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.

Dear Future of Mental Health Group,

Please review the following sources and take them into account as you work on your white papers!

1. Readings and Mini-lit Review on Neighborhoods and Mental Health (ESPECIALLY)
2. Evans, G. W. (2003). The built environment and mental health. Journal of Urban Health, 80(4), 536-555.
3. O’Campo, P., Salmon, C., & Burke, J. (2009). Neighbourhoods and mental well-being: what are the pathways?. Health & Place, 15(1), 56-68.
4. Sampson, R. 2003. “The Neighborhood Context of Well-Being.” Perspectives in Biology and Medicine 46 (3): S53–64.
5. Schaefer-McDaniel, N.J. 2009. “Neighbourhood Stressors, Perceived Neighbourhood Quality, and Child Mental Health in New York City.” Health & Place 15: 148–55.
6. Readings and Mini-lit Review on Health and Social Media.
7. Entries from the Encyclopedia of Critical Psychology on Pathologization andCircuits of Dispossession and Privilege.
8. Chirlane McCray and the Limits of First-Ladyship
9. Let’s Change the Conversation Around Mental Health (Feb. 17, 2016)
10. The League of Awkward Unicorns: A podcast that mixes mental health with laughter.
    • Episode 1: You know what your problem is?
11. Meditation vs. Medication: A comic essay on facing depression
12. A low-tech pop-ed video about anxiety
13. NEW YORKERS ON THEIR OWN HEALTH, MENTAL HEALTH & BAD HABITS
14. For Police, a Playbook for conflicts involving mental illness (April 25, 2016)

Key Project Activities:
Progress Made:
Community Contacts – Following up on Alexander’s project update from last week, we had Sam interviewing Dr. Mike Lamb, Libby meeting with Aashna, and Alex reaching out to Robert Melara.
Sam’s interview with Dr. Lamb went well, but not much information was provided as he wasn’t too informed about Thrive NYC. Although Dr. Lamb wasn’t too promising as a community contact, Libby’s meeting with Aashna was helpful. Aashna provided a huge list of clinics and community organizations for us. Along with that, she also gave her thoughts about Thrive NYC and expanded about her own project, Gleam. With the information provided by Aashna, we then decided to look into digital therapy. As for reaching out to Dr. Melara, there hasn’t been much of a response from him. The same can be said for Dr. Fietzer (clinician at Mount Sinai Hospital that Alex reached out to before).

White Paper – We started brainstorming for ideas on how condense our topic and see what exactly about Thrive NYC we should focus on. After bouncing ideas back and forth on Monday (4/11) we decided that we can assess how effective Thrive NYC is, compare it to established mental health programs, and then we can suggest what improvements Thrive NYC can make. On Wednesday (4/13), when it came time to structure the white paper, such as making a claim and supporting it, we were back to square one. We didn’t really have a solid claim because a simple assessment of a program holds no grounds in an argument. By the end of the day we decided that our argument could be “Thrive NYC is a promising program, but there are short falls as compared to other initiatives. Certain improvements can be made by _____.” This claim is structured so that we keep the same approach about Thrive NYC, but it also takes an argumentative stance. As for the blank provided, we are still researching and waiting on community contacts before we fill the blank in.

Research – In regards to research, we have looked into NICE and digital therapy. NICE is the National Institute for Health and Care for the UK and can be utilized as an established program that we can compare Thrive NYC to. Digital therapy was looked into as it can be an option on how to improve Thrive NYC.

What we plan to do:       
Community Contacts / Research – For the week (or weeks) to come, we await responses from our current contacts such as Dr. Melara and Dr. Fietzer. Along with that, we plan on reaching out to more people too. Kashaf has her friend who sought counseling. We plan on contacting her and asking on the availability of care, how has counseling helped, and if she has any thoughts on Thrive NYC. Sam also received a response from NAMI (National Alliance on Mental Illness) and will either speak to or email with them with our questions (refer to Alex’s post. Activities in Progress). As a group we also have signed up for Adult Mental Health First Aid training on Monday, April 25^th. This event is sponsored by the Department of Health and Mental Hygiene. This eight hour course will allow us to see and experience what organizations such as the DOHMH is doing for mental health. This course will allow us to extend our reach with contacts as we can go and speak with the instructors or organizers.

White Paper – Our claim and any support to our claim is still not yet solidified. We are waiting on the input from community contacts before setting it in stone. In the meantime, we will do what we can and create a general outline for our claim and its arguments. We also plan on compiling the necessary history that is relevant to our claim. Note that we may have to tweak parts or chunks of our white paper based off the responses that we acquire from our community contacts.

Challenges Encountered:
Community Contacts – As stated earlier in “Progress Made,” getting responses from contacts such as Dr. Melara and Dr. Fietzer poses a challenge. Nevertheless, we do have resources (such as NAMI, the Adult Mental Health First Aid training, Aashana) to utilize as community contacts. We will continue to branch out to other groups from the list that Aashana provided while hoping to hear from Dr. Melara and Dr. Fietzer.

White Paper / Research – Before our group decided on our current claim for our white paper, we were brainstorming on what other approaches we could take on Thrive NYC. One of the suggestions was “We should invest more into Thrive NYC because ____.” This raised questions on the budget of Thrive NYC, like where is the money coming from and how is it being distributed. After doing a quick search online and a skim of the white paper for Thrive NYC, we realized that there is no definite answer to how money is being distributed. This fact practically nullified any claim our group could make whenever financials are involved. In the end, we decided that our current claim was the better way to go.

Tasks Remaining:
Now that we have a general claim. Our remaining tasks can be summarized as:
Compile research that relates to our claim –> Solidify our claim –> Create general outline of white paper –> Write the white paper
Of course, reaching out to more community contacts and getting responses from our current community contacts is also on our agenda.

Group Dynamics:
All in all our group is working well together. We have met up to brainstorm ideas about which direction this project to go. Any updates from our community contacts, questions, and concerns are all thrown into the group chat on Facebook. As for any documents, such as the white paper, we have started it in Google Docs where all the members can freely edit and view the documents. As for the distribution of labor, everyone has and will continue to do their part.

Summarizing:
We have gotten responses from previous contacts, but our project seems to still be lacking a strong community contact. Despite that fact, we have done the necessary research to keep the project moving. Since we have established our claim for our white paper, we can now move onto looking for research, reasons, and evidence to support it. From there we can start compiling and writing our white paper.

Key project activities: Our group has still been in the phase of contacting potential community members for more information about their impressions of Thrive NYC. So far, all of our community contacts have been unavailable to speak with us. Since dropping contact with our initial community representatives (Families Together, Fountain House, Urban Justice Center’s Mental Health Project), we’ve attempted to reach out to Dr. Alexander William Fietzer, a clinician at Mount Sinai Hospital and a professor at Hunter College. As of today, we still haven’t heard back from him. We’ve contacted the counseling center at CCNY asking for a comment about Thrive NYC and requesting a meeting to become our community contact. Unfortunately, they admitted that they had never heard of Thrive NYC and declined to be our community contact. Kashaf’s community contact was also unaware of Thrive NYC and declined to be our contact. Because so many of our potential contacts have no strong opinions about Thrive NYC, we have met to discuss changing our tactic. Without clinicians’ input regarding the current government initiative to address mental health issues, it’s impossible to speak to the criticisms professionals have for Thrive NYC or even the awareness of noticeable changes in treatment adherence, accessibility, pathways to care, etc. We have agreed to incorporate more of a focus on the lack of advertisement and press coverage surrounding Thrive NYC into our project. In regards to our particular interests in mental healthcare, our focus has remained the same: we are still interested in comprehensive care and access to mental health services. However, we want to incorporate a discussion of how government programs attempt to transform the mental health system in New York.  In regards to our research, we’ve met to develop a comprehensive timeline of mental health initiatives in the United States, dating back to the early 19th century. We’ve found gaps in mental healthcare innovation and policy which we might incorporate into our white paper and use to illustrate the trajectory in mental health services.

Activities in progress: Instead of asking potential contacts to guide us as we continue our research, we have proposed interviewing clinicians at the Mount Sinai outpatient clinic where I work and using their input to inform our development of the white paper our final popular education product. On Thursday, April 7^th, Sam is interviewing Dr. Mike Lamb, the director of the Macaulay Wellness Program, an honors college-specific initiative designed to support Macaulay students through “direct, professional mental health counseling, services, and guidance”. In such a small community, the effects of the Macaulay Wellness Program could be very positive, but the funding could also be used ineffectively. Regardless, it could represent a role model in accessible mental healthcare, which could in turn influence our popular education product. In addition to meeting with Dr. Lamb, we’ve discussed interviewing contacts within the CCNY community. Libby will be meeting with Aashna, a contact from the Gleam project, which aims to increase accessibility to mental health services for people of low socioeconomic status. Finally, I will be reaching out to Dr. Robert Melara, the chair of the psychology department at CCNY, for a brief interview about Thrive NYC and how (or if) government initiatives inform treatment. In preparation for potential contacts, our group has met to develop pertinent questions that would help us interview community contacts and guide research in the right direction, such as:

• What resources do you offer to people with social, behavioral, and emotional challenges?
• What mental illnesses do you typically treat? Are there any good examples of such cases?
• What community-based practices are you aware of (e.g., other organizations that provide mental health services, government policies, and initiatives)?
• Do you feel that clients are getting the services and resources they need to overcome their mental health challenges? What additional services would they benefit from?
• What are your opinions about government programs like Thrive NYC and Parachute NYC? Do you think their aims are achievable, adequate, or likely to be effective?
• Are the clients you work with aware of or benefiting from these programs?
• What are these programs lacking in how they serve people with mental health challenges?
• What kinds of barriers do patients usually encounter in receiving treatment?

Challenges: We have come to the conclusion that being a community contact for the purposes of this class is a significant undertaking and requires a time commitment on behalf of our potential contacts, many of whom are clinicians or specialists in their field. The lack of contact with representatives from our organizations is understandable; mental health professions are prohibitively time-consuming, and (we hope that) our potential contacts go above and beyond to make treatment accessible for their clients. With little other to work with than a timeline of mental health and the Thrive NYC white paper, securing a contact is our main priority at the present time.

Team dynamics: Our group has met on several occasions to clarify any uncertain objectives, deliver report-backs about community contacts (or lack thereof), and discuss alternative methods of informing research. There is a clear and consistent breakdown of work and, for the most part, we are accommodating with each other’s busy schedules and willing to make up for any missed work. Each team member contributes what they are realistically capable of undertaking and is eager to contribute any experiential knowledge or prior community contacts. In order to document our discussions and ensure that there is no miscommunication, many of the important points are written in Google Docs accessible to all team members, and coordination is conducted through Facebook Messenger. These tactics have been relatively efficient in setting up meetings and assigning tasks.

Bottom line: Without a community contact, we’ve done a significant amount of research on our own. We’re quite frustrated with the lack of press coverage on Thrive NYC and we’d like to investigate why such a groundbreaking and significant initiative has almost zero visibility among mental health professionals. We’d like to incorporate that into the development of our popular education product and use Thrive NYC as an example of poor advertising.