Post-doctoral fellow Bonnie Kaiser joined the Duke Global Health Institute (DGHI) last August after completing a doctorate in anthropology and a master’s in public health in epidemiology at Emory University. Kaiser conducts global mental health research with a focus on cultural aspects of measurement, communication and intervention design, and it was DGHI’s growing global mental health initiative—along with her long-standing collaboration with DGHI faculty members Brandon Kohrt and Deborah Jenson—that drew her to Duke.
Kaiser’s PhD research, based primarily in Haiti, demonstrates how a nuanced cultural understanding of perceptions and experiences of mental illness can improve clinical communication and intervention design. Her publications have explored culturally-based idioms of distress and mental health communication, development and testing of transcultural measurement tools and treatment decision-making.
In Haiti, Kaiser explained, “people don’t talk about ‘depression’ or ‘anxiety.’ They use terms that actually mean something a little bit different, though there might be some overlap between the terms.” Understanding these differences is important, she says, because research suggests that effective communication in a clinical setting improves patient engagement with interventions, ultimately improving health outcomes. And this nuanced understanding also applies to developing, implementing and evaluating interventions.
Kaiser Looked at Resilience Factors in Dissertation
Kaiser’s dissertation research in Haiti explored the broader topic of resilience. She conducted epidemiologic surveys to learn about people’s experiences related to mental health and resilience—including the traumatic events they experienced and their daily stressors, as well as their social supports.
From her large sample, she was able to identify two groups of people: those who appeared to have better mental health than predicted given past traumatic experiences, and those who had undergone similar exposures yet experienced mental distress as a result. She conducted follow-up interviews with about thirty participants and spent five months participating in the daily lives of eight of them to learn more about their experiences and their supports. Ultimately, her goal was to determine the factors that might explain the different mental health outcomes.
She’s currently expanding her dissertation into a book that explores the concept of “resilience” and how it can be useful as a research and public health construct to inform intervention development.
Kaiser’s Connection to Duke Goes Back Several Years
Eight years ago, Kohrt and Kaiser overlapped for a year at Emory while he was completing his PhD in anthropology. They continued to collaborate on Kaiser’s projects in Haiti as he stayed at Emory to complete his medical residency. She met Jenson through an opportunity at Duke’s Haiti Lab, which Jenson co-directs, about four years ago.
For the past few years, the three of them, along with Hunter Keys—a PhD in anthropology candidate at the University of Amsterdam—have been writing a book that examines ideas of trauma and mental health interventions in the context of Haiti. The book analyzes the post-earthquake mental health response in Haiti and critically explores assumptions about the universality of trauma experiences, suggesting instead that interventions be sensitive to the ways that individuals and cultural groups may be conceptualizing and experiencing trauma differently.
Kaiser Is Helping to Launch New Health Humanities Lab
Currently, Kaiser’s main focus is developing the structure and programming of DGHI’s new Health Humanities Lab in collaboration with Kohrt, Jenson and associate global health professor Kearsley Stewart. Due to launch this fall, the Health Humanities Lab will engage students, faculty and partners in humanities questions in the context of global health through a range of activities, initiatives and resources.
“I’m really interested in how we can provide training opportunities for students to help them learn about and engage with the culture, language and history of their fieldwork sites to complement the methodological skills they’re developing through their courses,” Kaiser said. These opportunities might include web-based resources such as “cultural portfolios” developed by students and faculty members, creative partnerships to provide language instruction, seminars and conferences.
Kaiser is also involved in teaching courses and providing qualitative methods and analysis consulting at DGHI.
DGHI’s Appeal to Kaiser Is Multi-Faceted
Kaiser was attracted to DGHI because of its focus on global mental health and interdisciplinary research. “The way DGHI facilitates interdisciplinary interaction is so different than what I’ve seen elsewhere,” she said. “It’s so easy to interact with people in different fields here, and bringing multiple perspectives to a project is really exciting to me.” She’s especially looking forward to the interdisciplinary Bass Connections project she’ll be involved in starting this fall to establish a new global mental health integrative training program.
Kaiser also appreciates the fact that a number of DGHI faculty members conduct intervention research, an area of particular interest for her as she plans the next phase of her career. Another draw for her is the opportunity to help DGHI incorporate more qualitative methods and analysis training into the graduate curriculum. “Qualitative methods are becoming a more central part of global health work, so it’s exciting to see that DGHI is working to give students a strong foundation in qualitative research,” she said. “And I’m glad I can be a part of that.”
The way DGHI facilitates interdisciplinary interaction is so different than what I’ve seen elsewhere. It’s so easy to interact with people in different fields here.Bonnie Kaiser, post-doctoral fellow