Healing is Here Summit
An Interview with
Kelley Haynes-Mendez, PsyD

Early this October Nat Thomson, a student in the Simmons University Master of Social Work program and MPH Graduate Assistant attended The American Psychology Association's (APA) Healing Is Here Summit in Washington, D.C. Designed for the general public, the daylong summit took attendees through a variety of important concepts centered around overcoming trauma and oppression.

Kelley Haynes-Mendez was one of the morning's keynote speakers, with a talk titled Living, Loving and Learning  in Oppressive Systems. Dr. Haynes-Mendez, Senior Director of APA's Human Rights Team, was kind enough to speak with us before heading back home to her native Texas.

We’re here today to learn about trauma, oppression and healing. Not to cut things too finely, but for those of us in the Public Health sphere, what connections, broadly, might you draw between these topics and public health outcomes?

We have done some work in the field of psychology around health equity and social determinants of health. Out of that there is a subfield of psychology, community psychology, which applies principles of psychology at the community level. Those psychologists implement programs and work at the community level in order to attempt to achieve more equitable health outcomes for those populations. A lot of the research in that area centers around answering the question of “what are the social determinants of health?” with particular emphasis on exploring how racism, ageism and the other discriminations and oppressions impact society, but also how they impact individuals, families and communities. We have also begun to think about taking a population health approach in psychology; trying to leverage psychological science towards the idea of “there’s no health without mental health.” Community psychologists and population health psychologists are focusing on this area, in that we can’t achieve equitable health outcomes and address health disparities without addressing both the social determinants as well as the mental and behavioral health aspects.

If I understand the evolution of public health thinking, it seems like initially public health studies and thinking initially was centered around physical health, but over time, mental health has become a peer?

The mind body connection has become more prominent, definitely. If we’re experiencing trauma we have both physical and mental health consequences. In terms of treating and intervening with people who have experienced a trauma, collective or individual, we have to look at both aspects. 

Is the incorporation of the idea of collective trauma “newer” in your estimation?

I wouldn’t say that it’s newer, as an idea, but the language is newer. Whether it was researched and articulated in that exact manner, that might be the shift. I think that community psychologists have really seen collective trauma and landed on some intervention levels that are important; pre-intervention, intervention and post intervention. Oftentimes that happens with an entire community. Psychosocial interventions can be used to prevent trauma, but if trauma occurs regardless, there are levels we can employ at the community level.

There are often discussions or debates about treating the individual versus treating the population or the community more broadly; economies of scale, if you will, in the public health space. Any thoughts on the different approaches?

I think we have to be mindful that individual interventions are effective, so if I’m somebody who has experienced a trauma, and I’m looking to alleviate the anxiety or stress, an individual intervention will be positive and impactful for me. Also when we’re working with communities or groups of people who have experienced trauma collectively, in that setting there is some education that can happen and some community level interventions that can occur as well. So, they go hand in hand, it’s not necessarily one or the other. It just gets to a point where we really need individual or family interventions, and those tend to prove to be very effective in specific manners.

Given the last four or five years we’ve been through as a country, or a planet, do you feel like that tends to factor into community psychology ideas and interventions? Things like the uglier aspects of our current social media landscape, COVID-19 or law enforcement violence.

I think one of the more important things that happened for us in the field of psychology out of the circumstances you’re describing, alongside those trends, is the emergence of tele-psychology and how helpful it can be for people. COVID-19 forced us as a profession to do more tele-health and tele-interventions, because we simply were not able to be in person as we typically have been. So there is now a body of empirical evidence around the best practices and effectiveness of tele-therapy. Our advocacy office has been advocating on behalf of tele-psychology, partially in regard to the situation of those in rural communities, where access to healthcare in general, and mental healthcare in particular, can tend to be limited or non-existent. Tele-psychology is an alternative that accomplishes this, but the healthcare companies have not fully bought into the idea, as far as reimbursement, so in that regard our advocacy office is doing some important lobbying work to change that.

Before tele-health became a necessity or a best practice, do you feel like psychology was on the fence about it, or that in person was a must?

When psychology has a new intervention without much science or research behind it, there are definitely doubts about it being effective. It can be touch and go at first, with this, or anything else. With so many clinicians simply having to use it, we ended up with the data we would need to build the case that it is equally or more effective. The novelty of it and it being new, without research, held things back a bit. But now that we have that data and such, people are generally on board with the idea in the field.

Specifically with trauma, could you give some examples about how that connection tends to play out?

People who are vulnerable in the population for whatever reason have poorer health outcomes, just across the board and that very much includes having experienced trauma and the aftermath of these experiences. So people with mental health conditions, including traumatic impacts, are more vulnerable and have poorer health outcomes in other areas besides their mental health. There are many explanations around that; it could be that they are experiencing multiple-marginalizations, for example a person who is suffering with a mental health condition may also be experiencing poverty or another type of marginalization. This many times means they simply don’t have access to the care that they need for their conditions. Other times, untreated conditions also lead to poor health outcomes, because there are some basic standards of care that are not being achieved. Therefore, it’s important for mental health and public health practitioners to understand how it’s all interrelated and interconnected. We have learned to silo our disciplines; with mental health over here and primary healthcare over here, and then social work is somewhere else too. Programs with a “wraparound” service model are starting to emerge, where people can come to one person or organization not just for one thing, but come for their mental health, their housing, their healthcare challenges and whatever else they may need for their well being. That is a strategy that I understand to be successful. For psychology, for the last 7 or 8 years psychology has been focusing on integrated primary care, where mental health professionals are a part of the primary healthcare team. So that is a new and emerging way of working where we can better bring these connections together to serve.

Your focus is on human rights; let’s say someone’s struggling to see the connection between human rights and psychology, how do you tend to make this connection more clear?

The mission statement of the APA is to benefit society and improve lives; to me, taking a human rights perspective on this makes so much sense. We have psychological science, which we want to benefit society, so the ways we can leverage this science in order to promote the greater realization of human rights globally, I think that is really our drive, so that is how I tend to look at psychology within a human rights frame.

And how does that POV tend to play out, in a more practical sense? What does that look like in practice?

Some of the activities we conduct involve advocacy for various communities; we have an advocacy office which does a lot of work with the federal government around legislation, looking to improve the lives of those who are oppressed or discriminated against in some way. We also have a team of volunteer psychologists at the UN in NYC that promote the integration of psychological science into the United Nations programs and initiatives. We also often respond to calls for input on various UN missions and programs. In November, the UN Special Rapporteur on contemporary forms of racism and related intolerance will conduct a visit to the US. They distributed a call for inputs from all over, be it civil society organizations, states or others, to offer inputs into understanding the state of racism in the US. Our team is created a response to that particular call, as a way to showcase the relationship between psychological science and some of the human rights missions and initiatives the UN might be researching and planning.

For some regular non-academic people here in the states, when they hear “human rights,” I can’t help but wonder if their mind goes first to countries outside the US that are in crises, experiencing dictatorships or similar issues, and maybe not consider human rights as something we’re grappling with right here at home. What are your thoughts on the state of the idea of human rights here in the US?

I think we have to be really careful about the “American exceptionalism” idea that tends to permeate our culture when it comes to human rights issues. There are clearly people here in the US who are experiencing extreme poverty, racism and law enforcement violence. We have to really be careful to not let this internalized notion of American exceptionalism prevent us from labeling those trends as what they are, human rights crises. There can be a tendency to believe that human rights crises happen elsewhere, but not here. Something I’m fond of is the human rights approach, which are the foundational principles that support all human rights conventions, treaties, called the Panel Principles. It’s utilized by the WHO on how it structures its interventions and also used broadly in human rights contexts. When we as a discipline are building policy, interventions or other elements, we’re thinking about the Panel Principles. 

The APA is doing a lot of racial equity work right now. We’ve offered an apology to people of color in the past, we’ve conducted a racial equity audit of our programs and now seeded a racial equity fund to promote repair, reconciliation and redress for the organization's own responsibility for current and past harms that were based on racism. Also, one of the things the association did very early on was to invite people-of-color members of the psychologist community to come in for listening sessions. Out of that there were narratives around the shared experiences psychologists had in training and in their professional lives, regarding racism and discrimination. I bring this up because this kind of approach is central to a human rights based approach. The members from the community came to the table to talk about their experiences and their clients' experiences and how that tended to impact their well being. It’s been a step-by-step process over the past two years to be able to get to a place where we can offer forms of redress for what was uncovered in the process.

I appreciate that you brought up the idea of “American exceptionalism” and how we are somewhat socialized to believe that there are no problems to see here, or that people who are struggling are doing so because of individual failings and not on account of any greater forces at play.

There was a report from the Special Rapporteur on Poverty from a visit to the US where they were just stunned at the current state of this country. In their report they cited “American exceptionalism” as one of the essential issues with the state of things. There is deep poverty in Mississippi and other rural southern states. Particularly with people who are experiencing discrimination and oppression in their lives. The state of poverty in some parts of the U.S. was stunning to them.

Do you have any thoughts on how a more accurate or contemporary understanding of human rights is seeded here?

I think human rights education in the US is essential. Just so that we are educated on the fact that human rights exists, globally but also here for us. There’s an organization, The Human Rights Education Associates and their Dr. Felisia Tibbits, who do a lot of good work, both with UNESCO but also with our US universities. Dr. Tibbits was most recently at Columbia university. She does a lot of great work around human rights education. I also work with the University for Peace, which was established by the UN in the ‘80s and is on site in Costa Rica. They do a lot of global citizenship education, which is helping people see themselves as part of a global community. I think that type of education is really relevant to us here; if we can see ourselves in the experiences of someone else somewhere else, then we can see ourselves better as someone who is part of a global community.

Some of us have the privilege of being able to afford the costs associated with traveling internationally, and in those instances, you could see how the kinds of viewpoints or outlooks we’re discussing could be developed. However, not everyone has that privilege to take the time off of work or spend their money in that fashion, so it strikes me as important work, facilitating that kind of philosophical viewpoint.

There’s a quote that I really love - “travel is fatal to prejudice.” I really like that. Also in the global citizen space, I learned about an idea that 'what's global is local’; reaching out to refugee communities in our own cities, understanding the immigrant crisis in Texas, a global human rights issue which is happening in my own backyard. The understanding that these things are happening all around us but at the same time, there are or will be global implications. There is a refugee crisis here in The US and many times those same folks are living with us in US cities. Having that “global is local” approach can really help to create better understanding and reactions to the human rights oriented issues that tend to surround us.

I’m glad you brought up the border. Could you talk a little bit about what’s going on in Texas at the border with Mexico, through a psychology and human rights POV?

Some of the facts are that migrant families crossing from Mexico into Texas are experiencing lots of mental health trauma response, and so there are psychologists from the Texas Psychological Association advocating with the state legislature to do something about the trauma they are experiencing. So, something psychologists or other interested parties can be doing is lobbying at the state level to influence state law, policy and response around social inequalities and human rights issues that are happening in their state. Another issue we are seeing in Texas is anti-trans legislation; we have a group of psychologists who are showing up in Austin to try and advocate on behalf of the people who will be affected by these policies. I believe in Texas there’s a law in place where psychologists must report to the state any minor who is receiving treatment around gender. Psychologists there are pushing back, describing how it’s an issue for them as a profession to have to do these things. We can see from a psychological perspective that we can do psychology and then we can also advocate with our state legislators around the impacts of some of the laws and practices being proposed upon the people who we serve.

Both those issues are great examples of how, if people were a little more oriented around human rights in the global sense, we could be having very different conversations around what’s happening, be it people wanting to leave an oppressive nation or wanting to express their identity however they see fit.

I agree. We do a lot of capacity building with psychologists who want to have community or state impact. Many of the laws in these arenas, here in the US, are at the state level. So we have webinars and toolkits for psychologists interested in getting involved at the state level around these kinds of human rights issues. Federally, the US has not ratified the economic, cultural and social rights. And so I think advocacy at the federal level can work towards that ratification and the validation of that treaty. And then at the state level at the same time, the states are implementing laws that violate people’s human rights, so then as public health professionals, scientists, people who want society to benefit through their work, we can really leverage all of the literature and science to advocate at the state level. We can’t lose sight of the states who are implementing laws that take away people’s rights. I’m very encouraged by the next generation of students who see it as their goal to have an impact in society rather than just going to work alone out of graduate school. I think there’s a new generation of graduate students who are coming into the fields, psychology, public health or otherwise, who really want to have an impact and I think that that is very promising and I’m excited about it. I think it’s exciting how a program like Simmons is starting to prepare grad students to take that kind of transformative approach.