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Reflections of my internship in mental health facilities in Brazil

Amber Mulcahy and Miranda Weston

Undergraduate students, Department of Global Health & Social Medicine

13 February 2019

Undergraduate students, Amber Mulcahy and Miranda Weston from the Department of Global Health & Social Medicine undertook an internship in various mental health facilities in Rio de Janeiro in Brazil as part of their course. They write about their experiences.

In June 2018, we spent three weeks interning in mental health facilities in Rio de Janeiro, Brazil. We were drawn to this opportunity due to our interest in mental health and our desire to work in this field after graduation. We also would not have been able to do this without the generous funding and bursary from our Department to cover the flights and additional costs of this trip. We were also drawn to the trip because it was advertised as a structured split between hands-on experience in mental health settings and academic learning at the State University of Rio de Janeiro.

In addition to this, we viewed the internship as an opportunity to expand our language skills. When we arrived, it became clear that we would need some assistance in this area. One of the students offered to be our translator for the time we were there – this was invaluable to our experience! We had never been to South America and valued the opportunity to spend time in a radically different environment, such as Brazil.

When spending time in mental healthcare settings, we were initially confused as to why so much healthcare was provided in primary care settings rather than specialist mental health units. However, the reason for this soon became clear when we were shown the inpatient units. The threshold for treatment at these locations was clearly significantly higher than that in the UK. We also found that a lot of the mental health issues experienced by Brazilian citizens were a direct result of circumstances that are unique to their locality.

Internship in Brazil
Amber and Miranda went on an internship to various mental health facilities in Rio de Janeiro in Brazil

We questioned whether these localised mental health issues should be medicalised and/or medicated or whether they are a normal response to an acute stressor. These circumstantial experiences refer to the violence experienced, such as family members lost due to gun violence, on a daily basis by Brazilian citizens.

On our days off, we were privileged to experience the attractions that Rio de Janeiro has to offer. This included Christ the Redeemer, one of the seven wonders of the world, which was amazing to see on a clear morning. We also took a cable car to Sugarloaf Mountain, which we found to be the quietest place in Rio! One of the students from the seminars at the university offered to show us the local beaches, including the famous Copacabana Beach. We also spent many hours on Flamengo and Ipanema beaches.

In view of the recent election of President Bolsonaro, who is vehemently anti-LGBT rights, we reflect on our time in the gay capital of Latin America in a different light. As members of the LGBT community ourselves, we felt safe at the time to explore the LGBT scene in Rio and be open about our sexuality. However, if we were applying next year we may be more hesitant about our safety.

We found this experience to be invaluable in enriching our skills as researchers. The opportunity to gain access to mental healthcare on the ground – sitting in on mental health consultations and therapy groups was particularly important in broadening our experience in this field. This brought our class readings to life, now being able to read about Brazil with a lived experience of its culture and everyday life.

Having the opportunity to engage with postgraduate seminars at the university enhanced our critical thinking skills. Having academic discussions with postgraduate students and PhD candidates was a wonderful opportunity to challenge our understanding of how mental healthcare should be delivered.

In summary, we are incredibly grateful to our Department here at King's for this opportunity and to those that were so welcoming to us in Rio. Particular thanks go to our translator, Thais, who stood in at the last minute when we thought our limited language skills may bring the internship to a premature ending and a swift flight home.

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