Health Care in Venezuela
My forthcoming book (2019, University of California Press), State of Health: Pleasure and Politics in Venezuelan Health Care under Chávez, takes readers inside one of the most controversial regimes of the 21st century for an in-depth account of how poor people’s lives changed when the state reorganized its health system. This lively and accessible ethnography looks at the pleasure people took in new features of government health care such as personalized doctors’ visits, health activism, and therapeutic dancing. Based on extensive participant observation and interviews, this book shows that government health care in revolutionary Venezuela excited people because it provided more than medicine. Health programs empowered and affirmed poor people as valued members of society, making it clear that their lives mattered. This book explains the meanings of socialized medicine from the vantage point of historically marginalized Venezuelans, who made up the majority of the country’s population. It offers a singularly unique account of daily life in Chávez’s Venezuela. Although people’s lives have changed dramatically since the Chávez era, this book provides lasting insights into how ordinary people experience radical moments of social and political change. State of Health signals a paradigm shift in the field of medical anthropology by establishing the value of studying pleasure with the same seriousness of purpose with which ethnographers study suffering. This book shows how paying more attention to the positive aspects of medicine could revolutionize our understanding of how health care gives meaning to people’s lives.
ADHD and Stimulant Use
ADHD is one of the most commonly diagnosed mental health problems in North America, affecting both children and adults, yet much remains unknown about how an ADHD diagnosis and symptoms of the disorder shape people’s lives across the life course. Furthermore, although diagnostic practices and personal experiences of ADHD are strongly shaped by social and cultural forces, relatively few studies have considered ADHD and stimulant use from an ethnographic perspective. In Fall 2014, I began a collaborative ethnographic research project that includes anthropology undergraduate student researchers to conduct participant observation and interviews with young adults on topics related to ADHD and stimulant medications. Our goal is to better understand how young adults understand and experience ADHD and stimulant use in their daily lives. The study will focus on cultural constructions of the disorder among the campus community, everyday life with ADHD, illness-related stigma, notions of disability and enhancement, and the ways in which students use and conceptualize stimulant medication. This collaborative research project will allow undergraduates to contribute to all stages of the research process, including applying research findings in educational and other interventions related to mental health on campus.
An article based on this research is in press in the journal Ethos. I will continue work on this project in Spring 2019.
Homelessness and Mental Health
Between 2004 and 2006, I conducted ethnographic research on experiences of homelessness and mental illness in Chicago, as part of an NIH-funded research team led by anthropologist Tanya Luhrmann (Stanford). For this group ethnography, team members learned about psychiatric interviewing (using the SCID, Structured Clinical Interview for DSM-IV) and participated in ongoing collaborative ethnographic analysis. During this period, I conducted participant observation and interviews in a drop-in center for homeless women in the Chicago neighborhood of Uptown. Based on this research, I published an article in the journal Culture, Medicine, and Psychiatry that analyzes the importance of institutional time schedules in women’s experiences of homelessness. I continue to explore the unintended effects of social services on unhoused persons in my ongoing research on health care in Venezuela, where part of my research focused on a new government program to rehabilitate indigentes (“indigent people”).
Psychiatry and the Stigma of Mental Illness
Between 2001 and 2005, I worked with various mental health research groups to better understand psychiatric services and stigma in North America, focusing on institutions, patients, and psychiatrists in the Midwest. Projects included an NIMH-funded study of ADHD symptoms in children, psychiatric services program evaluations for the State of Illinois, and survey research on the relationship between stigmatizing persons with mental illness and care-seeking behaviors. This research has been published in The Journal of Nervous and Mental Disease and Psychiatric Services. My current teaching and research draws on this diversity of research experiences in mental health, which includes two years of coursework in clinical psychology and work as a diagnostic interview intern for the psychiatry outpatient clinic in Cook County Hospital (Stroger) in Chicago. I am particularly invested in incorporating anthropological methods and perspectives into research on psychiatric practices and experiences of mental health and illness.</p