In today’s world, where we’re swimming in data and using it for pretty much everything, data science has become this awesome tool. It helps us figure out cool stuff, make decisions, and push forward in different areas of human life. But you know what they say, “with great power comes great responsibility.” So now, people are really thinking hard about the ethical side of data science. We’re talking about the impact it has on individuals and society.
This research paper is all about diving deep into the world of “Ethics in Data Science.” We’re looking at the tricky ethical issues, the principles we should follow, and the frameworks that help us use data responsibly in this super-connected world. As tech keeps on shaping our lives, it’s not just an option to understand and deal with these ethical concerns; it’s a must if we want data science and humanity to get along smoothly.
Armenia is one of many countries whose population faces mental health struggles to a high degree. However, the extent of these struggles is unknown due to the country’s underreporting of recent, correct data on mental health statistics.
Armenia’s mental health crisis can be attributed to many factors, some of which include residual trauma from various events in the country’s history (such as the Armenian Genocide and the Spitak earthquake of 1988), domestic violence, perpetuation of cultural stigmas that keep individuals from seeking help for mental illness, and lack of resources and healthcare infrastructure.
A few of the most prominent consequences of the crisis include human rights violations, lack of economic mobility, and harm to interpersonal relationships.
For the past 30 years, the Nagorno-Karabakh conflict has taken a heavy toll on people’s mental health, especially among those living along the border between Armenia and Azerbaijan.
“We live in an environment of constant risks,” says Kristine Aydinyan, a schoolteacher from Aygepar. “I would often find bullets on our balcony, and when there was shooting, I would stuff cotton in my daughter’s ears so that she didn’t hear it. If a shooting occurred during school hours, we would take the children to an underground shelter and play games and music for them.”
The research conducted by MSF showed that one in two responders reported that they knew someone who had been treated for mental health problems; when asked about the number of people who had mental health problems in Armenia, responders’ views showed that, on average, 38% of Armenians have mental health problems.
Here are the key points of mental healthcare problems Armenia is facing:
Armenian mental health care is lacking due to large numbers of individuals requiring those services and insufficient resources dedicated to mental healthcare.
No significant number of effective practices are consistently being implemented in-country for this issue.
The government has recently been passing legislation that could lead to better mental healthcare in the future. Still, improvement is mainly speculative and hindered by an ongoing mental health stigma.
With a decrease in the stigma against mental healthcare, increased access to treatment, and deinstitutionalization reforms, mental healthcare would likely improve in Armenia and the general well-being of those with mental health conditions.
Questions to answer:
1. What has caused or is causing the mental health of the citizens?
2. What efforts has the Armenian Government made to improve the mental well-being of the citizens?
3. Are people living in Armenia aware of mental health in general? How well are they aware of mental health problems, and do they find going to therapy acceptable?
According to Armenia’s Ministry of Health, there are around 54,000 people with psychiatric illnesses in Armenia. Although all of them are under the supervision of a doctor, many do not wish to receive treatment in a psychiatric hospital: some prefer to conceal their health problems because of the stigma; others are simply terrified by the thought of living in an institution.
Domestic Violence
“In 2021, the Investigative Committee of Armenia investigated 556 criminal cases of domestic violence.
14.8% of women aged 15-59 who have ever had a partner have been physically abused by their husband or partner; 62.5% of women who were sexually abused were also physically abused; 27.8% of those subjected to physical violence were also subjected to sexual violence.
Of those who were subjected to physical violence, 44.7% did not tell anyone about what had happened, and of those who were subjected to sexual violence, 48%.
23.5% of abused women have left home. 63% of those who left returned to their husbands. 76.5% of women who have been physically or sexually abused by their partner continue living with him and never leaving him.”
War
The mental health sector in Armenia was already weak before the latest conflict, and it was not prepared for a new war. There are 176 psychiatrists in the country, and because psychological care is not regulated, no one knows how many psychologists there are.
The consequences of mental health issues triggered by this war will be measured in the long run. There was a collective high level of distress during the conflict, and individually, many cases of severe depression after the defeat.
“There was clearly a strategy from the Azerbaijani side,” says Dr. Alecian. The fact that they also made videos and photos of atrocities and sent them to families or Armenians in the diaspora. That is a strategy to have an effect on the psyche of the other side.”
Accepting the fact that mental health matters and working on it with the new therapies offered by international and local actors is key.
Post-traumatic stress disorder (PTSD) can be recognized through several symptoms, including nightmares, vivid flashbacks of a traumatic scene, sudden mood changes, intrusive thoughts and images, and intense distress triggered by a certain sound or word. It is often expressed through physical sensations like sweating, nausea, trembling, or pain.
PTSD is not necessarily related to war and can result from trauma caused by any form of violence or natural disaster. The devastating 1988 earthquake in Armenia exposed a lot of people to severe mental disorders and depression.
Spitak Earthquake
High rates of chronic, severe post-traumatic stress reactions were found among children in the two most damaged cities, Spitak and Gumri.
Analyses controlling for exposure revealed that girls reported more persistent fears than boys. These findings indicate that after a catastrophic natural disaster, post-traumatic reactions in children may reach epidemic proportions, remain high for a prolonged period, and jeopardize the well-being of the child population of a large region.
Systematic screening of children for PTSD can provide critical information for a rational public mental health program after such a disaster.
Post-disaster PTSD and depressive symptoms can persist for decades. Traumatic deaths in the core family, strong emotional responses to the event, and lack of social support predicted depression over two decades after the disaster. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.
An international mental health relief program for children and adults was implemented in Soviet Armenia after the 7 December 1988 Spitak earthquake. The rate of post-traumatic stress disorder was 74%, and major depressive disorder – with 22%, in a total of 582 hospitalized patients.
In September 2010, the RA ratified the UN Convention on the Rights of Persons with Disabilities. Among other commitments, the ratification of the convention necessitated utmost complex amendments for mental health services in the RA.
In Armenia, the mental health system is based upon inpatient medical care? and thus diverts its attention and efforts to persons with mental disabilities registered at various dispensaries, thus practically neglecting the problems of mental health among the general population.
Since 2011 the government undertook efforts to transfer the mental health care system from exclusively inpatient (institutional medical care) to another system that mainly focuses on the provision of medical care and assistance at community level.
The absence of the RA general policy was a serious challenge for achieving such systemic amendments and results, where each event or action would be exclusively driven by the fundamental principles and norms of human rights.
The drafting of the first mental health policy document was launched in 2011, when a joint working group was created by the Ministry of Health (MoH) of the RA with support of the Open Society Foundations – Armenia (OSFA).
The interdisciplinary working group was comprised of both state governing bodies and public sector specialists, including psychiatrists, psychologists, and NGO representatives. The goal of the working group was to draft the Mental Health Strategy for the RA, the first document directed to reform the mental health field.
Facing Problems
The following issues were encountered during the introduction of the alternative services model and drafting of the programs.
Stereotypical approaches
Material, legal and financial provision
Selection and training of the community-based home personnel
Selection of residents
Full insurance of human rights
In a country, where no effective legal and institutional anti-discrimination mechanisms exist, and the phenomenon of stereotypisation and stigmatisation towards vulnerable groups is accepted by society, it is difficult to achieve success in promoting the rights of persons with psychosocial disabilities by legal reform alone.
Stereotypical approaches among members of the policy-working group, especially during the development of national policy documents, were one of the main challenges faced during the development of concepts and action plans. Nonetheless, it is worth noting that those approaches have been overcome in the majority of cases and have not negatively affected the policy development process, however, they did complicate the implementation process.
The need for establishing alternative care facilities in the RA is determined by relevant governmental action plans and governmental agencies that are bound to implement those action plans. In the meantime, it should be noted that the adopted action plans failed to clearly define necessary allocations from the state budget.
Thus, although the process of introducing the model of community-based mental care services in the RA was accompanied by a number of problems and challenges, which were more or less successfully overcome (putting the issue on the agenda and introducing a community-based model as a result of joint work with state agencies, private and public sector is itself qualified as a success), currently the RA is facing greater challenges.
The presence of discrimination and stigmatisation in the society is a challenge, and the reduction or elimination of discrimination is as important as the introduction and implementation of community-based models with relevant state budget allocations and redistribution, as well as the enhancement of skills and knowledge of specialists and state officials.
Officially there are a total of 52,000 people with mental health problems in Armenia. 1454 adults receive treatment or care in psychiatric facilities, out of which 397 are legally incapacitated. Around 30% of these individuals are under the age of 25.
“In Armenia, there is no idea how mental health care should be. This understanding is also absent at the public level and decision making level. This is also evidenced by the fact that no legal document in Armenia states the need for preventative measures for mental health. Meanwhile, this is the most important thing to understand,” says Anahit Papikyan, a consultant of the Open Society Foundation’s (OSF) Armenia Public Health Program, noting that other problems in the mental health sector stem from this.
85 percent of mental disorders can be treated, allowing the individual to function and work–– but these cases are not acknowledged in Armenian society or prioritized in the mental health system.
Patients are reluctant to seek professional help in case of mental health issues. Traditionally, in Armenian society, close relatives and family members are playing significant role in advising and sometimes in bringing mental patients to mental health services. That is why secondary stigmatization is a huge problem in underuse of professional services for mental health patients, as well as in poor outcome of their treatment and psychosocial rehabilitation.
When asked about their interest in participating to training programs on mental health issues, 65% answered negatively, and explain their answer either by the lack of time or by the lack of interest, because they think it is not them but the society should change in mental health issues perception.
Conclusion
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Public health professionals, mental health professionals, social workers and mass media representatives should pay more attention to public education on mental health issues to prevent stigmatizing behavior in Armenian society.
It can be concluded that stigma of mental illness, although more often related to context than to a person’s appearance, remains a powerful negative attribute in all social relations influencing all aspects of life of mental health patients including their close relations within family.
The current worrisome mental health situation in Armenia can be substantially improved if right solutions are suggested and incorporated in mental health policy change strategy.
Armenia is one of many countries whose population faces mental health struggles to a relatively high degree. However, the extent of these struggles is relatively unknown due to the country’s underreporting of recent, accurate data on mental health statistics.
Armenia’s mental health crisis can be attributed to many factors, some of which include residual trauma from various events in the country’s history (such as the Armenian Genocide and the earthquake of 1988), domestic violence, perpetuation of cultural stigmas that keep individuals from seeking help for mental illness, and lack of resources and healthcare infrastructure.
A few of the most prominent consequences of the crisis include human right violations, lack of economic mobility, and harm to interpersonal relationships.
For the past 30 years, the Nagorno-Karabakh conflict has taken a heavy toll on people’s mental health, especially among those living along the border between Armenia and Azerbaijan.
“We live in an environment of constant risks,” says Kristine Aydinyan, a schoolteacher from Aygepar. “I would often find bullets on our balcony, and when there was shooting, I would stuff cotton in my daughter’s ears so that she didn’t hear it. If shooting took place during school hours, we would take the children to an underground shelter and play games and music for them.”
Questions to answer:
1. What had caused or is causing the mental health of the citizens?
2. What efforts has the Armenian Government made to improve the mental wellbeing of the citizens?
3. Are people, who live in Armenia, aware of mental health in general, how well are they aware of the mental health problems and do they find going to therapy acceptable?
Սարգիս Շահինյան 