A Community Effort
These days, the field is struggling mightily. At most agencies, "quality management" has mushroomed from a line on a job description to multiple-employee departments, and time for supervision and clinical learning continues to shrink. Nonetheless, the community mental health field refuses to be stomped or stereotyped into obsolescence. The City of Philadelphia, for example, has recently committed itself to a transformational mental health initiative based on the values of the recovery movement, which places consumers at the center of their own care, rather than making passive recipients of treatment.
Under the umbrella of this initiative, and with the additional support of the city's Department of Human Services, I'm working on a substance-abuse treatment project with three African American women who are graduates of residential treatment and aftercare. I'm training these women to conduct qualitative research on effective treatment for women and children by interviewing other women recovering from drug addiction, analyzing the findings, and presenting them to the leadership of the city's Child Welfare and Behavioral Health systems. Originally, I included these women because I thought the research process would be more effective if interviewees could identify with their interviewers. But these women, two of whom haven't yet finished high school, have performed beyond my expectations.
Jamila, who has seven children, is highly organized and breathtakingly intuitive, often completing my thoughts (accurately) as I begin to share them. Cynthia has taken on the responsibility of explaining the project to interviewees and has changed our format to make it more inclusive. Dawn has now gotten herself a job in the field, largely because she's been such an effective advocate for her own child. She brings a sense of professionalism and an incisive, questioning attitude to everything we do.
It's deeply satisfying to watch these women gain expertise and seize new opportunities. Somehow it seems to be the core of community mental health: this process of opening doors for people in the neighborhoods, sharing tools and skills, and allowing the lines to blur between professionals and "ordinary" people who turn out, quite often, to be extraordinary. I listen as Jamila, Cynthia, and Dawn learn to talk as researchers, publicly sharing their impressions of what other women have told them. I watch them present their findings, locally and at a conference in San Francisco; two of them had never flown before. I pay attention as they report on important discoveries they've made about effective treatment entry points for women, about the nature of relationships between recovering female addicts and staff, and about the social factors that help women stay clean and sober. My hope is that I'm passing on to Jamila, Cynthia, and Dawn a bit of the legacy of the CMH movement, especially the importance of staying curious and daring to not-know.