All posts by kashafkhatri

Audience Participation in Research

Research-in-Action

Throughout this course of this seminar, we’ve read articles and accounts of policies, gentrification and other changes in the community that have occurred against the desire of the community’s inhabitants. We’ve read about social movements that have been established as well as a continuous voice for justice. However, the “intentions” behind these changes are supposedly for the betterment of the communities. So the question arises: who has a voice in creating these policies?

In Angotti’s “From Dislocation to Resistance: The Roots of Community Planning” we read that community members seldom had a say in many of the changes that occurred in their neighborhoods. A key aspect of all our projects, whether it was a mental health initiative or the rezoning of a neighborhood, were assessing how these initiatives impacted the community and how much of a say community members had in the initiative. In “Critical Participatory Action Research as Public Service”, Torre et. al, introduce the concept of critical participatory action research (critical PAR).

Upon reading this chapter, one sentence stood out and really summarized the purpose of critical PAR: “[shifting] the gaze from “what’s wrong with that person” to “what are the policies institutions, and social arrangements that help to form and deform, enrich and limit, human development” and “how do people resist eh weight on injustice in their lives?” Critical PAR is about involving the community in the research, ensuring whatever policies and products result are truly beneficial for the community. Torre et. al provide an extensive history on critical PAR and how community members are evolved.

In critical PAR, there is great emphasis audience participation. To explain this, Torre et. all introduce Poll For Justice (PFJ), a contemporary PAR project which is “designed to examine the extent to which urban youth… experience injustices across sectors of education, criminal justice, and health. It began with a 2 day intensive for young people, university faculty, students, community organizers, and health professionals (175).” Using the expertise and experience of these individuals, the aim was to create a youth survey that can accurately document youth experience across various sectors of the city.

Critical PAR seems to be a promising research method, and a model I hope ThriveNYC and other government initiatives adopt. It’s emphasis on partnering up with the community shows that the outcome of such research is truly beneficial for the community members, and strengthens the bond and trust between the people and the government.

Discussion Question: How can apply this model to existing research and research findings?

 

Oppression and Privilege in Mental Health

Clarifying Key Concepts

Oppression is a difficult word to define, often subjective to the group being oppressed. In “Five Faces of Oppression,” Iris Marion Young attempts at creating an objective definition through the explanation of five different concepts: exploitation, marginalization, powerlessness, cultural imperialism, and violence. The Marxist theory of exploitation explains how class structure exists despite any clearly states distinctions. According to Young, exploitation is “a steady process of the transfer of the results of the labor of one social group to benefit the other” (330). Furthermore, it extends from class distinctions to sexual and racial oppression as well. Marginalization refers to the process that limits the resources and rights of people that “the labor cannot or will not use” (331). Powerlessness, often stemming from exploitation and marginilazation, mainly deals with the status of professional and nonprofessionals, the latter of which often face this kind of oppression. Cultural imperialism has a lot to do with privilege and the establishment “dominant group’s experiences” as the norm of society (333). Lastly, violence refers to the systemic oppression many groups have to fear, which include but are not limited to random attacks, damaged property, harassment, and humiliation.

In her last section, Young states, “the presence of any of these five conditions is sufficient for calling a group oppressed”. Reading this in context of mental health, those dealing with mental health issues deal with most, if not all five of the conditions. However, they are most impacted by marginalization. Mental illnesses are often debilitating, leaving individuals dependent on family, friends, and the government. As Young describes, they are (indirectly) excluded from equal citizenship rights. They are subjected to ill-treatment by both policies and people, and to the authority of others, leaving them powerless.

The idea of privilege also plays into the mental health system. In “Privileged Places” Gregory D. Squires and Charis E. Kubrin highlight spatial and racial inequalities, which are associated with the access to all products and services of “the good life”. Reading into the history of how mental health has been dealt with over the past century, mentally ill individuals are highly deprived. Prior to the 1900s, most were isolated from the community and placed in asylums or poor housing. Today, they are often incarcerated. Wherever they end up, they are not given the services they need to heal. Furthermore, the idea of “location location location” can be applied here. The uneven development of communties Squires and Kubrin highlight reinforce not only the system of privilege, but also the system of oppression Young discusses.

Discussion Question: How do we combat these disparities? This system has been in place for hundreds of years, so where exactly do we start?

Why Communities Matter

Clarifying Key Concepts

Harold DeRienzo distinguishes between neighborhood and community in “Community Organizing for Power and Democracy: Lessons Learned from a Life in the Trenches.” Neighborhoods are based on geography, while communities are based on the social ties that exist between the people. Reflecting on my past, I realized I’ve often mixed up the two words. I viewed community as the definition mentioned above, but specifically with the individuals in my neighborhood, which I never had. I’ve moved 4 times in my life, 3 of which have occurred in the past 6 years. As a result, I was never able to develop a “community” within my neighborhood. After reading this piece however, I’ve realized that my community extends far beyond the physical region I reside in. It extends to the organizations I am a part of, the friendships I have made across the country due to the organizations, and much more. This community has indeed given me the opportunity to reach my aspirations and goals, as James DeFilippis and Susan Saegert highlighted in “Communities Develop: The Question is, How?” However, this fact has made me question whether there was a set definition of community, and I do not believe there is. In that case, how does one find his/her community? I think the answer to that is using the resources available to you.

Linking this to the mental health system in the city, I believe there is a lack of resources for individuals dealing with mental health issues to create a community. They are often marginalized and isolated from the public. DeFilippis and Saegert state, “communities are the sites for our housing, education, health care, daily convenience shopping, and the other activities that sustain us physically, emotionally, socially, and psychologically”. When reviewing the history of mental health in New York City, individuals facing mental health issues were not given adequate housing, education, or health care. Even today, many do not have access to these resources, and as a result they are hurt physically, emotionally, socially, and psychologically.

Recognizing the importance of community is the first step in tackling mental health issues. ThriveNYC has specified an initiative to increase such resources, so I believe we’re going in the right direction.

 

Project Update 4/27

Updates - Mental Health

Key Project Activities/Progress Made/Interesting Findings:

  • Our group engaged in a direct participant observation by attending a Mental Health First Aid Training offered by the Department of Health and Mental Hygeine. ThriveNYC aims to have 250,000 individuals trained as one of it’s initiatives to “Change the Culture” around mental health. The class was an 8-hour long training period, in which we discussed what mental health first aid is, the importance of this knowledge, and different kinds of disorders including depression and mood disorders, anxiety disorders, trauma, psycosis, and substance use disorders. We were given action plan known as A.L.G.E.E. (Assess risk of suice or harm, Listen nonjudgementally, Give reassurance and information, Encourage appropriate professional help, Encourage self-help and other support strategies), and applied it to various scenarios. Through role plays, scenarios, and other activities, we learned how to respond to panic attacks, suicidal thoughts or behaviors, nonsuicidal self-injury, acute psychosis, overdose or withdrawal from alcohol or drug use, and reaction to traumatic events.
  • I attended this class on Friday, the 22nd, while the rest of the group attended the following Monday the 25th. For that reason, our experience may have been slightly different as we had different individuals in the training as well as different trainers. Most of my classmates were adults representing school health programs and other support services, with a substantial amount of experience in the mental health field.
  • The training provided us with a Mental Health First Aid manual which we all believe is useful and should be distributed on a larger scale. The manual not only covers material that was covered in class, but goes into further detail as well as covers other topics such as eating disorders, and provides further references.
  • The training was very introductory, and, considering the dynamic of the group, was information most of us already knew. I do not believe this is a bad thing however, as the initiative’s aim is to provide this education to everyone in all professions, and as a result I did learn things I did not learn in the earlier stages of my mental health education. However, the training can be deduced from a duration of 8 hours to a shorter time frame. While the training started strong, interactive, with enthusiastic students, it ended on a weaker note. A few individuals clearly expressed discontent at the length and speed of information being given. As a group, we will discuss this at our next meeting and possibly include our recommendations in our white paper.
  • I am still in touch with my community contact from London, and am waiting on a response for further information on how the National Institute for Health and Care Excellence (NICE) enforces its policies as well as how extensive it is as a system.

Challenges Encountered:

  • Throughout the semester, we have had trouble in getting in touch with our community contacts. However, we have worked around this and accumulated adequate research to address and support our claim.
  • From the training, we were hoping to obtain more information on ThriveNYC from a primary source. However, as the training lasted for 8 hours with only a half hour lunch break, we were unable to formulate questions and get access to this information. I think it’s safe to say by the end of the training, we were all quite exhausted.

Tasks Remaining:

  • As stated earlier, I attended the training on an earlier date, and we have not yet thoroughly discussed our experiences on the class. We will be meeting tomorrow, Friday, the 29th, to discuss this as well as work on our white paper. The structure we have decided on is as follows: 1) a historical overview of mental healthcare in New York City leading up to the present day, the limits of the current healthcare system, related issues of inaccessibility and financial and cultural barriers to treatment, and so on (with statistics and research to supplement our argument); 2) an introduction to ThriveNYC and how it specifically addresses these issues and is a viable plan, albeit one in need of some modifications; 3) a detailed rundown of our suggested policy recommendations related to the legislation, in order and with evidence to back up our claims.

Group’s Process and Dynamics:

  • Our group continues working well together. We communicate constantly through our Facebook Messenger group, and work on our documents via Google Docs. We continue to suggest ideas contributing to our white paper based on new research, community knowledge, and experiences. The division of labor is both clear and fair. We hope to get a large portion of the white paper completed tomorrow and complete the rest over Google Docs throughout the weekend.

 

The Power of Community

Uncategorized

“So that breakthrough…that we thought was gonna happen in ’88 or ’89 if we just worked fast enough..it did happen. But not until ’96 and so..a lot of people died. Maybe if Reagan had started putting money into AIDs a little earlier they wouldn’t all be dead.” -Mark Harrington.

How to Survive a Plague brilliantly captures the fight between the ACT UP community and government authorities. Using more than 700 hours of footage from ACT UP demonstrations, meetings, conferences, as well as news conference and interviews, this documentary presents a more honest history of the AIDS crisis than the one presented to us throughout our education. While I learned a lot about this ongoing struggle, it was not surprising to see the clashes between the people and the authorities. In the past, we’ve read about the building New York City as well as current efforts of rezoning; in each we see the exclusion of and a failure of outreach by the government to the communities directly impacted. Similarly, this film showed ACT UP demonstrating against secret meetings by the N.I.H. as well as the lack of the voice of the AIDS community in deciding drug regulations; “Dr. Anthony Fauci is deciding the research priorities for the National Institute of Allergy and Infectious Diseases. We’re down here ’cause we think we should be deciding the research priorities, because these are the people who know what’s going on ’cause they’re dealing with it every day” (~50 minutes into the film).

If any cause wants to fight for its rights, I would recommend they watch this documentary. ACT UP’s success was phenomenal and well-deserved. There are two main reasons ACT UP was able to all it did, and I believe this is something any cause should take note of. First is their determination and motivation, even in the face of hopelessness. Many believed they would die before a cure was found, but they did not allow that to stop them from fighting. It was clear from the footages of the protests and demonstrations how dedicated these members were in getting what they wanted. Second, and I think this is more important the first, is that they were educated on the issues. Thanks to Iris Long, they educated themselves on system, the research processes, how organizations like the FDA and NIH work, on the various drugs that existed in other countries, etc. They came together and read medical journal articles (science club) and “became scientists to some degree.”  In short, they spoke the language of those in authority. They did not give the authorities any opportunity to corner them into a wall. With all this information, they were able to create “A National Aids Treatment Research Agenda” for the government to adopt. This really shows how powerful knowledge is. Unfortunately, with the advancement of social media outlets, individuals often time take stances without doing any form of research and end up doing more harm than good. (Not saying there aren’t individuals who educate themselves, but you get my point)

Discussion question: How can causes today use ACT UP’s effort as a model to structure their fight?

Slums– by whose standards?

The Roots of Community Planning

“As tenants and small business owners invest their time and money into gradually upgrading their neighborhoods, real estate investors become attracted to these areas anxious to capitalize on the improvements.”

Gentrification. We’ve seen it unfold throughout various parts of the city, quickly creeping to the other parts. This chapter documents the fight of those inhabitants that were dislocated due to “redevelopment”, those who began to declare “we won’t move”; if only it were that simple.

Throughout the chapter, Angotti (directly and indirectly) states that if you weren’t white or with a position of power (which were usually elite urban reform activists), you were bound to be dislocated. On page 89 he brings up the “professional planner’s bias”. For urban renewal, city planners were to define the community a “slums” or “blighted areas”. Yet these terms were subjective to the city planners who were usually middle-class whites. They weren’t a part of the community, and projected their “racial fears and class anxieties” in their decisions.

Another interesting point to note is that if you were part of the working-class, being white gave you a upper hand. This isn’t so much of a surprise as this advantage still applies today, but the interesting point is that we haven’t progressed away from these race and class divisions in the past 50 years. In 1961, Jane Jacobs published her book The Death and Life of Great American cities. While her work was definitely significant, the main reason her community was able to stop the urban renewal process was because the majority of the neighborhood was white. Meanwhile, communities more vulnerable were not heard.

These two points highlight the other side of the urban renewal process; who is the city really trying to benefit with these plans? Do the inhabitants of communities undergoing this process today play a role in the decision making, or are powerful elitists still projecting their racial fears and class anxieties? I think we know which side the answer is leaning towards.