond accessibility to universal design. WBDG. https://www.wbdg.org/design-objectives/accessible/beyond-accessibility-universal-design

Mental Health America. (2022). What mental health accommodations can I ask for at work? https://screening.mhanational.org/content/what-mental-health-accommodations-can-i-ask-work/

National Center for Learning Disabilities. (2022). Learn the law- ADAAA. https://www.ncld.org/get-involved/learn-the-law/adaaa/

Pilkington, K., & Wieland, L. S. (2020). Self-care for anxiety and depression: A comparison of evidence from Cochrane reviews and practice to inform decision-making and priority-setting. BMC Complementary Medicine and Therapies, 20(1), 247. https://doi.org/10.1186/s12906-020-03038-8

Santini, Z. I., Jose, P. E., Cornwell, E. Y., Koyanagi, A., Nielsen, L., Hinrichsen, C., … & Koushede, V. (2020). Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): A longitudinal mediation analysis. The Lancet Public Health, 5(1), e62-e70. https://doi.org/10.1016/S2468-2667(19)30230-0

Schlax, J., Jünger, C., Beutel, M. E., Münzel, T., Pfeiffer, N., Wild, P., … & Michal, M. (2019). Income and education predict elevated depressive symptoms in the general population: results from the Gutenberg health study. BMC Public Health, 19(1), 1-10. https://doi.org/10.1186/s12889-019-6730-4

Solari-Twadell, P. A., & Ziebarth, D. J. (Eds.). (2019). Faith community nursing: An international specialty practice changing the understanding of health. Springer Nature.

Tangari, G., Ikram, M., Sentana, I., Ijaz, K., Kaafar, M. A., & Berkovsky, S. (2021). Analyzing security issues of android mobile health and medical applications. Journal of the American Medical Informatics Association : JAMIA, 28(10), 2074–2084. https://doi.org/10.1093/jamia/ocab131

Yokoya, S., Maeno, T., Sakamoto, N., Goto, R., & Maeno, T. (2018). A brief survey of public knowledge and stigma towards depression. Journal of Clinical Medicine Research, 10(3), 202–209. https://doi.org/10.14740/jocmr3282w

Your first task will be to prepare a short bulleted Outline (or one-to-three paragraphs, written, if you prefer) on your topic for your Final Paper, including your intended sources from our course materials, readings, and any supplemental resources you choose. Please list either the individual you intend to interview, or the two current events you intend to compare and contrast.

Then, due on the last day of the course, you will submit a 4-8 page Final Paper based on your approved Proposal. Final Papers are to be submitted via your individual Portfolio link.

Examples of each option for this Project are attached, below. Each came from students who received 100% of the available points.

Note that you have a choice in this Final Paper to either:

Interview a person who has lived with a disability, and contract/compare his/her experience with your knowledge and readings about disability history and rights from our course (using the interview as a source for your paper, DO NOT write a Q&A-style Copy); OR

Compare/contrast at least 2 (two) current events in disability, selected by you, from either our discussion of current events in this course or a reliable news source, applying what you have learned about disability history and rights in this course.

My approval on your Outline and sources is required before proceeding to the Final Project.