NYU Silver Hosts Transatlantic Mental Health Symposium as EU-Funded CRISP Knowledge Exchange Concludes

Associate Professor Victoria Stanhope gives opening remarks at the symposium she chaired.
Associate Professor Victoria Stanhope gives opening remarks at the symposium she chaired.

On July 19, 2019, NYU Silver hosted the culminating US event of the Citizenship, Recovery and Inclusive Society Partnership (CRISP), a four-year, transatlantic knowledge exchange program focused on mental health and social inclusion. At the day-long symposium with the theme “Mental Health and Creating an Inclusive Society: Transatlantic Perspectives,” a diverse group of academics, policy makers, practitioners and advocates from Europe and the US explored cross-cutting issues that have emerged through the CRISP program.

Supported by a European Union Horizon 2020 grant, CRISP is a joint effort among NYU, University of Strathclyde, Yale University, Ulm University, the Mental Health Foundation, the Finnish Association for Mental Health, and the Illinois Institute of Technology that unites leaders from academia, policy, practice, advocacy, and community organizations from Europe and the US to share learning on four key areas of social inclusion for people with mental health challenges: citizenship, recovery, stigma and public policy.

In welcoming remarks, NYU Silver Associate Professor and symposium chair Dr. Victoria Stanhope noted that NYU also hosted CRISP’s first policy forum in September 2016, at which stakeholders framed the overarching questions for the partnership’s four year agenda. “Since then,” she said, “we have brought together diverse voices from sectors including NGOs, arts, law, economics, as well as mental health services and people with lived experience, to fulfill our charge of advancing new ways to promote social inclusion and create a better world for people living with mental health problems.” Furthermore, she noted, “This symposium presents an opportunity to push back against the worrying global trend of isolationism and to share innovation across national boundaries.”

Dr. Lee Knifton, a Co-Lead of the CRISP Project, Director for Scotland and Northern Ireland of The Mental Health Foundation, and Reader and Co-Director of the Centre for Health Policy at the University of Strathclyde, reported on CRISP’s key achievements. These include publication of 20 collaborative papers, implementation of social innovation programs on both sides of the Atlantic, and the launch of the Thrive Edinburgh city-wide mental health strategy, which was modeled after and informed by New York’s Thrive NYC through an exchange facilitated by CRISP. Dr. Knifton also highlighted the key themes that emerged within and across CRISP’s work packages and around which the symposium was organized: the power of social determinants; the importance of strategic policy responses; the value of peer research; and the benefits of arts and culture.

Mental health and social determinants were the topic of the event’s keynote, given by Dr. Ruth Shim, Luke and Grace Kim Professor in Cultural Psychiatry and Associate Professor, Department of Psychiatry and Behavioral Sciences at University of California, Davis. Dr. Shim said that social determinants – or the environmental and/or contextual conditions in society that lead to disparities and inequities – may be even more significant in mental health than physical health because of the pervasiveness of mental illness and vastly premature death among people with severe mental illnesses compared with the general population. She underscored the distinction between disparities and inequities, noting that the former are differences by demographics while the latter are a result of structural, systemic factors that we have the power to change. Mental health inequities, she said, “are shaped by the distribution of money, power, and resources at the global, national, and local levels, which are themselves influenced by policy choices. The decisions we as a society choose to make about how we distribute power, who we value, and who we consider worthy of policy benefits are the things that actually shape health outcomes.” Dr. Shim made the case that all policies impact mental health and called for people in clinical settings to actively promote equity and inclusion.

Fittingly, the first panel of the symposium focused on policy and leadership implementation, and it was chaired by the CRISP Project’s other Co-Lead, Neil Quinn, also a Reader and Co-Director of the Centre for Health Policy at University of Strathclyde. Werner H. Obermeyer, Deputy Executive Director of the World Health Organization office at the United Nations, explained how the WHO QualityRights initiative is reforming mental health services and promoting the human rights of people with psychosocial, intellectual, and cognitive disabilities around the world. Meri Larivaara, a Senior Advisor for the Finnish Mental Health Association and former Ministerial Advisor for Finland’s Ministry of Social Affairs, gave an overview of the “Mental Health in All Policies” framework and the national mental health strategy in Finland. Gary Belkin, Chief of Strategy and Policy for ThriveNYC in the Office of the Mayor of New York City, explained how the ThriveNYC initiative is putting a mental health in all policies approach into practice as it integrates mental health policy work and builds out its 54 programs across all city agencies. Finally, Linda Irvine, Strategic Programme Manager, Mental Health and Well-Being, for the City of Edinburgh Health and Social Care Partnership, explained how Thrive Edinburgh is achieving its the priorities: identify and address root causes; build resilience and enhance support for people to live well and meet their potential; provide treatment that is easy to access and makes a difference; and focus on those who are highest risk.

The next panel, chaired by Mental Health Foundation Scotland Head of Programmes Julie Cameron, explored the benefits and challenges of peer research. Sonya Ballentine, Research Assistant/Project Manager at Illinois Institute of Technology College of Psychology called research led by people with lived mental health experience “the perfect combination of science and human perspective,” and said “It is priceless and bidirectional.” Gordon Johnston, Peer Researcher at Mental Health Foundation Scotland, observed that “A person with lived mental health experience can go places researchers cannot go and reach people they cannot reach. Peer research helps both academics and peers move in circles outside their comfort zone.” Joquanna Hardy, Peer Counseling Aide/Facilitator, NYS Certified Peer Specialist and Community Advocate at Pibly Residential Program in the Bronx, suggested that peer researchers are vital interpreters who bridge gaps between academia and the communities being researched. She added “You have people who are taking their stigma and making something positive out of it.” While the panelists were fully supportive of peer research, among the challenges they discussed were the potential for tokenistic inclusion of people with lived experience, and the extra time that it takes to execute truly collaborative research projects.

After breakout sessions in which participants shared insights from the CRISP project and future priorities in the areas of recovery, citizenship, and stigma, Dr. Michael Rowe, Co-Director of the Program for Recovery and Community Health and Principal Investigator of the Citizens Community Collaborative at Yale Department of Psychiatry, chaired the symposium’s final panel focused on improving mental health and well-being through the arts. Amal Azzudin, Equality and Human Rights Officer at Mental Health Foundation Scotland, discussed the therapeutic art groups the foundation facilitates for refugees and asylum seekers who often experience stress and poor mental health. Ms. Azzudin explained that art breaks down barriers between refugees who speak different languages. “Making art is not only therapeutic,” she said, “but it allows the maker to tell their story and be heard without words.” Carla Rabinowitz, Advocacy Coordinator at Community Access in New York City, described the organization’s annual peer-organized Mental Health Film Festival, which she co-founded in 2005. The event brings people together through films to discuss mental health, relate to the diverse experiences shown, and be inspired to promote human rights and social justice for people with mental health concerns. "If it doesn't make you laugh or cry you won't see it in our festival," she said. Lucile Bruce, Communications Officer at Connecticut Mental Health Center, spoke about the Center’s Survivors of Society Rising theater group, in which people in recovery developed and performed a play based on their own mental health experiences. Ms. Bruce described how the project enabled participants to share their stories, bond with castmates, and evoke audience empathy and understanding, illustrating this with a video of the actors themselves describing their experience.

Dr. Stanhope closed the symposium with reflections on day’s discussions. While the symposium was the partnership’s last event in the US, two more conferences are scheduled in Europe in fall 2019, and it is expected that many future initiatives will spring from the collaborations and knowledge exchange CRISP has fostered.