After a successful first year, the Brooklyn-based Arthur Ashe Institute for Urban Health is looking to broaden the impact of its mental health support program for children and youth in New York City communities of color.
Beyond the Stigma: A Collective Conversation on Youth Mental Health and Wellness — developed with funding and technical assistance from UNICEF USA and launched at the height of the COVID-19 pandemic, in response to increasingly worrisome effects on youth — exceeded initial targets. During its first year, the program directly reached 697 people with training in mental health awareness, coping and support strategies. Indirectly, it is estimated to have reached over 2,700 more, as trained peer leaders shared their new knowledge and skills.
About half of those who participated in the program workshops and related activities were high-school students, including 21 individuals who trained to be peer mentors. Hundreds of adult community members — parents, educators, faith-based leaders, community-based organization staff, barbers and hair stylists — also participated in training and discussions.
Having received an overwhelmingly positive response from participants, AAIUH is now preparing for Phase 2.
When struggling with mental health and other issues, youth tend to turn to other youth
While conducting its initial community needs assessment, the team learned that youth in the diverse urban communities the Institute serves primarily turn to other youth — friends, peers — when they are struggling with mental health issues. Faven Araya, AAIUH Community Engagement & Relations Manager, says this is why the team focused on building the capacity of youth — not only to better navigate their own struggles with mental health and take advantage of local resources and support services, but to help others do so as well.
Quanasia, 17, is a junior at Cobble Hill High School in Brooklyn and trained to be a peer leader in the summer of 2021. "Being in a strict household, I had a lot of anger," Quanasia says. "It was great to be able to share personal things that were happening to me. I feel like if I can speak to someone my own age, they will understand."
Introducing the P.A.U.S.E. framework for mental health support
Like many other young participants, Quanasia says she had never discussed mental health with anyone before joining her first session, a small peer-to-peer group discussion arranged by AAIUH and community partners. During subsequent sessions, she was introduced to the program curriculum, including a P.A.U.S.E. framework for taking action — Practice active listening without judgment; Assess for distress and harm; Understand and acknowledge the experiences/affirm their feelings are valid; Seek productive support; Encourage self-help and other supportive strategies — and then helped lead a workshop for a larger group.
Just having the conversation was a breakthrough for others as well. "To be very honest, it was my first time talking about mental health issues, so I found everything useful, and I learned a lot of stuff," one young workshop participant commented on a post-session survey.
In fact, the vast majority of youth participants surveyed reported satisfaction with the course; improved awareness and knowledge of mental health and psychosocial support techniques, including self-care, active listening, positive coping and support skills; and greater familiarity with available local resources after completing the program.
"I handle my mental health differently and learn to make more time for myself," one participant shared. “I am able to control my emotions better,” noted another.
Reviews from adults have been similarly positive. One of the CBO partners, an individual who is in direct daily contact with at-risk young people, shared several anecdotes as evidence of impact: a young man who had always been shy, who, after attending an AAIUH session, started coming to community events and asking, 'What can I do to help?'; a young woman with a difficult home life and a history of running away, who, after training to be a peer leader, expressed a newfound understanding of what to do if she's ever feeling 'not ok', "instead of turning to her normal vices."
A young woman with a difficult home life and a history of running away ... after training to be a peer leader, expressed a newfound understanding of what to do if she's ever feeling 'not ok.'
In a report, Josh Chaffin, an independent consultant hired by UNICEF to evaluate the program's results and impact, writes that Beyond the Stigma's principal achievement is delivering a tailored mental health intervention in communities where there is considerable stigma associated with mental health services —and where most people have had little or no prior access to them. According to another community partner, whom Chaffin quotes in his report, AAIUH "gave young people information and tools that the schools do not provide, that their parents do not provide."
Phase 2 will go beyond destigmatizing the topic of mental health to dig deeper into 'people's realities'
AAIUH's next series of workshops will go deeper into some topics and introduce some new ones, building on the youth-based support approach, Araya says.
"We used the initial curriculum to introduce mental health, to begin by normalizing and destigmatizing the topic, and now we want to connect to where people are at. If students are dealing with challenging family dynamics and want to work on fostering better relationships, then we want to equip them with the skills they need to do that in a healthy way. If they are experiencing higher levels of stress and don't know how to cope, then we want to have conversations about that. We just want to speak to people’s realities."
Meeting youth where they are at has been a key focus since the start, says Kenya Kirkman, AAIUH Senior Program Coordinator. "For this next phase, as we look to unpack some of the community norms that many of the youth are dealing with, we will also be teaching them how to use P.A.U.S.E. in their daily interactions, or to build their own action plans using tools like music or art therapy," she says.
It is meaningful to everyone involved that AAIUH has announced its plans for the program's next phase during Black History Month, Araya says. "It is important to acknowledge that there are issues specifically related to being a Black or African American person, that those issues need to be addressed, and that there are community-based organizations like ours trying to address them — and not just in February."
The population of AAIUH's catchment area is 88 percent Black, African American and Afro-Caribbean. Many members of the Institute's own staff are local. "This work is very personal," says Dr. Marilyn Fraser, AAIUH's CEO.
An opportunity to expand the conversation from mental health into other topics
The program's potential to cover more ground is clear, Chaffin reports. Discussions during workshops were not limited to the stresses of life during COVID-19, which turned out to be more of an entry point into other issues such as structural racism, historical or generational trauma, police bias and aggression and the immigrant experience. (AAIUH partnered with a local licensed clinical social worker to conduct a workshop on issues of racial trauma for the youth peer leaders.)
Chaffin credits the program's success in no small part to the team's thorough planning process, during which AAIUH consulted with many community partners, UNICEF USA experts and others to ensure that content was appropriate and culturally sensitive. As more than one focus group member noted, there was "open and clear discussion" of how to engage different racial and ethnic groups.
"Strategies and interventions were adapted to the particular context of the COVID-19 pandemic, and the simultaneous, historic racial reckoning that surged in the wake of George Floyd’s killing and the Black Lives Matter movement," Chaffin writes.
The program's model was very much about integrating community voices and experiences and developing an intervention that is community driven and community centered, Araya says. It's a model that could be replicated in other cities, and AAIUH is happy to share it, she adds.
"We’ve achieved what we set out to achieve, but our work is not done."
For more details about the Beyond the Stigma program approach and curriculum, read Peer Leaders Making a Difference in Mental Health. Or email Kenya Kirkman at email@example.com to learn more.
UNICEF supports mental health for children around the world. Donate today to support this important work.
Top photo: Matthan, 18, left, and Quanasia, 17, both of Brooklyn, New York, were two of the hundreds of youth who participated in peer-to-peer mental health and wellness workshops developed by the Arthur Ashe Institute for Urban Health, with funding and technical assistance from UNICEF USA. The two friends were photographed in August 2021 at a youth summit hosted by Flatbush Leadership Academy, an AAIUH community partner. "The experience allowed me to see how my friends think and have a sense of what they are going through," says Matthan, a freshman at Vaughn College of Aeronautics and Technology. Opening up about mental health, he says, "is a conversation that a lot more youth need." © Photo provided by the Arthur Ashe Institute for Urban Health