Looking Beyond a Single Person: Community Psychology and Mental Health

Consider a child at a local elementary school that seems to have some depression and is very quiet. She does not have much to say about her family, and won’t have any friends over to her house. She seems bright, but her homework is frequently incomplete or undone. The teacher may recognize that there is an issue and refer the child to the school counselor. The counselor teaches the child some coping skills, and calls the parents in for a meeting. He cannot understand why the parents will not attend despite multiple messages that he has left. Looking beyond the individual, we come to find out that the family is homeless, and concerned that the school will find out that they do not have an address in the district. The child is concerned that her peers will make fun of her for not having a home.

Looking beyond the individual as well as focusing on prevention are two key elements of community psychology practice. I learned about these ideas with the following analogy: A lot of people are in a river, drowning.

Other people are trying to pull them out of the water, using a lot of time and energy – and still missing some. Then someone realizes that you could go upstream a little ways, and stop people from ever jumping into the water. It takes less time and energy, and the people don’t have to get wet! This paradigm pushes community psychology practitioners to think about preventing a variety of distressing situations, and how to work with an entire community rather than a particular individual struggling in the water.

So how does community psychology practice address this homeless child’s needs? There are a variety of interventions that aim both to prevent mental illness as well as to help to improve the situation of those with mental illness in their lives beyond services (many of which can be found at http://ctb.ku.edu/en/default.aspx). For example, by working with children who are homeless on a Photovoice project (giving children cameras and lessons on how to take pictures to document their experiences, think “Born into Brothels”), colleagues of mine gave these children an opportunity to have a voice that is not typically heard. This project also helped them interact with positive role models and peers who were also homeless.

Beyond the individual, interpersonal, and organizational levels, these photographs served the entire community by bringing awareness to the fact that there are many children who do not have a stable place to live. This better understanding of the issues of homelessness– particularly the personal experiences of children – helps community members to be less likely to have stigmatizing views of homelessness and even support homelessness initiatives put forth by local government.

So community psychology, a field at the juncture of psychology, social work, and public health (among others) challenges us all to promote mental health for everyone. Learn more about community psychology at http://www.scra27.org/.

----
Post by Rachel Smolowitz
Psychology Intern
Community Psychiatry
University of Maryland-Baltimore

On Entering an Unfamiliar Community

I spend one morning per week at a homeless kitchen in Tacoma. The kitchen has been feeding around 400 people per day until recently, when state budget limitations began to reduce the amount of assistance to persons not eligible for Medicaid and SSI. The numbers are accelerating now.

I have been active there for seven years. I do several things there. I circulate among the guests wearing a name tag that also says I am a psychologist. I speak with whoever wants to talk with me. Some do; many do not, and I don’t intrude. I am available to conduct psychological evaluations that guests want to help determine their eligibility for state financial assistance, and ultimately for SSI. I am available for street-level brief counseling. When needed, I help serve food, mop up liquids on the floor, and offer advice/consultation/referral suggestions to guests who have questions. I offer advocacy assistance, and occasionally I walk with guests who want to go there to the local community mental health center two blocks down the hill from Hospitality Kitchen. I provide support to kitchen staff and participate in some staff meetings.

All of that sounds pretty mundane as I re-read the above. However, if has given me entry into the community of the homeless and credibility with its citizens. I have been there so long they know they can count on me when they want something I can help with. Also, I know I can count on them. Acceptance, mutual respect, and trust are valuable gifts!

So what have I learned? It takes time to get known and trusted. Patience and persistence are virtues when entering an unfamiliar community while hoping to be of service. It is important to learn what is wanted rather than to assume I already know. It is important to speak plainly rather than in professional language. It helps to ask guests to teach me about their community and/or their individual circumstances. It helps to respond with visible action when guests need something, even if the action is an honest statement that I cannot or (sometimes) will not help. It helps to say “Keep me posted” when guests will need time to take actions in their own behalf, and to offer further assistance when needed and I can help. It is important to remain involved if I want to be an effective part of the actions to improve things, rather than just an observer or evaluator of interventions.

My experience at Hospitality Kitchen also has been valuable to me as a member of the City of Tacoma Human Services Commission. That commission advises City Council on policy questions and also screens applications for city funding grants by nonprofit human services organizations. I can participate not only as a community psychologist, but also as a person who continues to accumulate “street experience” and can help to improve outcomes purchased with city grant funds.

-----
Post by Al Ratcliffe, Ph.D.
Tacoma, Washington

Community Psychology and Health: Battling the Global AIDS Epidemic

On the heels of an exciting announcement of a breakthrough in the battle against AIDS, it’s important to consider the social and community-level influences that will be at play once the controlled conditions of scientific trials have faded away. AIDS is a community-level phenomenon. Though it is individuals who pass HIV to their partners, the degree to which any person’s behavior puts them at risk for contracting HIV is in part attributable to the amount of virus in all HIV-positive people in a community, or “community viral load” . Community and cultural influences play a large part in whether practices will be adopted, so it is significant that this breakthrough was found in a multi-nation study in natural settings. However, what this study did not take account is what may be the biggest barrier to global benefit from this breakthrough: economic inequality.



Since highly active antiretroviral therapies (HAART) became available for the treatment of HIV/AIDS, mortality rates from this disease have decreased dramatically. However, these benefits have not been distributed evenly. For instance, in Hawai‘i where I live, diagnoses of AIDS have been decreasing over the last decade, and AIDS-related deaths decreased sharply in 1996 and the years immediately following it, coinciding with the widespread use of HAART. However, the decreases in AIDS-related mortality have not affected all groups similarly. Prior to 1996, the proportion of deaths due to AIDS for different groups were similar to the proportion of people living with AIDS. After 1996 this changed, with Caucasians comprising a relatively smaller proportion, and Native Hawaiians and Pacific Islanders comprising a much larger proportion of those dying of AIDS in the 5 years after the introduction of HAART compared with both their previous mortality rates and the proportion of those living with AIDS. This may be due to a number of factors, but economic disparities surely play a role, as the treatments for HIV/AIDS can be extremely expensive.

Across the globe, there has been debate about whether and to what extent countries and organizations should provide funds for HIV/AIDS treatment. Some of the debate is in regard to whether prevention or treatment should be prioritized. Fortunately, this breakthrough diminishes this dilemma, as it involves using “treatment as prevention.” Those same antiretrovirals that help treat those with the disease decrease the viral load and make it less likely that a person infected with HIV will pass on the virus. This has long been suspected, but this trial is the first large-scale study to truly investigate whether the timing of antiretroviral treatment affects transmission. HIV-positive persons with HIV-negative partners were assigned to either begin receiving antiretroviral treatment right away or to wait until their disease had progressed further. Those who began taking antiretroviral drugs right away were 96.3% less likely to pass it on to their partner. In addition to reducing transmission, early retroviral therapy improved outcomes for the HIV positive partner. As scientific advances transform the AIDS epidemic, issues of social justice increasingly come to the forefront, as treatment continues to be more available to the economically advantaged. As community psychologists, we can work to ensure that these issues are discussed, and to remind people that decreasing community viral load means decreasing risk for all people.

------
Post By
Gina Cardazone, University of Hawai`i, Mānoa

PBS-TV Premieres “Freedom Riders” Doc Film, May 16

If you doubt that large social change can be effected by individuals taking small steps, treat yourself to a look back exactly 50 years ago to the U.S. Civil Rights movement.

The 1961 Freedom Rides mostly took place in May and early June of 1961, starting with the CORE Freedom Ride. More than 400 Americans risked their lives to challenge segregated travel facilities in the Deep South, crossing state lines (thus involving Federal jurisdiction) in interstate buses. They were there to test Jim Crow laws and do nothing less than to move America. The riders were met by savage mob beatings, unprotected by local law enforcement, and most were imprisoned in brutal conditions. The key players included not only veteran members of the civil rights establishment but also students, with now Congressman John Lewis (D-Georgia) notable among them.

A superb documentary film (“Freedom Riders") will premiere May 16 on PBS-TV, part of the American Experience series. A 2-hour long film by filmmaker Stanley Nelson, it is based on Raymond Arsenault’s 2006 book, Freedom Riders, 1961 and the Struggle for Racial Justice. It mixes archival footage with interviews with participants and observers. I saw the film a year ago at Silverdocs Film Festival of the American Film Institute, near Washington, DC, when the executive producer and several of the original Freedom Riders, seated in the audience, spoke at length. The audience was enthralled by this edge of your seat film experience.) I commend it highly to all who talk about, study and/or practice social change, including community psychologists. (Our heroic conception of Martin Luther King, Jr. will be challenged by this film.)

To further commemorate the 50th anniversary of the breathtaking courage of these early civil rights heroes, PBS has set up a terrific website that includes film clips, histories of that era, a space for sharing stories among Freedom Riders, a teacher’s guide, an interactive map of the various rides, biographies of some of the key participants and a timeline of events.

The website also includes comments from the public, including recollections from participants in the events and their families or friends.

Also a related traveling exhibit is visiting 20 US cities in 2011.

Between now and late November, 2011, the exhibit will visit West Palm Beach, FL; Austin, TX; Raleigh, NC; Salt Lake City, UT; Lawrence, KS; San Francisco, CA; Tempe, AZ; Birmingham, AL; Seattle, WA; Detroit, MI; and Denver, CO.

Meanwhile, you can access several clips from the film, online. For example, “The Student Leader” is a 4-minute clip featuring a true American heroine, Diane Nash. (Have you heard of her?)

“Diane Nash, a young Chicago native, was attending Fisk University in Nashville, TN, when she was introduced to nonviolent direct action. She quickly became an influential student activist through her leadership of sit-ins in Nashville, her participation in the Freedom Rides, and her role in founding the Student Nonviolent Coordinating Committee (SNCC) and the Selma Campaign.”

Diane, although a significant figure in the Civil Rights Movement, is only infrequently mentioned in the media, as compared to her male counterparts. She lives in Chicago and lectures on social change.



Most exciting, as an accompaniment to the TV airing, a group of 40 select college students is currently retracing the route of the 1961 buses, May 6-17, 2011. The ride began in Washington, DC and will end in Jackson, Mississippi. You can follow the journey, day by day; read the biographies of each of the participating students; learn about the many speakers who will meet the students; and interact with them online.

To learn more about that critical period of American history, a much larger event occurred in 1964, when over 1,000 college students joined with many thousands of local African Americans in Freedom Summer (otherwise known as the Mississippi Summer Project). This journey into the Deep South was intended to register African American adults to vote and teach the children. That was the summer when James Chaney, Andrew Goodman and Mickey Schwerner were killed. (“Mississippi Burning” was a wildly inaccurate Hollywood film, loosely based on this episode.) An excellent book with a good bibliography, Freedom Summer: The Savage Season that made Mississippi Burn and Made America a Democracy, by Bruce Watson, is reviewed here.

Community psychology trivia: Andrew Goodman’s mother, Carolyn Goodman, was (until her death in 2007 at the age of 91) a Fellow of SCRA.  (Read more about Andrew and Carolyn Goodman here).  A psychologist, she was a lifetime civic activist around racial justice, and other progressive, issues.

------
Post by:
Gloria Levin
Freedom Summer participant

Community Practitioner Spotlight: Eric P. Green

Name: Eric P. Green, Ph.D.
Titles: Research Associate and Adjunct Assistant Professor
Employers: The Population Council and New York University
Affiliations: Innovations for Poverty Action, Research Network
Website: www.ericpgreen.com

Promoting Global Health through Practice, Research and Technology

Dr. Eric P Green is a community psychology practitioner whose work is positively impacting the lives of people across the world. His training in community psychology has played a vital role in his current work. His work is illustrative of community action guided by community psychology principles, including the respect for human diversity, social justice, and individual and community wellness.

As an Associate in the Population Council’s Poverty, Gender and Youth Program, Dr. Green is leading a project called Demographic Data for Development. His work involves data sharing and use in three African countries. He and his colleagues are collaborating with in-country partners to help journalists to access and use data in their reporting on health and developmental issues. For example, this project focused on policymakers and their reports of the current data being used and the data they want but do not receive to develop and improve certain policies.

The Population Council is an international, nonprofit, nongovernment organization that aims to improve the well-being and the reproductive health of people around the world. The Council also seeks to help achieve “a humane, equitable and sustainable balance between people and resources.”  In addressing their mission, the Population Council conducts research on HIV/AIDS, reproductive health, and poverty, gender and youth to improve policies, programs and products in over forty countries.

Dr. Green is also an Adjunct Assistant Professor of Global Public Health in the Public Health Master’s Program at New York University. He teaches students about the use of technology in computers and communication in global health, and the perspectives and policy challenges that influence action in global public health.

The nature of Dr. Green’s work at the Population Council requires a number of skills in research, communication, technology, critical thinking and so on. For Dr. Green, graduate training has played a vital role in his current work. He earned his Master’s of Arts in International Studies and his Doctorate in Clinical-Community Psychology from the University of South Carolina.

 

According to Dr. Green, the Clinical-Community Psychology program was a great fit for him. He gained a solid foundation in prevention, program evaluation and developed skills using GIS – a tool he continues to use in his job.  He also utilizes mixed-method research strategies and acknowledges the importance of ecologically oriented and culturally-anchored approaches to interventions for communities.  

While in graduate school, Dr. Green worked with a regional food bank through his community practicum. Through this experience he was able to understand how non-profits work and how research and programming coexist. He also spent eight months in northern Uganda conducting fieldwork for his dissertation. These experiences were certainly helpful in preparing him for his current work, which involves collaborating with both regional and international groups. 

The confluence of his training in community psychology, application of innovative technology and commitment to improving global health has helped make a positive impact in communities around the world.

------ 
This profile was written by Kyrah Brown, from Wichita State University.  It is part of a series of community psychology practitioner profiles.  If you have a suggestion for future profiles, please email ComPsychPractice@gmail.com 

Psychology of Climate Change: Place and Community

In Psychology, Sense of Community means the connection an individual feels to their community. When the sense of community is both strong and positive, we can typically expect to see greater wellbeing.

Sense of Place means the connection an individual feels to a place. When sense of place is strong and people have their needs fulfilled in their space, we can typically expect to see greater wellbeing.

Community and place can overlap, but they do not necessarily overlap. For example, I no longer participate with the Middle Tennessee Storytellers Guild (since I live in Hawai`i), but I’ve been in the same online writing group for almost a decade despite multiple moves spanning 6,000 miles. A basketball team may no longer be a basketball team without a court. But a religious congregation who lost their church/temple/mosque could certainly still gather in another location, though they may greatly feel the loss or lack of their space.

For some communities, the connection to place and community are so integrated as to be virtually meaningless (or highly damaged) without each other. People identify themselves according to their place and their community. This is true, for example, with people who have lived their entire lives, or multiple generations, in one location. Spatial home, family home, and community home become interchangeable.

This interconnection is especially true for indigenous people whose cultural values and norms evolved over thousands of years in the same space. Daily activities, worldviews, traditions, stories, and life expectations of the community are defined by their place. In such cases, sense of place and sense of community are not so much interconnected as they are indistinguishable.

Which brings us to climate change.

At the recent climate talks in Cancun, climatologists offered a number of models ranging from best to worst case scenarios for mitigation and adaptation. The coming century may see nearly 200 million people displaced globally as land becomes uninhabitable. Climate change will not impact the world equally. This map from NASA, for example, shows that while the sea level on the coast of the U.S. mainland is dropping slightly, the increased winds are pushing the Pacific Ocean waters southwest, which is causing an extreme rise in sea level for South Pacific islands.

The unfortunate truth of climate change is that those least responsible are first and most affected. Developing nations do not have the money, power, or infrastructure necessary to mitigate or adapt to the rapidly changing climate. In the near future, multiple developing countries are faced with the loss of their countries’ land.  While this raises important legal questions on an international scale (e.g., is a government still a government without its homeland? ), many important psychological questions are also raised regarding community, culture, and place attachment.

For years, the Tuvaluan government has been an active voice in global forums advocating for wealthy industrialized nations to mitigate climate change by reducing consumption, waste, and burning of fossil fuels. In addition, the Tuvaluan government has called for wealthy industrialized nations to aid developing nations to develop the infrastructure necessary to adapt to climate changes. The goal for Tuvalu is to keep their home safe by limiting sea level rise.

My preliminary studies in Tuvalu show that the culture is strengthened by the integration of land and community. Tuvaluans’ identities are heavily reliant on their connection to their home island community. Even after migrating to the capitol atoll of Funafuti for economic or educational opportunities, families continue to identify strongly with their home island, even across generations. People invest a lot of time, energy, and emotional resources into church and community groups that are island-specific. Just as their island is home, so too is their island community home.

The Tuvaluan people are diverse in their opinions about climate change and future responses of the country. Some feel that migration is likely in the coming generations. But not all Tuvaluans would be willing to leave. One woman explained to me that some people do not want to leave because they feel that if they do not have land then they do not have a home. They will be lost. Another woman told me, “I will not go. I was born here and I will die here.”

Tuvaluans who have lived in other countries (e.g., Australia or New Zealand) often struggle with the individualistic culture and community norms. Tuvaluan islands are small and the people live close together in constant interaction. Homes are open and neighbors are close. Families are extended and community connections are strong. Living in foreign places where neighborhoods sprawl over vast areas with clearly delineated private yards and houses, Tuvaluans struggle from that lack of constant community interaction.

This is not to say that Tuvaluans cannot thrive in other places—many have and continue to do so. But Tuvaluans should not be forced into migration. Though many articles speak about migration as an inevitability, this is not so. With concerted and sustained mitigation and adaptation efforts by the United States and other nations with a high carbon footprint, Tuvaluans and others around the world can maintain their homelands.

Understanding the importance of place and community, the question becomes not whether Tuvaluans should be able to keep their home, but what right do we have to destroy it?

------
Post By
Kati Corlew, University of Hawai`i, Mānoa

Community Stories: Trash Tree Triumph

It’s not often that volunteering gets a bad rap. Everyone praises and pushes volunteering - volunteering as a means to assisting your community, volunteering as a tool for learning, volunteering as a way to expose yourself to new experiences and cultures.  Even President Obama is calling on Americans to volunteer in order to help our country out of the current recession.

But what happens when volunteering just isn’t enough? Imagine that you’ve volunteered, volunteered and volunteered for “Cause X” (insert a cause close to your heart here). And after all the time you put in, you don’t see any progress. Where do you go? What are your next steps? Are you likely to volunteer again? Many individuals arrive at this critical intersection, one in which I think we often lose people to discouragement or boredom. This situation also represents an opportunity, a place where volunteering can develop into advocacy.  Here's one of my personal favorite examples of the volunteering to advocacy transformation.

A year ago, I had the privilege to work with members of the newly formed Youth Council in a small town in the Republic of Moldova. The youth members of the council are the first Moldovan generation to grow up under a democratic government.  To many Moldovans, the term “volunteer” still means something to the effect of “forced work one under the Soviet System.”

Location of the Republic of Moldova 

The Youth Council, run entirely by its members, has two goals: to better their community and to show the adults that they too can make a difference. The group started out with small projects, activities that could be done in a day with tangible results (very much in line with the Small Wins Theory). Their first project was cleaning the local park. And did they ever clean it. That first day they spent over six hours in the park picking up trash. It was a good day, and for many, marked their first involvement in a volunteer project. Over the next few days they showed off their handiwork in the park (a popular meeting place for members of the town, also the site of the local “piata” or market).

This pride was short lived, as less than a week later, the park could be described as “dirty.” So again, the youth decided to meet and clean the park. Their second effort took less time, but they also had less enthusiasm for doing a job they had already done. Another week goes by, and predictably, the same thing. Again the youth clean it. (It’s gotten to the point where people in the town have actually commented that they think the youth are being paid to clean the park).

Eventually the proposal to “clean the park” was met with strong resistance within the Youth Council. “Why clean it, when it’s just going to get dirty again?!” Giving up on it was discussed, as were other options, which got to the root of why people were littering in the park in the first place (laziness, lack of trash cans, lack of knowledge of the effects of pollution, thinking “it’s just one piece”). Installing trash cans was a possible solution, however, the youth didn’t have access to funding.

The conversation moved towards how we could get people to stop littering. As we know, changing behaviors involves changing attitudes, and advocacy is one tool that can be used to influence others’ attitudes.

Advocacy was a new idea to the youth council members. I presented what I knew about it - getting people’s attention, raising awareness, and lobbying for change. To them, at first, the idea sounded similar to “do nothing” especially because there weren’t guaranteed concrete results. They struggled with whether the activity would be worth their time, how they would gage success, and the reaction of the population (they wanted to err on the side of not upsetting others).

The group came up with a creative, idea - very specific to the beliefs and values of their community.  The next Saturday we gathered and cleaned the park, one last time. Instead of throwing out the trash, we stored it. In the morning, the youth tied strings to each piece of trash - from candy wrappers to empty beer bottle, and moved the trash into the center of town. They then tied the trash to the branches of a tree - it looked as if the tree was “growing” trash. Underneath they wrote in Romanian, “What you put in the ground, that, is what will grow.” This message was highly appropriate for the agriculture-reliant population.

    

     

They then stepped back to observe people’s reactions to the tree (Sunday is market day, so the tree got a lot of traffic). Many simply walked by the tree, confused. Others yelled at the youth for putting the garbage where it shouldn’t be. Many more stopped to talk. “What are you doing?” “Where’d you get this trash?” “Is it Christmas?” “Do you really think this is true?” “Who are you?” etc.

It was a great chance for them to talk about the Youth Council and their ideas for putting trash cans in the park. People were amazed at the amount of trash that accumulated over such a small time. The “buzz” generated by the “strange tree” the youth made lasted a few weeks.

At the time they weren’t able to capitalize on the buzz and secure funding from the local public authorities for trash services in the park. But the activity did get them recognized, gave them credibility in the town, and generated excitement about the environment. As a council, they started to attend the meetings of the local government. The next time they cleaned the park, others joined in. They kept this up for six months until something was done. Currently, there are eight trash cans through the half mile park at the center of town, and according to the youth, they don’t have to clean it more than once a year. A success in their eyes!

-----
Post by Sharon Hakim, Wichita State University

The group described in this piece was the "Counsilul Local al Tinerilor in Singerei"

This blog entry was part of an upcoming “Community Stories” series. 
Do you have a story from your own community work that you would like to share on our blog? ... a teachable moment? ... lessons learned? ... insights into a community? ... funny incidents? ... collaborations or achievements you are proud of? 


Please share your stories with us - and with the larger community. 
Email communitypsychpractice@gmail.com.