Recoup-NY: How One Team of Researchers is Reimagining Culturally Competent Mental Healthcare.

Since the early days of the pandemic, there has been an increasing strain on the nation’s mental healthcare system. Many therapists and social workers have noted challenges in ensuring their clients’ continued connection to care, especially during periods of strict quarantine. Burgeoning cases of newly developed mental health issues have raised alarm over clients’ needs, outpacing the number of specialists available. The lack of equal access to care for low-income and other marginalized communities has shed light on some of the problems in our current system. The lack of resources to support the psychological well-being of mental healthcare providers has, in turn, become a crisis of its own. 

  The public has taken to and embraced the idea that there is an “ongoing mental health crisis.” Potential policy shifts and their social implications have a personal import to those most affected. Communities have taken to social media to discuss these significant problems and demand change. Yet, for policymakers, imagining what this change might look like has been a formidable task. As a result, many social science researchers and public health officials have been galvanized to innovate strategies to deliver high-quality, culturally responsive care.

In New York City, the Mayor’s Office has partnered with George Washington University and The New School for Social Research on a public health initiative called Recoup-NY. Dr. Adam Brown, associate professor and head of The Trauma and Global Mental Health lab at The New School for Social Research, is one of the lead researchers behind the project. Recently, his work has focused on combining well-known, scientifically validated public health strategies with new and emerging research on global mental health. This project aims to establish culturally appropriate care for New Yorkers, focusing on low-income communities of color. 

“When we look at the data of who is trained, licensed clinical psychologists and psychiatrists in New York City, we see a disproportionate number of white clinicians compared to clinicians of color. And, we know historically, throughout the United States, there's a long history of communities of color not being treated fairly and being left out of decision-making. So there's often a lack of trust in different kinds of mental healthcare,” Dr. Brown explains.

Recoup-NY employs licensed clinicians to train community members with no background in mental health; they equip them with a foundational knowledge of emotional support strategies. This task-sharing strategy draws on the strengths of mental health clinicians from outside the community who have specialized knowledge about psychological and psychiatric disorders and the trainees who possess unique cultural understanding. The goal is to create a new and more effective model of what mental healthcare can look like. 

The interventions are tailor-made for each individual and include a series of one-on-one and group meetings. Those seeking help are taught breathing exercises, problem-solving techniques and how to strengthen social support during times of stress. 

The initiative is based on cross-cultural research that argues against conventional mental health paradigms. “We are learning and simultaneously unlearning how we've thought about mental health support in innovative ways. And for me, one of the most exciting aspects of this is that we're really doing this with communities. It's not just researchers and scholars telling people, ‘this is what you need to do to feel healthy,’” says Dr. Brown. 

Recoup-NY is making a point of prioritizing underserved populations. Using data from the Mayor’s Office of Community Mental Health, Dr. Brown’s team have identified 33 neighborhoods that have been disproportionately hit by COVID and mental health issues throughout the pandemic. 

These neighborhoods are predominantly housed by low-income communities of color whose needs are often overlooked. According to a 2021 report published by the New York City Department of Health (DOH), “Risk factors for poor mental health outcomes vary across racial and ethnic groups.” This is partially due to ways in which financial stress, unequal access to healthcare, and stigma intersect with racial identity.

DOH’s report further mentioned that in New York City, “Latinx adults were more likely than White adults to report experiencing the death of someone close to them since January 2020 and being financially stressed due to the impacts of the pandemic.”  The study also found that Asian and Pacific Islander adults were more likely to report a lack of emotional support compared to their White counterparts.

Recoup-NY is a major public health policy initiative to formally and scientifically reintroduce and fund what has been known for millennia. “For as long as humans have been documenting culture, we've always known that in times of stress and trauma and adversity, people have always taken care of one another in their communities… in so many ways, we have to take a step back and think about, well, what is the definition of care and who are the best people to be delivering that care in different settings?” says Dr. Brown.