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JOURNAL OF STUDENT RESEARCH ST. THOMAS UNIVERSITY Volume 2 Number 1 Fall 2016 Journal of Student Research EDITOR-IN-CHIEF & Maria D. Suarez – M.B.A. Candidate BOOK REVIEW EDITOR St. Thomas University ASSISTANT EDITOR & Alexandra D. Valdes – J.D. Candidate PUBLIC RELATIONS St. Thomas University COORDINATOR ASSOCIATE EDITORS Lacey A. Skorepa – Ph.D. Candidate Wayne State University Emily Bello-Pardo – Ph.D. Student American University FACULTY ADVISORS Co-Founder and Faculty Advisor Hagai Gringarten, Ph.D. Co-Founder and Faculty Advisor Raúl Fernández-Calienes, Ph.D. CONTACT INFORMATION Maria D. Suarez, Editor-in-Chief Journal of Student Research c/o Professor Hagai Gringarten, Ph.D. St. Thomas University, O’Mailia Hall 16401 N.W. 37th Avenue Miami Gardens, Fla. 33054 E-mail: [email protected] JOURNAL WEB ADDRESS http://www.stu.edu/jsr MISSION STATEMENT Like in its parent journal, the mission of the Journal of Student Research is to promote excellence in leadership practice by providing a venue for students and future academics to publish current and significant empirical and conceptual research in the arts; humanities; applied natural, and social sciences; and other areas that tests, extends, or builds leadership theory. Primarily, JSR seeks to provide a platform for academic growth. Journal of Student Research CONTENTS Editorial Details … inside front cover Mission Statement … inside front cover About the Journal … inside back cover Editorial By: Maria D. Suarez … iii ARTICLES Public Mental Health Services in Brazil: An Analysis of the Reform, Current System, and Future Challenges By: Estefania Konarek … 1 ISIS’s Forbidden Fruit: Challenges and Contradictions of State Building in Wartime By: Anh T. Tran … 17 Examining Latino Success at Community Colleges: Retention and Transfer By: Amilcar Guzman … 34 In Defense of Fanon’s Conception of the Struggle to the Death By: Heather Stewart …56 BOOK REVIEW Unspoken Politics – Implicit Attitudes and Political Thinking By: Emily D. Bello-Pardo …73 ii Journal of Student Research EDITORIAL elcome to the Second Edition of the Journal of Student Research (JSR). It is W truly an honor to present to you the second student publication at St. Thomas University as we continue to grow and evolve as a student-led publication. The Journal of Student Research welcome submissions from all undergraduate, graduate, Ph.D., and law students in a wide ranging interesting subjects. Our mission is to offer a platform to promote excellence in leadership and provide academic growth. The JSR also seeks to provide a creative and academic outlet for students to publish current and significant research in their areas of interest. The Journal of Student Research is the offspring of the Journal of Multidisciplinary Research (JMR), a publication with international recognition. This great work was possible only with the guidance and support of Dr. Hagai Gringarten, Editor-in-Chief of the JMR, who together with journal advisor Dr. Raúl Fernández-Calienes envisioned a student journal to foster academic participation by students. Each article in this volume was carefully selected to reflect St. Thomas’ rich culture, diversity, high quality education, and global entrepreneurship. This issue contains publications highlighting controversial topics as well as a book review discussing political thinking. Respectfully yours, Maria D. Suarez Editor-in-Chief iii “September” By: Alexandra Valdes 2016 Panoramic Photography of STU Library All rights reserved. Used with permission. JOURNAL OF STUDENT RESEARCH Featured Article Public Mental Health Services in Brazil: An Analysis of the Reform, Current System, and Future Challenges Estefania Konarek Georgetown University Abstract Brazil’s mental health system has undergone various reforms to serve the population’s need for mental health care. It is important to understand the history of mental health services to move forward with substantial policy reforms. Brazil, known for its universal healthcare system, Sistema Único de Saúde (SUS), can offer the capacity to provide universal mental health services to its citizens. This article focuses on the analysis of the current mental health system, and how its historic transformation led to higher population access to mental health treatment and services. The research will analyze the development of the public health mental system and will understand the impact of the overall psychiatric reform in the country. Furthermore, the article will address the most challenging aspect of the system, the lack of human resources willing to provide services to the needed populations. Brazil has excelled in moving from asylum care to community care, but challenges still remain. It is important to understand the current challenges and historical facts, to apply successful implementations that will improve mental health outcomes and indicators in Brazil. Introduction razil, with a Gross Domestic Product (GDP) per capita of $11,420, is considered to be one of the largest and fastest growing economies in the South American continent (World Bank, 2012). Consisting of nearly 199 million inhabitants, Brazil exhibits a diverse and contrasting demographic profile as well as social indicators. The World B Bank classifies Brazil as an upper-middle country, yet in 2009 the percentage of people living under the national poverty line was 21.4% (World Bank, 2012). The main language spoken is Portuguese and 85% of the population lives in urbanized areas (UNICEF, 2011). Over the past decades, Brazil has seen significant improvement in their health indicators. In 1990, for instance, Brazil showed an Infant Mortality Rate (IMR) of 49 per 1,000 live births; twenty years later in 2012, the country recorded an IMR of 13 per 1,000 live births, falling behind Uruguay, Argentina and Chile (World Bank, 2012). Additionally, a decline in incidence of some communicable diseases such as malaria has been observed over the years (Oliveira- 1 JOURNAL OF STUDENT RESEARCH Ferreira, 2010). The average life expectancy at birth is 73 years and 8.9% of Brazil’s GDP is allocated to health expenditures, in which 45.7% is attributed to public health costs (World Bank, 2012). The country has the highest health expenditure per capita in the Latin American region consisting of US$1,120 (World Bank, 2012). Brazil operates under a universal healthcare system that guarantees free healthcare services to all citizens. The country’s Sistema Único de Saúde (SUS), or Unified Health System, was created in 1988 by the introduction of a new Constitution that guaranteed “health as a right for all and an obligation of the State.” The implementation of the system helped millions of Brazilians obtain healthcare services. Although a relatively young system, 80% of the population depends exclusively on the services provided by the SUS (Ministeria da Saúde, 2010). The three main principles of the SUS are universal access to healthcare, integrality, and equity for all citizens (Paim, 2009). SUS is a single, public health system that combines all health services that are provided at the municipal, state and federal levels of government, directed and monitored by the Ministry of Health, while also including the private sector (required to be under contracts) and foundations supported by public funds (Paim, 2009; Mateus et al., 2008). In other words, SUS is responsible for the administration and management of all health care services in Brazil. Further, the system emphasizes primary level care and focuses on health promotion and public health prevention programs. Under SUS, individuals needing complex medical procedures must undergo a referral mechanism to be seen by a specialist or attend a hospital (Mateus et al., 2008). SUS is a decentralized system—mostly because service provision comes from municipalities and states—that incorporates a holistic approach to care and encourages community involvement and social participation (Paim, 2009). When it comes to mental health indicators, in 2008, Brazil had a suicide rate of 7.3 per 100,000 people for males and 1.9 per 100,000 people for females (WHO, 2011). According to the World Health Organization (WHO), mental health disorders are estimated to contribute to 20.3% of the global burden of disease in Brazil. Furthermore, Brazil has displayed significant progress in applying policies and legislation regarding mental health delivery services. However, even though Brazil has a remarkable and one of the most successful mental health systems in the region, challenges still remain. As a result, this article will provide an overview of the Brazilian approach towards the provision of mental health care services, mostly focusing in the public sector. Further, the article will describe the development of the public mental healthcare system and will analyze the impacts of the psychiatric reform in Brazil. The article will conclude with a discussion of current and future challenges, and address the human resources aspect of the mental health system. Other countries with similar conditions as Brazil can learn from the mental health system’s model presented by this article. The article can help highlight the importance of successful mental health policies and asses the needs for policy-making. Origin and Reforms – Brazil’s Path towards an Exceptional Mental Health System Brazil’s first reform in mental healthcare occurred in 1978. The reform was mostly attributed to the Movimento dos Trabalhadores em Saúde Mental (MTSM), or Movement of Mental Health Workers, where health workers,
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