Reflecting on Mental Health and Social Services in the Peruvian and U.S. Context*

[the what] As I reflect on and observe my trip and experiences in Cusco, Peru, I notice that there are similarities and differences that can be exchanged between Peruvian culture and American culture.  My focus during the class in the Peru Program for study is mental health, and as such it is important to discuss and observe human behavior in social environments while in Peru and based on my experiences in the U.S. Understanding the importance of mental health and its strong connections to physical health is important, particularly when considering interventions in any culture.

American culture and society can be considered rich in available resources when dealing with any type of need for individuals.  The emotional and mental health needs of Americans are similar, if not the same in some circumstances, to those I observed in Peru, but the delivery of services can be considered dramatically different. The differences do not necessarily indicate negative or positive implications, but rather a better scope to decipher what is always necessary and what is secondary for any individual, regardless of culture. In Cusco, I observed a strong community and familial bond in every setting I found myself in.  Many individuals in Peru operate on a level of general care and concern for all of those around them.  Children were generally watched over by all, not just parents or immediate caretakers, many smiles were exchanged. Even when getting to know some of the locals in Cusco, I could feel the general caring and loving attitude that is practiced just from the behavior of those around me. While my American ethnicity was always an elephant in the room, the elephant was typically warmly welcomed and treated with general respect, even if there were questions for me to answer. While this experience for me may have been largely skewed by being American, I do believe there is a stronger bond among the people of Cusco as a whole.

In contrast, when speaking with a Peru Program service partner, Nestor, who is a psychologist and co-founder of AbrePuertas, I learned that mental health is still stigmatized and under-treated in Peru. Many individuals who suffer from any type of mental disorder are typically under-treated to the point of mental symptoms becoming largely physical leading individuals to their Primary Care Doctors. It is then that they realize the root problem is mental and then they are sometimes referred to a psychologist or mental health care professional. Early intervention and available resources do not seem to be as easily obtained in Cusco where it might be available in the U.S. more readily.

[so what?] Since mental health and physical health are so intertwined, it is through this experience, I sought to further look at what is necessary for any individual to live a high quality of life for them and those close to them, regardless of culture or ethnicity. Cusco appears to have an experiential type of learning and care-taking. This experiential learning and independent nature of children stayed with me beyond the trip into my thoughts here in America. I kept wondering why we care-take and parent so differently in the U.S. and questioned which method is better, and if either or both approaches led to different human behavior and mental health statuses both in comparison and in contrast.

An example of this is El Comedor, a site where myself and the other students worked during our time in Peru. The soup kitchen provided meals to any community members who were in need of food or nourishment. Whether it was a family or workers in the area, it was a general understanding that they come, eat a large meal for a small price, and leave with that need being met. This exchange demonstrating such a beautiful and useful way of indirectly tending to physical need, which cyclically improves mental health needs as well in a community bond strategy.

[now what?] In the U.S., community health is something that is constantly being revamped and improved in order to improve the overall health of individuals. Programs like El Comedor (the soup kitchen) and Corazon de Dahlia (a children’s after-school program) demonstrate a type of bonding among people and understanding of emotional and physical needs that Cusco seems to master through their innate human behaviors. On the other hand, there are systemic concerns that prevent some individuals in Cusco from achieving optimal health care and mental health goals in order to live a higher quality of life. While there may be very limited economic or government support in Cusco in comparison to U.S. for needs like emotional care or mental health care, the communities seem to take it into their own hands through bonding and affection—demonstrating true the public service value of community. Ultimately, the U.S. can benefit from the affectionate way that Peruvians care for one another and generally look out for each other when we are faced with challenges of apathy here at home.

The formal concern and understanding of the need for mental and physical health care in the U.S. would provide very beneficial change in the lives of many Peruvians on a macro level because of the need for a more resources and larger support. The formal health care that we provide in the U.S. could be useful if implemented in Peru for individuals suffering from behavioral dilemmas of any kind. However, U.S. mental health and social service might too have lessons to learn from Peru. A give and take from both cultures could benefit both greatly on mezzo/community levels and macro/systemic levels. If all human-beings are attempting to achieve optimal quality of life well beyond that of just surviving, then we can see the importance of using each other’s beneficial techniques in working with communities and its people.

Elizabeth Pisani-Woodruff

Master of Public Administration (MPA) and Master of Social Work (MSW) Dual Degree Student

* This CCPA blog series is by CCPA graduate students participating in the Peru International Service Learning Program led by CCPA Professors Susan Appe and Nadia Rubaii. The blog series allows participating graduate students to reflect on their experiences during their time in Peru in June 2015, using a what, so what, now what? model (see: Rolfe, G., Freshwater, D., Jasper, M. (2001). Critical Reflection in Nursing and the Helping Professions: a User’s Guide. Basingstoke: Palgrave Macmillan)

A View From The Top: Local Government in the Andes.*

[the what] Coming to Peru I was most excited and anxious to talk to locals about the politics and government systems in place and how they felt about them. Doing research before arriving, I discovered that Peru had a long history of corrupt politicians and a large and very powerful central government that did not seem to be working for the citizens of Peru (this is true in many countries around the world!). Due to years of corruption under previous presidents such as Fujimori, who had been charged and convicted of human rights violations among other things, it seemed like Peru was on the right track, electing Ollanta Humala, who ran on a leftist platform, promising to reform government, stop mining and give power back to localities to better serve the people. I was really excited to hear how much things had changed since the times of Fujimori. However, what I have heard from most people I speak to here in Peru is that many people feel the new administration has been ¨more of the same¨ and very little has actually changed. When I asked My host Mom, Leonor, about the campaign promises that President Humala had made she said ¨that it was nothing more than propaganda, he has done nothing for Cusco¨ in particular. I was stunned, expecting that this would be a pleasant conversation about the good outcomes of decentralization, it quickly turned into a wakeup call. The political realities of the rural municipalities became abundantly clear after visiting our service sites of Abre Puertas in Coya, Corazon de Dahlia in Saylla and Comedor Virgen De Fatima in the outskirts of Cusco.

View of Cusco
View of Cusco

[so what] After hearing the opinions of the few people I spoke with I thought, wow there are so many problems and promises that have been broken to the Peruvian people, how will they ever more forward? I quickly realized that the culture here has a fierce sense of community and people truly take care of one another and their families. Even though there are various economic and social issues in Peru and more specifically Cusco, I learned through working with our service partners how resilient communities are and how they find solutions to difficult problems by working together. When volunteering at Abre Puertas in Coya, a rural community in the sacred valley of Cusco, we spoke to the Mayor and many other offices in the Municipality about the biggest obstacles they faced and how they dealt with them. They expressed that their budgets were far from enough to cover all the need in their community but they tried their best to promote the programs that were available them by speaking directly with the locals. They had one specific program to promote hygiene, environmental protection and reduced waste where the office literally had no budget, however they worked with individual families and neighborhoods to educate them on these issues and get volunteers to help out. The Mayor said they often have to compete for grants for certain projects but he seemed optimistic and proud about the work they were doing and the possibilities of the future.

AbrePuertas in Coya
AbrePuertas in Coya

[now what] All of the conversations with the Municipality and later with the staff at Corazon De Dahlia at our second service site inspired me as someone who will soon be working in public service. It has taught me that no matter the difficulty in any situation there is always a way to bring about positive change, especially when you bring the people you are trying to serve in the conversation. It is important for me to see how the public service value of collaboration in particular is key in any project and it takes many hand and minds for it to be successful. Working in Peru, which has such a deep history and robust culture, I have also learned that it is essential to be adaptable and conscious of the customs and beliefs of every place, neighborhood and community. As I continue to work on our last service project I constantly think about the impact we are making here and how long our efforts will go in terms of growing and helping these organizations, also keeping in mind the growth and experience they are giving us in return. I’m excited to continue to speak to locals and people who work or have worked in local government to learn more about the complexities of different systems and how they function, affect the people, and prevail.

Diana Reyes

Master of Social Work (MSW) and Master of Public Administration (MPA) Dual Degree Student

* This CCPA blog series is by CCPA graduate students participating in the Peru International Service Learning Program led by CCPA Professors Susan Appe and Nadia Rubaii. The blog series allows participating graduate students to reflect on their experiences during their time in Peru in June 2015, using a what, so what, now what? model (see: Rolfe, G., Freshwater, D., Jasper, M. (2001). Critical Reflection in Nursing and the Helping Professions: a User’s Guide. Basingstoke: Palgrave Macmillan)

Nathan Gismot, MSW ’12 on the Value and Versatility of Human Service

I remember a joke from my days as a master of social work (MSW) student at Binghamton University: When most people think of social workers, they think of people who take kids from their families and put them in foster care.

Most MSWs would likely recognize that joke for what it is: an intentionally ridiculous statement made for the sake of easy, if sardonic, humor among colleagues who know better. It does, however, indicate a truth: “Social work” is largely an enigma to most people outside the profession.

The MBA stands in sharp contrast. In my experience, many professional laypeople not only know what the acronym “MBA” stands for, but have at least a vague sense of what the holder of that degree may have studied in school (“business”) and what their career trajectory might be (“business leadership”).

Mention that someone else has an MSW, however, and the response will likely as not be a series of blank stares and halting questions.

“What does ‘MSW’ mean?”

“Master of Social Work.”

“Oh, okay. Uh…what’s that?”

I had an epiphany about halfway through my course of study at BU: Despite the general lack of awareness about MSWs and what they do, MSWs have the training and versatility to be of great value to any organization in any industry or sector. I decided then and there to make a point, wherever possible, of addressing that gap in understanding throughout my career.

The way I see it, MSWs are interpersonal and organizational ninjas. Kidding aside, MSWs deliver incredible—and marketable—value. We help our clients identify and achieve goals. We understand the often-challenging process of change, and we know how to manage it – from setting expectations to facilitating progress to holding clients and colleagues accountable. We are skilled in the art of organizational assessment and stewardship. We are advocates. We are solution-finders. We are emotionally intelligent, and are, therefore, able to forge authentic and honest working relationships with our clients and colleagues. We are systems thinkers, considering others’ perspectives and the interdependent nature of organizations (and sectors, communities, and societies) as we navigate difficult decisions and develop strategic plans. We are collaborators. We are champions of inclusion, equity, and social justice.

In other words, we are leaders. Moreover, we offer the sort of dynamic leadership that is so desperately needed in this time and place.

For my part, I have spent only a fraction of my career in the field MSWs are traditionally trained to go into, i.e., that which is commonly referred to as human services. But I have learned that the critical element of any business or organization is just that: human service.

And I have learned, therefore, that my MSW from Binghamton University has been the catalyst to a series of unexpected, fascinating, and deeply fulfilling career opportunities that I could never have envisioned before their occurrence. I am humbled and grateful to be building a career I enjoy and am proud of, non-traditional though it may be; and I am honored and awed to note that my MSW education from BU continues to guide me, and to inform my growth and development as a helper, as a professional, and as a person.

Nate Gismot (MSW ’12) lives in Colorado with his partner (and fellow BU MSW alumn) Kristy and their two corgis, Willow and Gus. He works for the University of Northern Colorado as the Director of Corporate and Foundation Relations. You can connect with Nate on LinkedIn at


Social Work Student Legislative Action Day Paves the Way for Change

By Erin Moore, 2nd year MSW Student, Anthony T. McCabe, 2nd year MSW Student

On March 10th, 2015 Binghamton MSW students joined over 400 of their peers in Albany to lobby for the passage of the New York DREAM Act and an enhancement to the Social Work Loan Forgiveness program. The trip was meant not only to provide an opportunity for students to dip their toes in the political well, but to also get a more intimate understanding of the ways in which state policies impact their social work practice at the micro, mezzo, and macro levels.

The Development, Relief, and Education for Alien Minors Act – more commonly referred to as the DREAM Act – seeks to expand educational opportunity for the nearly 5,000 annual undocumented high school graduates in the state by extending access to New York’s Tuition Assistance Program (TAP).  It also seeks to establish a Dream Fund Commission to raise private monies for the same population.

At the time of the MSW students’ visit to Albany, the bill had already passed the State Assembly 87-45. It currently awaits final resolution by the State Senate – but since the bill faces such formidable opposition from the Republican majority, Senate action is unlikely at this point. The DREAM Act’s last hope is Governor Andrew Cuomo’s budget proposal for fiscal year 2015, in which he strategically linked the DREAM Act to a controversial education investment tax credit which is supported by Senate Republicans. The final deadline for a budget resolution is March 31st, at which point it will be clear as to whether or Cuomo’s coupling strategy paid off.

The Social Work Loan Forgiveness Program (SWLFP) hit a little more close to home for the student advocates. The New York State chapter of the National Association of Social Workers (NASW) sought a $500,000 increase to the current program, which allocates approximately $1.2 million dollars annually to eligible, licensed social workers.

The underpinning of the case for enhancing the SWLFP is that recruitment and retention of licensed social workers has remained an ongoing challenge in New York State in spite of a projected 25% growth in need of their professional services in critical human services areas. One way to incentivize licensed social workers to begin or continue their career in high needs communities is to offset diminished income potential through student loan forgiveness. This particular incentive has become increasingly important as starting salaries have stagnated at an average of $35,000 per year and student loan debts continue to increase. According to the NASW, over half of NASW social workers have loan debt upwards of $39,000.

As the program is currently administered, only 32 of the more than 1,000 annual applicants will be granted the award (which, over 4-years, has a maximum pay-out of $26,000). That’s less than 3% of all applicants — and the allocation of awards tends to be concentrated in New York City. For this, among other reasons, the NASW is seeking the enhancement to the SWLFP to ensure that more upstate social workers are brought into the fold so that they can work in the communities that need their services the most.

The student advocates each met with their elected officials in groups varying in size based on constituency. As representatives from Binghamton University, many students met with Senator Tom Libous and Assemblywoman Donna Lupardo–both of whom represent the region where Binghamton University is housed and many students reside.

Senator Libous was not available due to health reasons, however a member of his staff was able to meet with the group. The staff member was receptive to the proposal of increasing the funds available for the SWLFP. While he did not expressly state Senator Libous’ position on the New York DREAM Act, he did tell the group that he sees a lot of opposition to the bill within the senate. The students and professors present took turns dispelling the myths around the bill that encourage opposition. The staff member promised to pass the message to Senator Libous, and he gave a bottle of Senator Libous’ “famous” steak sauce to anyone who wanted it.

How Do You Practice Self Care?

It’s the end of the semester. We’ve gotten through Thanksgiving and the December holidays are ahead of us. It should be an exciting time of year, right? Right, except for the pressure that comes from all of these things.

As I walk through the University Downtown Center and greet colleagues and students alike, there are a few common denominators, the look of exhaustion and the answers you get when you ask them how they are it’s “busy”, “stressed”, “overwhelmed”. Tis the season, right? In the MSW and HDEV classes that I am teaching this semester I have done my best to periodically check in with the students and ask what they are doing for their own self-care. Some of them are incorporating it nicely, others give me the understandable, “what self care, I am too busy”.

In the College of Community and Public Affairs we are training students to help others through Human Development, Social Work, Student Affairs, Public Administration and Doctoral Students who will one day teach. I fear that for many students though, helping themselves gets lost in the vision of helping others. I speak from experience as I suggest this.

As I have shared in my previous blog, I am a graduate of HDEV and the MSW programs at Binghamton University, I can speak to the rigor that I encountered as I went through both programs. They both took up a lot of time with classes, practicums and field placements. While I was a student I was not great at self care- I like some of the students I teach now would give the pat answer of “ I have no time!” That having no time and not making myself a priority translated into the field of social work for me.

Upon graduation I was hired as a Medical Social Worker where I worked with terminal illness, death, grief and bereavement. I worked ten years full time in this particular field. As I left that job this past summer and joined BU’s MSW department full time, I realized just how burnt out I had become and how I was not practicing what I was preaching.

Between working full time, being married, having two young children and a house to keep up with, my self care was on the bottom of my to do list. This made me irritable, exhausted and not the best version of myself, personally or professionally. I needed to make a change.

During the last year in the medical field I started to make a change. I went to a spiritual retreat sponsored by my workplace, during which we participated in making soul collages. What came out of my soul collage is how burnt out I was taking care of everyone else, personally and professionally, it was time for a change.

Over the last year I have started incorporating self-care into my life as a daily practice, it has been work. I have learned that self-care for me is time alone- meditating, running or practicing Baptiste Yoga. My journey into self care has been a challenging one, as everyone around me was used to me putting myself last, so making time for myself has not always been welcomed or even understood. I have been called selfish and even a bad mom because of it. Due to the self-care that I have incorporated into my life I feel that I am better both personally and professionally- I feel that I have more to give.

I am still just as busy, a husband, 2 young children, 2 dogs, teaching 2 MSW and 1 HDEV class, and facilitating bereavement groups part time. The difference though now is that I schedule my self-care in just like I do everything else. This may mean that I don’t have time to go out to lunch with friends, or catch up on TV shows, it means eating my lunch at my desk as I work, because I squeeze a run in during lunch or get up at 5 am to practice yoga at 6am.

While teaching my children and students about self-care, I also want to role model it for them. I love to see my students when I am out running, I love when my family comes to watch races, or when my daughter sees me dressed she will say have fun at yoga mom. I am now finally practicing what I preach.

As for those who have called me selfish and a bad mom, they need to do some self reflection and re-prioritize and make self care a priority for themselves. All it takes is 15 minutes a day- wake up 15 minutes earlier, stay up 15 minutes later. For me self-care is physical, but it does not have to be physical for you. How do you nurture your soul? What makes you feel at peace? Many people can not answer these questions, do a self inventory what do you need? Then try something new; journaling, meditating (try the Honest Guys guided meditations on Youtube, paint, walk the dog, take a bubble bath, read a book (not one that is assigned or that you will be assigning), make plans with a friend who you keep putting off, just pick something and try….

Through the holiday season and winter break, as you look for the perfect gift for everyone else, give yourself the gift of self care. In order to help others you need to start by helping yourself. My favorite line of thinking is what is told to us on the airplane- put the oxygen mask on yourself before you help someone else. Treat yourself how you treat others! Happy Holidays!

*Editor’s note: Binghamton University’s Dean of Students office offers some unique de-stressing events for students in the month of December. Find out more about it here.

Sarah E. Hopkins, LMSW

Full Time Lecturer

Department of Social Work

College of Community and Public Affairs