Westmont Magazine A Mental Challenge
Jeff Swanson ’79 knows how he would like to be remembered: As a good parent and as someone whose work helped alleviate suffering. Both ambitions present challenges for the medical sociologist, an associate professor of psychiatry and behavioral sciences at Duke University Medical Center in North Carolina.
The father of three children, Jeff faces demands most parents never encounter; his 16-year-old daughter was born with cerebral palsy. “That changed our lives forever and shattered the platitudes of an easy faith,” he states. He’s proud of his daughter, who is a good student and fine writer, but he wishes people would look beyond her wheelchair to see the person there.
Jeff is also concerned with the well-being of another overlooked population: People with severe mental illnesses. As a research scientist, he studies the relationship between violent behavior and psychiatric disorders. He asks
questions like, “How do various risk factors interact and lead to violence in some people with schizophrenia? Can better mental health programs and policies lessen this violence?”
Helping people with mental illness requires balancing their right to decline treatment with the public health imperative to provide it. Mentally ill individuals often resist taking medication and may become a danger to themselves or to others, requiring hospitalization or incarceration. What is the best way to meet their needs?
In his research, Jeff and his colleagues at Duke have studied the effectiveness of assisted outpatient treatment (also known as involuntary outpatient commitment), which authorizes court-mandated treatment for serious cases.
In a recent editorial in the Los Angeles Times, Jeff cites his studies showing that outpatient commitment can make a difference, and discusses the controversy over adopting this legal policy in California. “It is unfair to reject mandated treatment without considering the larger context of the real limits of a debilitating condition such as schizophrenia — the impoverishment of life’s choices, the loss of chances and constrained self-determination,” he writes. “Coercion compared to what? Autonomy in what sense?”
“I’m grateful for the chance to do interesting and meaningful work,” he says. “When I first reviewed the literature on violence and mental disorder, it became clear this was a very complex, controversial topic of national significance. Through my research, I want to be useful in shaping better and more ethical public policies regarding people with severe mental illnesses.”
The son of missionary parents, Jeff grew up in Ecuador. “Living around a mission hospital in the Amazon region, I had the chance to observe the kinds of health problems that people commonly suffer in less-developed countries — sicknesses bound up with extreme poverty and made worse by lack of access to medical care. I got a glimpse of how people in different social environments and cultures experience illness, construct its meaning, and seek help in diverse ways.”
As a sociology major at Westmont, Jeff acquired a “starter kit of intellectual tools” from Professors Ron Enroth and Brendan Furnish.
“Bob Wennberg taught me how to ask provocative and scary questions,” he adds. “Westmont professors take a risk in the way they teach students to ask honest questions about big things, not knowing, of course, where those questions will lead. But the risk is worth it.
“Jim Mannoia, who taught philosophy of science, helped me learn to think critically about science as a human enterprise, and what is the (appropriately modest) place and posture of scientific inquiry in the scheme of things.
“David Neu taught me statistics, which I use every day. He is a wonderful teacher, one of the best. He was patient and kind, yet rigorous and demanding. He taught students not only to master difficult material, but to enjoy the process.”
After graduating from Westmont, Jeff earned a Ph.D. in the sociology of medicine and the sociology of religion from Yale University. For his doctoral dissertation, he interviewed 100 American missionaries and wrote about religious experience and personal identity construction in the context of cultural marginality. His work was published in 1995 by Oxford University Press as a book titled, “Echoes of the Call: Identity and Ideology among American Missionaries in Ecuador.”
Jeff’s wife, Pam, grew up in Latin America, also with missionary parents. She is a nurse practitioner specializing in obstetrics and gynecology. The Swansons have three children, ages 10-16.
“Frankly, I struggle with what it means to be a Christian and also be part of a secular academic community that is pluralistic, with an intellectual posture that is tolerant and respectful of others’ beliefs. I don’t have the answers. So faith becomes a lived experience; it’s what I hear myself telling my children about what we’re doing here on earth, in spite of the intellectual skepticism that lies in the background. If God can reach and hold us even then, it’s grace.”