Addiction Awareness Scholarship Campaign 2020 – Embracing Diversity in the Treatment of Mental Health Conditions

Name: Ali Khan

Embracing Diversity in the Treatment of Mental Health Conditions

Diversity in the Treatment of Mental Health Conditions

a lecture as part of the 2018 Summer Institute for Medical Students
at Hazelden Betty Ford in Center City, Minnesota, I learned that the
etiology of addiction is multifactorial and spans four overlapping
components – genetics, behavior, environment, and physiology. The
same can be said for mental health diseases like
attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder.
Yet, as a child of immigrant parents from Pakistan, I am told my
older sister’s bipolar and stimulant addiction are either the
result of bad omens put on my sister by jealous friends or because my
sister, twenty-eight years old, has not gotten married. My mom prays
each day that the omens be taken off my sister and that she finds a
husband and has a child to occupy herself.

have seen post-it notes my sister writes to herself hoping that her
bipolar is managed, and it has been a four-year battle for my sister
and I to stop my parents from serving as barriers to my sister’s
treatment (and not having them tell my sister to stop medications and
treatment, especially when she is stabilized and no longer feels she
needs medications and treatment). In 2015, when my sister was first
diagnosed with bipolar disorder, I applied for the Take Five Scholars
Program at the University of Rochester to pursue a year of immersion
in behavioral health. I studied personal identity as a potential
barrier to treatment of mental health conditions and worked as an
intern at a behavioral health clinic. I soon realized that some roles
that make up my sister’s identity – being a Pakistani-American,
Muslim, and student – had constructed obstacles to her getting
better. Her diagnosis and the misunderstandings about bipolar
disorder placed upon my sister by herself as well as our
Pakistani-American family and friends are part of a driving force for
me to work on mitigating hyperstigmatization faced by new Americans
around mental health.

the Take Five Scholars Program, I took a deeper dive into the
biopsychosocial elements that are integral in helping patients
through every rehabilitation journey, whether it be related to mental
health or from cancer remission or recovery after a spinal cord
injury. For my sister’s 26th birthday, I constructed a quote-book
of thirty quotes from memoirs and scientific literature about bipolar
disorder so that my sister could keep this quote book with her as she
confronted issues around her diagnosis, including difficulties with
parsing out her personality from her diagnosis and the importance of
checking in with her support systems and team of family, friends, and
healthcare providers. It was important for to me to include quotes
from authors like muslim lawyer and mental health activist Melody
Moezzi, who like my sister and I has immigrant parents from a
population that also hyperstigmatizes mental health. Moreover, I have
been trying to begin piloting a 12-week book club support group for
young adults, age 18-30, living with mental health conditions that
will similarly emphasize targeted readings.

a current medical student, I learn about the chronic care model,
longitudinal follow-up, and medication-assisted treatment (MAT) for
both addiction and mental health diseases. I also learn the
importance of community in recovery and rehabilitation. I try to
bring my parents to family programs committed to rehabilitating
families affected by addiction and mental health diseases to teach
them the skills to prevent family relapse of enabling or other
negative behaviors. I started volunteering in Hazelden Betty Ford in
Chicago, a short walk from Feinberg School of Medicine at
Northwestern University, where I am currently a medical student. The
family program at Hazelden pairs a patient and a volunteer/family
member of a loved one who is living with a similar condition, under
the model that we all see and hear differently what our own family
member has to share with us due to bias and emotionality. The hope is
that I will learn something from the patient who is not my family
member, and he or she will learn something from me.

future plans revolve around improving access to health care,
especially mental and behavioral health care. I
chose medicine as the mode through which I will dismantle mental and
behavioral health stigma because of its intersecting opportunities in
clinic, research, education, and outreach.
first year of medical school was dedicated to finding projects that
emphasize sustainably improving access to health care and
disseminating scientific information for vulnerable populations. I
began interning for Strengthening Chicago’s Youth/Lurie Children’s
Hospital of Chicago to evaluate the success of the pilot year of a
diversion program for justice-involved youth as an alternative to the
juvenile detention system. The majority of justice-involved youth
have at least one mental health disorder or substance use disorder
(Kretschmar et al. 2015, SAMHSA); the diversion program aims to
connect youth to specific community resources and address unmet needs
of the youth and their families while keeping youth in the community.

project extends upon my prior experiences improving access to health
care for justice-involved populations; I worked as an intern at a
behavioral health clinic in Rochester, NY, to address streamlining
continuity of care post-incarceration for women recently released
from incarceration. I specifically was part of a project that
evaluated data on pregnancy in this population. At the start of
working with the justice-involved women, one of the community health
workers took me to an evening Narcotics Anonymous meeting. I was
welcomed in the manner that all NA members and visitors in this group
welcome one another – sharing names and receiving big hugs from the
other participants. I remember from that meeting the candid
confrontations group members had with substance abuse and mental
health, which spoke to pitfalls for recidivism.

sister wonders where her bipolar comes from. When I see my big and
extended nuclear family, I know that my sister’s experiences are
similar to those of many South Asian new Americans living with mental
health conditions. I find that one of the best parts of having a dual
Pakistani-American identity is that it has given me an ability to
bridge disciplines and act as a better translator for the
dissemination of information. I have often played the role of
translator in my life – translating English into Pashto for my mom
as she was learning to speak English, translating biochemical
pathways into similes and metaphors to provide semantic memory cues
to my students as a Teaching Assistant, and I also briefly wrote a
translational science poetry blog. However, my favorite role as
translator continues to be translating behavioral health to my family
and to communities with a history of hyperstigmatizing mental and
behavioral health.