Emergency room doctors at the University Hospital of Bern were stumped.
Lately, more patients were reporting headaches, stomach and back pain that, despite extensive testing, did not show any clear physical root. That this uptick occurred mostly among one patient population — recent refugees from Iraq, Syria, Afghanistan, and Eritrea — made them wonder if stress and other similar factors might be at play. So they invited Associate Professor of Psychology Adam Brown to help them dig a little deeper.
As a Fulbright Specialist, Brown collaborated with the Bern doctors, the Swiss Department of Health, NGOs, and refugee communities over two summers to research the situation, identify gaps in mental health care, and plan and launch a new intervention. Now, refugees awaiting treatment at University Hospital emergency room complete a brief, carefully-worded, and culturally-sensitive mental health assessment via iPad.
It’s an important first step. Brown has since returned to help the program scale and expand to Zurich, Basel, Geneva, and other Swiss cities. New funding from the Andrew W. Mellon Foundation means he’ll be returning for four more summers.
Investigating and developing treatments for populations routinely exposed to and impacted by stress and trauma has become the focus of Brown’s work as a clinical psychologist. He’s traveled across the globe to work refugees and migrants, human rights advocates, emergency workers, combat veterans, and more; before heading back to Bern this year, he wrapped up a large-scale mental health survey of 17,000 United Nations staff members. His findings have informed the organization’s ambitious new Workplace Mental Health and Well-Being Strategy.
From Local to Global
Surprisingly, Brown’s path to a career in global mental health started on a much smaller scale. Graduating college with a degree in environmental studies and political science, he worked for a Bay Area nonprofit, interviewing neighborhood residents to find out how their environmental concerns and access to green space affected their wellbeing.
“It was through those interviews that I became really interested in the psychology of how they were dealing with stress, of how they were coping with day-to-day experiences,” he says. “And that just opened up a set of curiosities and interests in the mind.”
That realization led Brown from California to New York in 2002 — specifically to the Psychology MA program at The New School for Social Research (NSSR), where he fit in well with the many other students pursuing psychology as a second field or career.
Just one year after 9/11, New York City was still finding a new sense of normal. Brown remembers that time as an emotional turning point for both psychologists and patients in the city. “[After the attacks] there was a more careful and systematic approach to measure and study how people were coping with stress and trauma on a fairly large scale. And there was this whole tough masculine culture that, prior to that, might have placed barriers [for men] to talking about mental health issues. Suddenly, they were considering reaching out and connecting with a therapist.”
Brown teamed up with a New School alumna at Cornell Medical School to study utility workers who had cleaned up debris at Ground Zero. At NSSR, he co-founded and wrote for the New School Psychology Bulletin. As his interests in memory and trauma grew, he planned conferences together with with sociologists and anthropologists in the interdisciplinary Memory Studies Network. And in a cognitive psychology class with Malcolm B. Smith Professor of Psychology William Hirst, he formally began to study Post-Traumatic Stress Disorder (PTSD).
New Research at The New School
In the early 2000s, most PTSD researchers believed that traumatic memories would resurface and cause new waves of stress and impairment in the present. Brown has taken those understandings one step further. “As more research came out suggesting that our ability to imagine the future depends so much on our ability to remember the past, I began to wonder if we would see similar alterations and maladaptive processes in how people with PTSD imagine the future. And that is what we’re finding…. We also believe this is partially what makes it hard to recover from those sorts of events.”
But memories aren’t always accurate and memory itself isn’t fixed; in fact, it’s quite malleable, much like the brain itself. That quality drives Brown to ask bigger questions about PTSD treatment as well as prevention. “We’ve found that if we have people recall memories in which they were able to overcome or successfully manage a stressful event, it seems to actually increase people’s sense of self-efficacy. And then when we give them tests they’re much more effective at problem solving, emotional regulation, they view the future more optimistically…. As we begin to better characterize risk factors, we might be able to do things prior to exposure to events that might help to mitigate the negative impacts of stress.”
That could mean moving more post-crisis treatment plans from the hands of psychologists to the people themselves. “We’re thinking about psychological first aid,” Brown plans. “What are some of the things we might want to put in place to help reduce stress or to identify things that might require urgent care? We need to think about how we can train community leaders and other people to be the drivers of mental health care in those communities.” Such program promise to be more efficient, more cost-effective, and more personal, all helping reduce barriers to mental health care.
Brown is looking forward to bringing students from NSSR and across The New School into his work. “Most science happens in teams. The ability to work across disciplines for me is really so important,” he says. In his new Global Mental Health Lab, he’s working closely with Psychology master’s and doctoral students as well as Eugene Lang undergraduates and Parsons graduate students — some of whom will join him in Switzerland this summer. A Global Mental Health minor, currently in development, aims to help more New School students engage in the topic and apply their social science skills in fieldwork with local and international NGOs, in collaboration with the Zolberg Institute on Migration and Mobility.
Teaching at his alma mater is a fitting homecoming for a world traveler, and Brown sees his research as fitting squarely with The New School’s progressive history and mission. “Within science in general there was a feeling that if you brought politics into your work, you couldn’t do good research. We’re finally at a point now where that is being challenged and dismantled.”