By: Esther Liu, Contributor
The Silhouette: What is the IMPACT study?
Marla Beauchamp: With the start of COVID-19 and the public health recommendations on social distancing and staying home as much as possible, one of the things that concerned us was: "How could this be affecting older peoples' mobility and their social participation?"
We know that mobility is a really really critical aspect of health for older people and when you lose mobility, you're at risk of falling, of negative health outcomes, of hospitalization. So our team wanted to understand the impact of these social distancing recommendations on peoples' mobility and participation over time.
[/media-credit] Marla Beaucamp
Brenda Vrkljan: Our sample is focused on people in Hamilton and one of the things that we wanted to do with this study was to be very thoughtful about who is gonna be included in the study. We aim to have a random sample, but that's a very loose term because when you say “I want a random sample,” it's not really that random because you still need to obtain informed consent and those kinds of things [and] you still need to recruit people. But what we did was we sampled people in different areas of the city, different economic statuses, different social determinants of health.
How did this study come into existence?
Beauchamp: I do a lot of work with people with chronic Lyme disease. Some of the guidelines for people include that you should remain at home completely, you should not go out at all. And so I was really concerned that we were telling people not to move, right? And I wanted to understand the impact of staying at home and not going about doing their usual activities, what that could do to their health.
So that was part of the reason for doing it. Also, Brenda and I are always talking about ways that we can support older people to live in their homes and to live independently. So if we were going to think more long term about this pandemic, we really needed to understand what has been the impact: what are people doing, what are people noticing?
Vrkljan: Like any good idea, there tends to be what I called the idea stack. So, Marla goes: "I have an idea," and I go: "Oh what if we did this too?". This might draw some other people in too and then what hopefully happens is that it's picked up in a better place. One thing we have is that we involve older adults in our initiatives. Of course, we might talk to our families, but that's not quite the same as talking to somebody who's not so close to us.
Marla and I have parents who are aging. . . and we also had an older adult partner who said that we're asking her lots of questions, but one thing that we're missing out on was the impact of the quarantine. We were missing out on the experience of living through a quarantine. So we've added interviews to our study with questions about their lives before the pandemic, during the pandemic and how they foresee their lives after the pandemic.
We're calling it the trilogy approach — it's not quite Star Wars — but this idea of thinking about your life in segments and trying to understand how people manage is our next step. We want to see what strategies people are using that are helping them do really well and see if those strategies could be implemented to help more people.
We're calling it the trilogy approach — it's not quite Star Wars — but this idea of thinking about your life in segments and trying to understand how people manage is our next step. We want to see what strategies people are using that are helping them do really well and see if those strategies could be implemented to help more people.
What are some highlights from the study so far?
Vrkljan: As an occupational therapist, I'm very interested in things that occupy peoples' time — their ability to do things that are important to them. For example, being able to get out to Tim Horton's could be really important to some people, that could be where you get your socialization. When you can't do those things, it could mean that you're not getting rest, that you're not moving around as much. So together, we're very interested in how people manage their mobility and manage their social participation because we want to leverage that.
Resilience is something . . . interesting as well. It's interesting to see that some of our participants actually reported that they're having such a hard time that they would actually have symptoms of post-traumatic stress disorder. It's not a diagnosis, but it's a real struggle. Now, we don't know how they were doing before, but we just had their snapshot in time.
[/media-credit] Brenda Vrkljan
Beauchamp: I just want to emphasize that it is a small proportion of people, but obviously concerning still and not nontrivial. Another big concern with our study is that almost half of respondents said that they were very worried about falling and of the people that had a fall in previous years, almost 40% said they had a fall in the last 30 days. That is a high number of calls during a pandemic where you're supposed to be with your family at home and less in the community.
So it just speaks to the fact that if you're less active and you do have problems with mobility, it can really have an impact on your health. These are all routes highlighted by the survey that are going to be important concerns going forward as we come out of the pandemic.
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By: Sophie Geffros
The use of trigger warnings in the classroom is not just an accessibility issue; it is also good pedagogical practice.
Both of these statements may shock you. Indeed, given the recent spate of hand-wringing articles by academics regarding their use, one would be forgiven for thinking that “trigger warnings” involved warning a professor before pulling a trigger.
Of course, they’re nothing of the sort. A trigger is a stimulus that produces a disproportionately negative reaction in people with mental health concerns. They are most commonly associated with Post-Traumatic Stress Disorder (PTSD) and other anxiety disorders, and may describe a stimulus that evokes an individual’s trauma so strongly that they “flash back” and relive the traumatic event in their mind. Although every person has different triggers and a different reaction to exposure, there are some that are more frequent than others. Descriptions of abuse, sexual violence and traumatic injury are all common triggers in people with PTSD.
Alerting students to the contents of the next day’s lecture is already common practice in most classrooms. In my four years at McMaster, I cannot recall ever having been assigned a reading without the professor reminding us to pay particular attention to certain themes or phrasings. Including a warning about the graphic descriptions of rape will not prevent professors from also directing students to pay particular attention to the use of birds in Tess of the d’Ubervilles.
A trigger warning is an academic accommodation that instructors are legally obligated to provide, but the onus should not be on the student to reach out. To begin with, there are many individuals with PTSD symptoms who have not been formally diagnosed. PTSD is very common in individuals who have been sexually or physically abused, and these individuals often do not feel comfortable disclosing their symptoms to a physician, as to do so is also to admit to the abuse. Even individuals with a formal diagnosis may not be comfortable approaching Student Accessibility Services about this, and even fewer will be comfortable speaking with an instructor.
Even if you do choose disclosure, instructors are often unsure of how to react. In my first year, I tentatively approached a philosophy professor who seemed sympathetic. I told him that I had heard from other students that some of the case studies on the syllabus dealt with some distressing issues, and that as a person with PTSD, I would appreciate it if he would give us a warning about the content when he assigned the cases. He frowned thoughtfully, and asked “So PTSD, huh? What happened to you?”
I didn’t know what to say. I still don’t. If anyone has come up with a way to disclose years of sexual abuse and two very serious motor vehicle accidents to a professor without feeling as though you should melt through the floor, I would love to hear it.
That night, I experienced nightmares and flashbacks that were the worst I had experienced since seeking treatment for my PTSD.
Psychiatrists call this phenomenon “retraumatization,” and it is relatively common in people with a trauma history. It can leave a person jittery and anxious for weeks, and may result in significant relapse.
Instructors should consider that warnings for content does nothing to diminish the experiences of the group, and allows many students to learn and engage with the material who would be otherwise unable to. Most students with triggers don’t wish to avoid the material entirely—although if they do, it would be within their rights to ask for an alternate assignment—but instead wish to be given sufficient time to prepare themselves. They may discuss the content with a friend or counselor, or they simply may make sure that they are in a safe place and positive state of mind when they choose to engage with it. Regardless of their choices, the provision of a warning will drastically improve their academic experience.
A university should provide an environment that is safe and accessible for all students, regardless of their disability status or life experience. If providing a trigger warning can make the difference between a student engaging with the material or being unable to, I fail to see how an educator can refuse to provide the necessary accommodation.
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By: Teresa Park
Once a year, Canadians come together to commemorate the brave who died and those still fighting for our freedom. But as November passes, poppies are put away, and we move on.
But for some, every day is Remembrance Day. There are those among us who are in invisible pain, living in neither the present nor the past. For many veterans who suffer from post-traumatic stress disorder, each day brings back the worst moments of their past – often through vivid visions and nightmares.
PTSD is a mental disorder that can manifest after traumatic experiences such as war, sexual violence, and major accidents. People with PTSD often describe feelings of “numbness” and “emptiness.” They might avoid certain activities, public spaces, or socializing with others for fear of triggering past memories. At times, they are unable to feel any positive emotions, and have little or no plans for the future. Depression, alcohol and/or drug abuse, and anxiety disorders are conditions that commonly occur with PTSD.
The Canadian Forces Mental Health Survey of 2013 estimated that 5.3 percent of Canadian war veterans are currently experiencing PTSD, a number that has doubled since 2002. Generally, one in six members of the Canadian military report experiencing symptoms of mental or alcohol-related disorders. In the 1990s, many war veterans suffered in silence, but as soldiers begin speaking up about their psychological wounds, they also start raising awareness.
There are support systems in place for those suffering from the condition, including clinical counseling and Paws Fur Thought, a non-profit organization that provides trained service dogs for veterans with PTSD. Unfortunately, there are still many who go on living in pain, and due to limited resources, there are also those who remain stuck on long wait-lists, unable to receive timely assistance. This past summer, three veterans, Steve Hartwig,
Jason McKenzie, and Scott McFarlane, marched across Canada to raise awareness about military-induced PTSD. The campaign, “Into No Man’s Land” solicited $15,000 for mental health initiatives.
PTSD is not a sign of weakness nor is it an indication of failed resilience or readjustment. Our troops’ battles do not end simply because they are back on Canadian soil. Let us support our veterans as they continue to show bravery and strength every time they reach out for help. Lest we forget.
For more information and ways to help, visit Wounded Warriors. Get involved with McMaster’s very own COPE: A Student Mental Health Initiative to help fight the stigma against mental illnesses.
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There is an entirely different war going on in the East than we are aware of.
Ryan Mallough
Silhouette Staff
On March 16, 1968, American Soldiers from the 1st Battalion, 20th Infantry Regiment, 11th Brigade of the Americal Division opened fire on the civilians of the South Vietnamese village of Mai Lai. Between 300-500 Vietnamese, mostly women and children, were killed in the massacre, which would be covered up for a year before reaching the American public.
Twenty-six American soldiers were charged, twenty-five of them acquitted. Only Second Lieutenant William Calley was convicted, given a life sentence on being found guilty of 22 murders. While Calley’s name will forever be associated with the massacre, his sentence was reduced to three years’ house arrest by President Nixon, and he was ultimately released in 1974, serving a total of just over three years for twenty-two murders.
There was no justice for the victims of Mai Lai.
On March 11 of this year, Army Staff Sergeant Robert Bales allegedly left his base in Afghanistan an entered two nearby villages, opening fire on sleeping families and killing seventeen. This time, there was no cover-up. Staff Sgt. Bales was quietly withdrawn from Afghanistan back to the United States via Kuwait and held at Fort Leavenworth military prison in Kansas, where he has been charged with seventeen counts of premeditated murder.
Bales’ lawyer has cited post-traumatic stress as the trigger behind his actions. It was Bales’ seventh tour, he had lost a part of his foot in previous duty and he had a close friend lose his leg days before the attack. While the Afghan shootings were shocking, what is perhaps most surprising is that something like this has not happened before.
According to a 2011 study by Catherine Lutz of the Watson Institute at Brown University, 88,719 veterans of the Afghan and Iraqi wars were diagnosed with post-traumatic stress disorder as of 2010. Lutz also noted that 39 per cent of soldiers deployed in Afghanistan or Iraq were on their second or higher tour of duty.
The American army does not have the man power to afford their soldiers single tours of duty. The longevity of the conflict and the relative strength and staying power of the insurgency have forced the Americans to stay far more engaged than expected at the outset of the war. In response, President Bush, and President Obama after him, oversaw a surge in troop levels, hoping to overwhelm insurgent forces, bringing more soldiers into the area, many of them veterans of multiple tours of duty.
However, as a result of the insurgency, the enemy no longer looks like the enemy, but instead looks like the people they are there to protect. The result was soldiers patrolling the streets and seeing a threat in every passing face. It inevitably takes a psychological toll.
The rationale behind Bales’ actions will be analyzed both in the courts of law and public opinion, and PTSD discourse will inevitably dominate the Western airwaves.
While PTSD is an issue that needs to be brought to the forefront, another issue will be lost in the coverage: the issue of justice, not for Bales’ actions, but for the Afghan people.
Whether it was ever their intention or not, the American forces entered Afghanistan under the pretence of removing the Taliban and brining democratic values to the region. Central to those democratic values are the ideas of accountability and justice. That one has to be held responsible for his actions.
Despite the fact the soldier was American, he committed crimes against the Afghani people. In light of the American’s role in Afghanistan, it would go a long way towards future relations to hold the trial in Afghanistan under Afghani law, even if the Americans reserve the right to punish Bales on their own terms. The Afghani people deserve to have their right to trial upheld.
At the very least the Obama administration should extend an invitation to the Karzai government to send a delegation to bear witness to the proceedings should they be held in the United States; even better would be to extend an invitation to an Afghani lawyer to participate in the prosecution. Such a gesture would do infinitely more to repair the damage caused than the current American strategy of throwing money at the problem ($50,000 per victim) and bringing the trial behind closed doors.
President Lyndon B. Johnson said that “ultimate victory will depend upon the hearts and minds [of the Vietnamese]” in Vietnam War. Allowing events like the Mai Lai massacre to happen and the handling of its aftermath ensured that America would fail. Once again administrations have emphasised the importance of winning over “hearts and minds” This may be their last chance to fix the past, and to show they ever really cared.
His trial is pending, but if it continues on the track it is on, there will be no justice – conviction or no, death penalty or no – for the Afghan people. America has a chance to makes things right.
