keegan traveling fellowship
For exhaustive details, visit the Keegan website. My bio on the Keegan website is available here. My CV is here.
THE PROJECT
TITLE. “Making, erasing, and researching mental health.” The title is based on the idea that researchers can use science to make/construct mental health (providing “scientifically” authoritative definitions of what mental health is) and erase alternative narratives (oftentimes more folk or cultural understandings). This is tied to Ian Hacking’s concept of looping effects or “making up people”.
AIMS. I am researching how historical, political, and cultural influences shape the ways people conceive and approach mental health. I am especially concerned with dominant narratives that situate mental health as a medical fact (i.e., something you either have or do not, or something that can be objectively measured).
GUIDING QUESTIONS. How and why have clinical language and methods come to be so influential? How does medicalization relate to historic and ongoing colonialism? How do people around the world resist or embrace the shift from mind to brain?
METHODS. Travel the world and speak to people with a diverse array of experiences and expertise, including clinicians, social scientists, community organizers, and laypeople with no particular interest in mental health.
OUTPUTS. Importantly, this is not “formal” research. There is no IRB. I have no intent on sharing my experiences while traveling in a peer-reviewed journal. I hope to maintain a Substack where I post my writing about mental health and welcome insights from people I meet, though this is subject to change.
THE AWARD
The Michael B. Keegan Fellowship is a $25,000 award given to a select number of graduating Vanderbilt seniors each year in order to travel the world for experiential learning. There are no required outputs. Rather, the award is intended to be a no-strings-attached, self-guided year of travel and learning to inform later endeavors. Keegans can go to as many countries as they please and are recommended to change plans as they travel (e.g., as opportunities and connections arise).
ADVISOR: KEN MACLEISH
This project is advised by Ken MacLeish, PhD, a medical anthropologist at Vanderbilt’s Center for Medicine, Health & Society. His scholarship mainly concerns war and militarization, especially is it relates to the politics of health. Much of this has to do with psychiatry and medicalization (e.g., consider PTSD and suicide as they are used to situate military health [and biopolitics]). Dr. MacLeish has been a stellar mentor to me for the last several years, and as an advisor to this project, he has helped me write more thoughtfully in materials like the one you’re reading. While I travel, we will meet once- or twice-monthly to consider certain topics or writing of mine more carefully.
LIVED EXPERIENCE, POSITIONALITY STATEMENT
It is important, in my opinion, that mental health researchers give context for how they interact with the psychiatric systems they study. How did a researcher’s interests develop, and what experiences can a researcher speak to? How might these things affect the questions a researcher asks, the methods they use, or the conclusions they draw? I have been diagnosed variously with OCD, ADHD, and MDD; though foremost, I think I am just neurotic with low “executive function”. My Tourette Syndrome is similarly complex. My tics regularly interfere with my daily function in an obvious, physical, and social way. Yet, like most disabilities, the shape and form of my tics also change constantly. I have, at different times, exhibited coprololalia (inappropriate words, phrases, or noises); copropraxia (inappropriate gestures or movements); and physically violent tics (to both myself and others). Some days, I go hours without ticcing, or my only frequent tic is scrunching up my face. Other days I can’t speak for more than 10 seconds at a time without ticcing. Both my mental health and my tics are amorphous. These experiences shape my approach to mental health. I cannot help but recognize it as blurry.
Still, positionality statements and disclosure have their limits. There are experiences of mine that I will not share – so even as they affect my perspective, I could not be characterized as a “lived experience researcher” on those fronts. Perhaps even more important, “lived experience” is not a monolithic thing to begin with: what is “lived experience” in the mental health space? Arguably as important as disclosing that some things have happened is identifying what hasn’t. I have not faced involuntarily hospitalization. I have not been labeled with a “serious mental illness” like schizophrenia or bipolar. Though I have faced certain misfortune, I am still a “high-achieving”, White, cisgender man who graduated from an elite private college. With scholarships, on-campus jobs, and family support, I have no student debt. My family is resoundingly upper middle-class. In all of these ways, I am a “fashionable” service user. I am the kind that mental health organizations like flaunting as their source of “lived experience” even as I have been spared so many kinds of marginalization. As a movement, we must name this wherever possible.
ITINERARY
My travel is primarily informed by where I have connections/am invited, and how prepared I believe I could be before entering a region (e.g., familiarizing myself with political and historical context). These plans are obviously pretty loose. If I am going somewhere, I plan to be there for at least two or three weeks, even if traveling throughout the country. Let me know if you would like to talk with me, or if you have any recommendations!
THE UNITED KINGDOM. My travel begins in London on Sunday, September 3rd. Here, I am interested in why critical perspectives seem far more common than in the US. I want to explore interdisciplinary programs on madness and disability, especially to understand how they are received by students, comparing this experience to my own back in the US. (I was fortunate to attend a school with interdisciplinary majors, but most American universities lack such critical programming.) I also hope to learn about the experiences of organizers and academics who protest involuntary hospitalization in the UK.
IRELAND. My parents immigrated from here. I have not familiarized myself with Irish history and mental health but really want to; and, I hope to stay with family here for free. No particular guiding questions. I also want to learn more about my own ancestry and the history of Irish Americans.
SPAIN. I am attending the 2023 International Association for Suicide Research/American Foundation for Suicide Prevention’s biannual meeting in Barcelona (October 15-18, 2023). I hope to take dutiful notes and exhaustively study the conference proceedings to observe the scale of neuro-reductionism in suicide. I am also curious about the frequency (if at all) that people will discuss involuntary treatment and other ethical concerns inherent to suicidology.
ITALY. I want to read more about Franco Basaglia and see if Italian mental health really is as good as people say. I want to visit Trieste.
FRANCE. I know very little about French mental health but want to visit historical places and spend time reflecting on Michel Foucault and Frantz Fanon.
BELGIUM. I want to learn more about St. Dyphna’s history and current role in Belgian mental health.
JAPAN. I am interested in Western obsessions with Japanese suicide and mental health. In particular, how might Logan Paul’s vlogging in Aokigahara Forest (2017) or video games about “culture-bound syndromes” like Omori represent a latent fetishization of Japan by Westerners? How are these things received by locals?
INDIA. I plan to observe psychologist Steve Hollon and psychiatrist Vikram Patel’s work in India, especially on Sangath: a community-led task-shifting initiative that trains laypeople to provide basic psychotherapy. I hope to collect testimonies not captured in typical epidemiological studies of Sangath and task-shifting generally.
SOUTH AFRICA. I hope to explore heterogeneity in approaches to mental health in South Africa, especially considering historical conflicts and extreme variations in demographics and culture.
ZIMBABWE. I hope to study the Friendship Bench and other task-shifting initiatives to think critically about their role and Global Mental Health more broadly.
SURINAME. Suriname has no majority racial-ethnic group and has extreme variation in suicide rates from one region to another. The suicide rate appears to be especially high among South Asians (Suriname’s largest racial-ethnic group, historically brought to the country as indentured servants to the Dutch). I want to explore this variation and the content of pamphlets on suicide by global health organizations like the WHO. Epidemiologists might characterize Suriname as having a “high suicide rate” without identifying how silly such a single descriptor is for such an incredibly diverse country.
ARGENTINA. I hope to connect with psychoanalysts in Argentina to learn more about their historical resistance to “evidence-based” Western psychotherapies.
WHERE ELSE? I am happy to change plans and expect to pivot as different opportunities, recommendations, and challenges emerge.
joseph sexton 