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Sarah Lowe, PhD, on a Public Health Approach to Mental Health

March 02, 2021

Sarah Lowe, Ph.D., is a clinical psychologist and Assistant Professor in the Department of Social and Behavioral Sciences at Yale School of Public Health. Her research focuses on the long-term mental health consequences of a range of potentially traumatic events, from hurricanes to pandemics.

While doing her clinical training with trauma survivors at a community health care center in Boston, Lowe's patients were dealing with more immediate life stressors, like not having a place to live.

"That showed me that you can't understand mental health without paying attention to the context and the social and economic stressors that trauma survivors face," she says. Lowe explains that within public health "we're able to look at those things simultaneously. So both the symptoms and treating symptoms but also thinking about systems and policies that both put people at risk for trauma, but then make their traumatic experiences even more negatively impactful."

As a disaster mental health researcher, Lowe immediately knew the COVID-19 pandemic was going to be a mental health crisis. She's collaborated with students and other faculty on work related to the pandemic and mental health, particularly the mental health burden of health care workers on the frontlines.

"I can say in this pandemic, Yale was able to provide support to me and to my colleagues to do really cutting-edge research. Just observing my colleagues on the forefront of the response to the pandemic doing things like modeling transmission, understanding the genetics of the virus, that's been really really inspiring to see."

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  • 00:17When I was doing my clinical training, my main placement was at a community health center in a
  • 00:22low-income area in Boston and there I worked with patients who had pretty extensive trauma
  • 00:28histories, domestic abuse, sexual violence, and what I found was that I had been learning about
  • 00:34all these empirically supported treatments for PTSD, which are effective, but on the other hand,
  • 00:39my patients were dealing with more immediate life stressors, like they didn't have a place to live.
  • 00:44And so a lot of my work with them was actually case management, so helping them
  • 00:48navigate systems to secure the resources to gain some level of stability before we could dive into
  • 00:54their histories and work on their actual psychological symptoms. And I think that
  • 00:59showed me that you can't understand mental health without paying attention to the context
  • 01:04and the social and economic stressors that trauma survivors face. And so in public health, I think
  • 01:10we're able to look at those things simultaneously. So both the symptoms and treating symptoms but
  • 01:15also thinking about systems and policies that both put people at risk for trauma, but then
  • 01:20make their traumatic experiences even more negatively impactful.
  • 01:33As a disaster mental health researcher, it was immediately apparent that the COVID-19 pandemic
  • 01:39was going to be a mental health crisis. So when we think of disasters, we think of hurricanes
  • 01:44or tornadoes or terrorist attacks, but this was similar in that it was affecting not just
  • 01:50individuals but entire communities as well as social infrastructure. I've been fortunate at Yale
  • 01:57to have been able to collaborate with students and colleagues on work related to the pandemic.
  • 02:04One example, i had an MD/PhD student approach me interested in exploring how the pandemic was
  • 02:10affecting health care workers, mental health across the country and we were able to work
  • 02:15together to launch a survey of 25 academic medical centers throughout the country. We've
  • 02:20been able to look at factors both related to their work but also to their social networks,
  • 02:25their communities and also their perceptions of the local and federal government response to the
  • 02:29pandemic and how that's influenced their levels of depression, anxiety, PTSD and alcohol use.
  • 02:37I think for me as a researcher it's really exciting to be here and I've already been
  • 02:41able to see how my collaborations at YSPH have been able to enrich and expand my work. You know,
  • 02:48as a disaster researcher, something that is really challenging is that these events happen
  • 02:53and time is of the essence. So you want to get out there quick to see what people are doing
  • 02:57and how we support them and that's challenging. You need infrastructure to get your surveys out
  • 03:03and you need funding. I can say in this pandemic, Yale was able to provide support to me and to
  • 03:08my colleagues to do really cutting-edge research. Just observing my colleagues
  • 03:13on the forefront of the response to the pandemic doing things like modeling transmission,
  • 03:18understanding the genetics of the virus, that's been really really inspiring to see.
  • 03:25The students that we get here have been absolutely
  • 03:28brilliant but also really caring and kind people who are committed to
  • 03:33social justice and bettering the world and that to me has been a joy to get to know them.