Medical Anthropology Illness narrative student sample Bea

Medical Anthropology Illness narrative student sample
Beautifully and Wonderfully Made
December 21, 2013, is the anniversary of a day that Paige can’t
remember. In fact, she
can’t remember a full two weeks after this day, as she was in a
medically induced slumber.
Concerned family watched as she lay in isolation, hallucinating
and tossing and turning, her
blood count plummeting. Today, she enthusiastically announces
this day as her “re-birthday.”
Paige, 52, her husband, and her three adult daughters live in
Hemet, California. She
addresses her family’s illnesses with a holistic attitude, viewing
diet, exercise, and spirituality as
having as much healing potential as pharmaceutical drugs. She
values doctors who share this
perspective, yet who are also aggressive and candid. Her
approach to medicine reflects a union
between the Western biomedical model and the growing trend of
favoring natural and organic

remedies seen among the upper/middle-class public. Until the
summer of 2008, she was
unaware of just how much these professional qualities would
mean to her.
Summer was vacation time when Paige worked at a local public
school. Yet, as a self-
described “Type A personality,” she liked to keep herself busy
with other activities. However,
Paige soon became aware that she was unusually tired and
requested a blood test from her
doctor. The results came back that she was intensely anemic.
She was given a prescription and
changed her diet to include iron-rich foods.
By July, she had developed a painful lump on the back of her
right knee, which was
diagnosed as a torn muscle. But the lump was still there when
school started in August. While
supervising a detention class, Paige stood up from her seat,
heard a popping noise, and
collapsed to the ground. By the time a student had gotten help,
her knee had swollen to three
times its original size. Managing the pain long enough to wait
for a friend to drive her to the
hospital, Paige received an MRI and a leg brace on the

assumption that she had torn her ACL.
Two days later, she received a phone call from her doctor
requesting an immediate
appointment. He would even keep the office open late until
Paige and her husband were
available. It just had to be that day. That night, they were told
that the MRI revealed
deterioration in the bones of her knees. Taken with her anemia,
these were signs of bone
cancer.
Two weeks after a referral to a hematologist and a bone marrow
biopsy, she was
diagnosed with myelofibrosis with pernicious anemia, a serious
and rare bone marrow cancer.
The hematologist explained to her that the bone marrow is like a
blood factory, and Paige’s was
so scarred that it wasn’t producing any. Her body was a machine
with a broken part. An
abnormal blood-producing stem cell had multiplied and replaced
the bone marrow with scar
tissue. Paige’s illness, the simple experiences of lethargy and a

swollen knee, had become an
alarming, life-threatening disease.
At the time, the only thing Paige and her doctors could do was
treat the symptoms. She
was given steroids and medications for the pain and swelling.
She had to quit exercising, a
practice she enjoyed and valued holistically as an element of
health, because the pain was too
acute. Her anemia kept her constantly tired. Other symptoms
arose. Her spleen began to swell--
it had taken on the job of producing blood. Because her spleen
was preoccupied, Paige’s body
couldn’t fight off infection as well and she was prescribed more
medication to counter this.
Despite the drugs, she developed severe mouth infections and
her teeth began to fall out as the
bones decayed. Today, only about six of her teeth are real. She
was dissatisfied with her
treatment and was disappointed that her doctors not only
wouldn’t consider, but were dismissive
of alternative treatments, such as diet changes to improve her
quality of life. Throughout these
trials, Paige continued to work, as accustomed to the busyness
as she was.

In 2012, an experimental new chemotherapeutic “miracle” drug
was approved by the
FDA, called ruxolitinib (trade name Jakafi). There were high-
risk side effects, including extreme
anemia. Given she was already anemic, this gave Paige pause.
But within a few weeks, she
had improved. She had more energy, was less achy, and her
spleen had shrunk. But this
reprieve didn’t last long.
Three months later, Paige needed her first blood transfusion.
She had begun to feel
unwell again and her blood count had plunged, but this new
procedure was frightening to her. It
was unfamiliar and it meant that her treatment wasn’t working.
Soon the transfusions would
become commonplace; she would need another one about once
every month for the next
eighteen months. And the transfusions came with their own set
of problems. This new blood
was 90% synthetic, causing her liver to swell and her iron
(ferritin) levels to soar. A healthy

person’s ferritin level is under 200 ng/mL-- Paige’s was at
5,000 ng/mL. Her skin took on a
yellow tinge and she was prescribed another drug, this one
called XJ, to remove the excess
ferritin. It took a toll on her work life when, every day after her
morning dose, she had to remain
in the bathroom for several hours, passing the ferritin.
Paige’s body was like a gas tank, only stuck at half-full. This
was how her doctors
explained it to her. She was a machine perpetually needing fuel.
The Jakafi she took daily to
cure her, depleted her “tank” to empty and the transfusions
could only bring her back to half-full.
This iatrogenic paradox of the medicine making her sick was
part of Paige’s life for eighteen
months and early on it forced her to finally make the decision to
leave work. She had to use her
“fuel” wisely, and she wanted to spend it on her family.
All of a sudden, Paige had a lot more time on her hands. What
time wasn’t spent
sleeping, was spent with her family or God. As Christians, the
family grew closer together as
they looked to their God, in addition to therapy, for comfort and

solutions. Family and friends
supported and took care of Paige through these difficult months.
Paige wasn’t scared, though,
because she trusted God. After spending time strengthening her
faith, she asked Him, “God, will
you heal me? I’m tired now. I don’t want this anymore.” It was
then that Paige believes that she
began the journey back to health.
Her oncologist at City of Hope recommended her for a stem cell
transplant. Within
weeks she had an astonishing four perfect bone marrow
matches. Six months later, almost two
years after starting Jakafi, she was checked into the hospital for
the procedure. Five days of
chemotherapy to kill her cancerous bone marrow cells, which
were then replaced with the
healthy cells of a forty-year-old male donor. One hundred and
thirty five days of isolation after
December 21, 2013, a bone marrow biopsy declared her 100%
free of cancer.
Now, Paige has been in complete remission for very nearly a

year and a half. She is
Relay for Life’s “Hero of Hope”; she gives speeches with the
hope of inspiring, providing
information, and helping others. Her disease has made her view
illness in a more positive light.
She believes taking on the sick role is an opportunity to re-
prioritize and to better understand
life. Paige tells her story often. Her explanatory model is half
science, half faith. Is it the placebo
effect-- simple optimism-- that allowed her to advocate for
herself, drive the events of her
treatment forward, and heal? Or something bigger? The
connection between mind and body
can be just as real as Paige’s God. While her disease was
idiopathic, she talks about its cause
biologically, making no reference to “God’s plan” as the root.
She was cured with science, but
only through God’s help. Where her doctors discussed her body
as a broken machine, she was
able to find her personhood in her religious faith. She may be a
machine, but she is one that is
“beautifully and wonderfully made.”
Response ONE

The specific socioeconomic factors that may be contributing to
the patient's abdominal pain include her limited English
proficiency and financial situation. She may not be able to
afford adequate medical care or treatment for her condition,
which could be causing her pain to worsen. Additionally, her
limited English proficiency may make it difficult for her to
communicate effectively with clinic staff, which could lead to
delays in diagnosis and treatment.
The patient may be experiencing spiritual pain that is
manifesting as physical pain. The staff should ask the patient if
she is in any pain and if so, what kind of pain it is. They should
also ask if she is feeling any other symptoms, such as fatigue,
anxiety, or Depression. They should then try to determine what
might be causing the pain. This could include stress from a
recent event or from ongoing life challenges, as well as spiritual
issues such as feeling lost, hopeless, or unsupported. If the staff
feels that the patient could benefit from spiritual care, they
should refer her to a chaplain or other member of the spiritual
care team.
Based on the information provided, it is likely that the patient is
experiencing a stomach ulcer. This can be caused by lifestyle
factors such as smoking or drinking alcohol, as well as by
stress. The patient may need to make changes to her lifestyle in
order to help improve the symptoms of the ulcer. These changes
could include quitting smoking and drinking, and reducing
stress levels. She may also need to take medication to help treat
the ulcer.
One possible cultural factor that may be impacting the patient's
care is her language barrier. The first visit, the staff relied on
her younger bilingual daughter to translate, which may have
impacted the accuracy of the information relayed to the staff.
Today, the patient presents with the same problem, but worse. It

is possible that the patient is not able to communicate her
symptoms accurately to the staff due to the language barrier.
Additionally, it is possible that the patient's cultural beliefs or
values are impacting her care. For example, the patient may
believe that medicine should be taken only when symptoms are
severe, which could lead to her not taking the medication
prescribed to her.
There are a few specific issues that we would need to be
sensitive to when interacting with this patient. First, the patient
may not have regular access to medical care or may be unable to
afford necessary treatment. Additionally, the patient may not
have regular access to food or may be living in poverty, which
can lead to malnutrition and other health problems. The
patient's culture may also play a role in their health. For
example, some cultures believe in traditional remedies instead
of seeking medical care. Additionally, the patient's faith or
religious beliefs may influence their treatment decisions. We
would need to be sensitive to these cultural and socioeconomic
factors when interacting with this patient.
The five targeted questions you would ask the patient to build
his or her health history and to assess his or her health risks.
1. What is the nature of your abdominal pain?
2. When did the pain start?
3. Does the pain come and go, or is it constant?
4. Was the pain worse yesterday or today?
5. Have you experienced similar pain before? If so, what was
the cause?
Explanation:

Based on the patient's symptoms, it is likely that she is
experiencing a gastrointestinal issue, such as gastritis or
pancreatitis. Omeprazole may have helped to relieve her
symptoms initially, but they have worsened in more recent days.
The staff should continue to provide her with medication and
pain relief as needed, and should also work to determine the
underlying cause of her pain. If her daughter is available, she
can be helpful in translating for the sta. 2 APA References
Response 2
Scenario: Paloma Hernandez, 26 year-old, Spanish speaking
patient who presents to the clinic for the last 2 days in a row
complaining of abdominal pain that is getting worse. The first
visit the staff relied on her younger bilingual daughter to
translate. She was treated with Omeprazole and encouraged to
take OTC medication. Today she presents with the same
problem. Her daughter states it is the same problem but worse
today.
Culture reflects the whole of human behavior, including ideas
and attitudes, ways to relating to one another, manners of
speaking, and the material products of physical effort,
ingenuity, and imagination (Ball, Dains, Flynn, Solomon &
Stewart, 2019). Language is part of culture. As healthcare
providers, we have to be culturally competent to administer care
to our patients. culturally competent care requires that
healthcare providers be sensitive to patient’s heritage, sexual
orientation, socioeconomic situation, ethnicity, and cultural
background. As indicated in the scenario patient Hernandez is a
26 year old female with language barrier. She relies on her
younger bilingual daughter to translate. Because it is impossible
to learn the native language of all our patients, when language
barriers arise, we must become aware of our resources and know
how to effectively use interpreters. The use of medical
interpreters has a positive impact on healthcare quality, but we

continue to use suboptimal methods of communication such as
family members. Even though the patient has a younger
daughter who does the translation, she is not trained to offer
this service. She is limited in her ability to explain medical
terminology. Hence, introducing a certified translator will have
a positive impact on the patient’s quality of health. Also,
patient Hernandez may have something very private that she
wishes to explain to the healthcare provider, but because her
daughter is present and is the translator, she may be unwilling
to disclose such information. Providing her with a little of
privacy without her daughters presence and having an
interpreter may cause her to be more comfortable to express
herself. According to Flower, Skinner, Yin, Rothman, Sanders,
Delamater, & Perrin (2017), providing care in Spanish via an
interpreter for Spanish -speaking parents is an essential step
toward quality medical care.
It is important to note that the Spanish meet one
another’s eyes and look for the impact of what is being said
(Ball, Dains, Flynn, Solomon & Stewart, 2019). Hence, when
talking to patient Hernandez, it is very important to maintain
eye contact, and express sympathy and empathy.
Five Targeted Questions
· When did the pain start?
· Where do you feel the pain (show me where it - location)
· Is the pain constant or does it go and come?
· Does the pain radiate to other parts of your body or does it
just stay in one location?
· On a scale of 0 to 10, “0” being the lowers and “10” being the
highest pain, how would you rate your pain?
· Did the medication (Omeprazole or any other medication)
help? How often did you take the medication? Did you take any
other medication?
· What makes the pain worst or feel better?
2APA refrences

Medical Anthropology, UCI Illness narrative student sample
Union of Biomedicine and Religion: An Understanding of an
Illness Experience
Phil is a young man who thrives off of physical activity. This
has been the norm for him
ever since he was young. Throughout the years, he has avidly
been involved in basketball, tennis,
hiking, and biking. His time spent exercising is an opportunity
to de-stress, spend time with
friends, and re-balance his life. Unfortunately, this vital
component of his character was taken
away from him at a very critical time in his life.
Phil was finishing the final year of his undergraduate career and
was amidst the nerve-
wracking process of applying to medical school when he
decided to take a quick break from
studying to play basketball. During a pick-up game, he was
running down the court when he
decided to jump up for a layup. While in air, another player
bumped him in an attempt to halt his
shot. As a result, his body weight was thrown off balance, and

he did not land properly on his left
foot. He experienced a twisting motion in his left knee and
heard a pop, after which he felt a
sharp pain for five minutes. Phil wasn't too concerned at the
time; with a history of experiencing
a slew of minor ankle sprains and knee bumps over the years, he
was no stranger to sports
injuries.
He limped home to his apartment and waited until the next
morning, hoping his knee
would feel better as it had many times before. However, the
next morning, the knee was bruised,
swollen, and more painful. He thought it could be serious so he
called his father -- a doctor -- and
sent him pictures. His father suggested he may have torn a
ligament. As result, Phil came home
from his college to be further assessed by one of his father's
colleagues, who was an orthopedic
surgeon. The doctor drained excess fluid from his knee. The
fluid showed a high amount of
blood, further suggesting a ligament may have been torn.

Phil then returned to his college, where he used his university
health insurance to get an
MRI of his knee, which confirmed a tear of the anterior cruciate
ligament (ACL). The moment
he learned of his ACL tear, Phil was disappointed and
disheartened because he knew his mobility
would be limited for some time.
Phil scheduled his reconstructive surgery as soon as possible
because he wanted to get
back on his feet. Following his surgery, he had to follow a strict
regimen of physical therapy for
three days per week with physical therapists and three days on
his own, with limited mobility
during this time. He was expected to do about two hours of
physical therapy per day. The total
time for him to recover completely was nine months.
The Sick Role and Effect on Social Relationships
The injury was very difficult for Phil because when it happened,
he was taking summer
classes to finish his degree and applying to medical school at
the same time. He was expected to
continue to excel in his classes and finish his medical school

applications, all while being limited
in mobility and spending extra time on physical therapy. He had
to take a wheelchair to class for
some time, and the university staff helped him with this.
However, he did not enjoy the attention
this brought towards him, which made it slightly embarrassing.
It made it difficult to focus in
class and on his medical school applications.
People in situations like Phil's are often excused from their
societal responsibilities for a
period of time to recover. Talcott Parsons, an American
sociologist, termed the sick role to mean
a "sanctioned" form of deviance in which patients have the right
to be exempt from social norms
until recovery. However, when Phil suffered his injury, he was
actually denied the sick role, in
that he was not excused from his day-to-day duties as a college
student and medical school
applicant. Even though he was brought to class in a wheelchair,
he was still expected to finish his
courses in time to attain his degree and apply for medical

school. Perhaps this denial of the sick
role highlights a larger problem within our competitive and
sometimes unforgiving culture in
colleges and universities.
In addition to denial of the sick role, for Phil, the most
significant consequence of the
injury was the lack of time to socialize and have fun through
sports. His social relationships
were, therefore, significantly impacted by his ailment. Phil's
situation shows the distinction
between illness and disease. A strictly Western biomedical
disease perspective would consider
Phil's ailment only in terms of the observed conditions in the
body -- a tear of the anterior
cruciate ligament. However, the illness perspective recognizes
the lived experience of the
symptoms and suffering from the patient's viewpoint. For Phil,
his illness was not simply a torn
ligament, but rather a lack of social relationships and relaxation
time that helped him keep
balance in his life.
Healthcare Inequalities

During Phil's recovery after surgery, he had sessions wi th a
professional physical
therapist in order to re-gain strength in his knee. This service
was provided through his
undergraduate university's health insurance. However, after he
graduated, Phil lost his university
health insurance and was not able to go see his physical
therapist. This factor affected the quality
of his recovery. Phil's lack of health insurance was not an issue
of biomedical pathogens, but
rather a product of his socio-cultural and economic context.
Therefore, this shows that we must
understand disease in not only the biomedical, individualistic
view, but rather we must also
consider the larger context within which the illness is being
experienced. The biomedical tenet of
individualism says that disease is a condition that affects an
individual and should be treated as
such. But rather, there are more factors to consider, such as an
individual's access to healthcare in
his or her socio-economic position.

Encounters with Biomedicine
Although Phil's ACL injury is healed now, he does often sprain
his ankle while playing
basketball, which gives him a nagging pain. Phil had done
research on this problem and had
started doing particular exercises to strengthen his ankle. He
went to see his doctor to ask if there
was anything else he could do to improve his ankle or if there
was perhaps a more serious issue
underneath causing the problem. However, Phil felt that the
doctor dismissed what he was asking
for, since the doctor simply repeated what he had already heard
in the past. The doctor didn't take
a sincere interest in his illness experience, but rather followed a
strictly biomedical model by
addressing the injury without understanding or acknowledging
Phil's concerns and feelings as a
patient.
Explanatory Models
Coming from a family of doctors and healthcare professionals,
Phil understands his
sports injuries largely through the lens of Western biomedicine,

in that he believes in the
materialistic view that his injuries can be observed through
signs in the body. But for his ACL
injury, a biomedical explanation wasn't enough, and he turned
to his religious beliefs to help
explain why the injury happened to him. Phil comes from a
conservative Hindu household and
believes in the 'Swaminarayan' sect of Hinduism. In this sect,
they believe that one is constantly
reborn after death, and that each life's pain and suffering as well
as material happiness is dictated
by the balance of sins and good deeds one did in previous lives,
known as 'karma'. He believes
that major medical problems like his ACL tear are a result of
'karma.' While he firmly believes in
this religious outlook, he does not think about his day-to-day,
mundane pains as products of
karma. But when a major event such as his ACL tear comes
around, he finds it easier to
understand and explain it with his religious ideology. This helps
him find a bright side to his

injury -- at least his pain and suffering happened for the noble
reason that he was atoning for sins
he had done previously.
Biomedicine is based on an assumption of naturalism, which
deems illness as amoral and
non-discriminatory. Phil's notion of 'karma' fills the gap left by
the assumption of naturalism, in
explaining why and how his injury happened. Essentially, Phil's
religious beliefs help him place
his experience with this medical event into a larger context and
meaning in life.
Conclusion
After nine months of physical therapy, Phil was finally able to
regain strength in his knee
to return to his normal physical activity and restore balance in
his life. He is now a medical
student, and as an aspiring doctor, he does not believe that
medicine/science and religion/faith
are mutually exclusive. For him, religion is simply the
explanation of why science works.
Overall, his outlook on his ACL injury is a union between
biomedicine and traditional Hindu
values.

Description of Interview:
My interviewee is my friend that I met in U.S., and now she
went back to Hong Kong. I interviewed her through Facetime in
Monday midnight. The interview was 50 minutes long. I
documented it as handwritten notes.
Interview notes:
Q: Age, place of birth
A: 27years old and Hong Kong
Q: Family composition
A: My mother and I
Q: Where did you grow up?
A: Hong Kong
Q: When you were growing up, who took care of you when you
were sick? Were you treated at home? Taken to a medical
clinic? Did you consult other kinds of healers?
A: My mom took care me when I am sick, I am treated at home,
and I am consulted therapy and psychiatry
Q: Who are you living with now?
A: My mother
Q: Who do you usually consult when you or a member of your
family are sick?
A: Family doctor
Q: What are the qualities you look for in a doctor or other
health care provider?
A: Patient, and chat with me
Q: Can you tell me from the beginning to end about one serious
illness you experienced?
A: When I went back to Hong Kong after I graduated university,
I often fight with my mom, and I felt hard to control my feeling
and emotion. I am not used to live with my mom because I study
aboard in U.S. 7 years. However, I had a family history-my
grandma got schizophrenia, mania, paranoia. After I went to the

psychiatry, then I diagnosed medium states depression. I got
medicine from psychiatry. Treatment for two months. After I
took the medicine, I feel more depressed, so I went to the
therapy.
Q: What are the symptoms that bothered you most?
A: Feel lost and can't control my emotions and I was trying to
hurt herself.
Q: What do you think the illness does to you? How has it
changed you?
A: After I got medicine, I felt sluggish and always need to
sleep, every day slept 18 hrs+, and the antidepressants gained
my weight 15-20 pounds.
Q: Were you frightened by the illness?
A: No. I don’t feel that serious, and I know I has a family
history of mental illness.
Q: What did you fear most?
A: I am afraid to bring negative emotions to my family and
friends.
Q: Why do you think you became ill? What do you think
caused the problem?
A: I believe I got the gene of mental illness.
Q: Why do you think it started when it did?
A: Because the psychiatrist told me that mental illness onset in
the age 10-30.
Q: Has your illness caused any problems within your family? At
work? In other areas of your life?
A: At school, is hard to focus due to the
medicine(antidepressants)which regulate dopamine in the brain.
Q: What did you do about your sickness? Who did you consult
first? Who else did you consult?
What kind of treatment did you receive?
A: Chat with a therapist and medicine treatment.
Q: Were you satisfied with that treatment?
A: Yes, it helps me to calm down. The medicine made me don’t
feel any emotion. Then I can relieve myself.
Q: What kind of attention or treatment do you think you should

have received?
A: I don’t think I need any attention.
Q: Did you follow the treatment recommendations that were
prescribed? Why or why not?
A: Yes, I stopped the medicines until the doctor said I can.
Q: What are the most important results you hope to receive from
medical treatment?
A: I really hope I can get rid of the illness and get back to
normal life.
Q: How did the illness experience change your life or the way
you think about life?
A: I became more introverted than before.
Q: What does being healthy mean to you?
A: I think is lose weight and got a healthy body.
Q: What do you do to stay healthy?
A: Everyday workout for 1 hours.
Q: What things are most harmful to people’s health?
A: I believe is mental illness.
Q: What does being sick mean to you?
A: It means that life is fragile.
Q: Do you think there is any larger purpose/meaning to
sickness? Which diseases are you particularly afraid of? Why?
A: I believe the meaning of sickness is to understand ourselve
and how to fit with the society. I afraid of cancer diseases
because it can bring a lot of stress to family members such as
money and time.
Q: How would you define a good life?
A: Happiness.
Preliminary analysis part A:
Social relationships
From the experience with the interviewee, there is a close link
between a disease and illness in the way they are understood by
the society as illustrated through the interviewee. Based on the
feedback, a disease results into adverse effects on social
relationships. When the interviewee was asked on the disease,

she indicated to be much afraid of cancer disease. The reason
she gave was that the disease can cost the family much money
and time. However, this comes up as an issue that is based on a
shorter period of time compared to an illness. The interviewee
has a mental illness which has affected her for a longer time.
Although the illness has affected some of her social
relationships such as the fight with the mother, there has been
interventions to reduce the adverse impacts on the family. It is
viewed as a condition that can be controlled and thus the
negative outcomes on the social relationships can be controlled.
The victim is more comfortable to live with the illness as the
symptoms can be controlled but is afraid of a disease as it might
have greater and long-lasting effects on the people, she values
most such as intermediate family members.
Effect on normalcy
The interviewee understands illness as a factor that affects
normalcy. Normalcy as used in the interview’s context refers to
the normal functioning and behaviors or conduct of a person in
their day-to-day life. This is evident through the contrast drawn
by the interviewee is asked about her experience with the
condition and when it started. At one point, she explains how
much she has been supported by the mother and describes the
mother as the closest family member whom the live with.
However, after graduating, she started developing the condi tion
which was characterized by her fighting the mother and finding
it hard to control her feelings and emotions. According to the
interviewee, this is a shift from the normal functioning of her
mental ability or operations. Also, she claims that medications
help her get calm as she used to before developing the
condition. This proves the interviewee interprets illness to
affect normalcy.
Effect on self-identity
According to the feedback given by the interviewee, illness has
a negative impact on self-identity. When she is asked what
symptoms bother her most, she describes how she is frustrated
of not being able to control her emotions and the fact that she is

trying to hurt herself. Also, there is an aspect of disappointment
and frustration for having the condition. This is evident when
she is asked what she fears most. She responds that she is afraid
of bringing negative emotions to her friends or family. This
shows she has problems believing or trust herself. Her self-
identity in this case is greatly affected in that she no longer has
full confidence of what is happening to her life. There is also an
aspect of blame where she believes the condition was inherited.
This shows she views herself as an outcome of some past
generations and inherits negative traits from her fore parents
such as the grandmother who had mental illness conditions.
Preliminary analysis part B:
Structure of health system
There are various facilities and systems that are used in the
management of mental illness in healthcare system. As used in
the context, there are different structures that are used in
healthcare systems to manage mental illness. Among the
components of the structure include healthcare facility or
hospital. This is reflected in the interview where the client
would attend to receive her medication. Presence of a hospital
or a facility where the client can attend and have her condition
assessed helps in managing the condition. Also, it creates a
platform where the client can attend and have her condition
treated without experiencing stigma from the public. Another
component of the structure of healthcare that influence the
interviewee’s illness is healthcare provider. In this case, the
specific component is the psychiatrist or therapist whose role is
assisting the client overcome the symptoms of the illness. The
third component is medication or prescription framework which
ensures the clients receive medications to control the symptoms.
Social inequality
There are various ways in which social inequalities can
influence mental illness and individuals with such conditions
such as the interviewee. One of the ways in which this occurs is

through bullying and violence. People with mental illness may
be subjected to bullying particularly in school. The interviewee
already reported to have experienced hard time in school and
engaged in fights. This is influenced by inequalities where some
students bully individuals the person which might in turn trigger
violence. Another social inequality factor is discrimination
where the affected person or the ill person is discriminated
against. When this occurs, the ill person may be provoked and
can result into severity of the condition. This may also create
fear on the ill person as they fear being discriminated against or
act in a way that leads to being discriminated against (Yu,
2018). In the interview, this is evident where the interviewee
claims to be afraid of hurting the emotions of close family or
friends.
Healthcare policy
Healthcare policy influence mental illness in that they
determine the role of government and those in authority in
addressing the needs of those with mental health conditions
such as the interviewee. Health care, housing, and even
criminalization all has an impact on people with mental illness.
For people with mental health conditions, new policies can lead
to better outcomes as well as better treatments. Stigma about
mental health issues and mental illness must be considered
when developing mental health policies. Ministers and the
public aren't paying attention, which leads to a lack of resources
and morale, deteriorating institutions and inadequate
information systems. Stigma harms not only those with mental
illness but also the health of society as a whole because it
causes social exclusion for those who suffer from it. Too
frequently, our services serve as launching pads for social
exclusion rather than stepping stones toward inclusion (McDaid
et al, 2019).

Reference
McDaid, D., Park, A. L., & Wahlbeck, K. (2019). The economic
case for the prevention of mental illness. Annual review of
public health, 40, 373-389.
Yu, S. (2018). Uncovering the hidden impacts of inequality on
mental health: a global study. Translational psychiatry, 8(1), 1-
10.

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