Yale School of Medicine
Dr. Ayana Jordan.
New Haven will test a new approach to treating severe substance abuse with the help of $3 million from the federal government.
The money will fund a new Black Church Project, started by Yale psychiatry professor Ayana Jordan.
Jordan has been testing out her new approach over the past few years in small-scale treatment programs housed in churches in the Hill and Dixwell. It builds on “cognitive behavior therapy” to help people with severe addiction go deeper into the causes that leads to their substance abuse. It also partners with churches in communities of color to work with people who might not otherwise feel comfortable participating in traditional treatment settings. (Read a previous story here about the pilot programs in the Hill and Dixwell.)
Those pilot programs led to dramatic results. Based on those results, Jordan was able to secure the new $3 million grant came from the National Institutes of Health’s National Institute of Alcohol Abuse and Alcoholism.
She discussed her plans for how to spend the money at a press conference held with government officials and religious leaders Thursday at Dixwell Avenue Congregational United Church of Christ.
The Black Church Project will recruit 200 people with severe substance abuse challenges to participate in an eight-week program.
The project will recruit those participants in a “neutral setting,” the city-run Opportunity Center on Dixwell Avenue. Then it will determine which of two locations to send the participants to: a traditional non-religious setting, MCCA on Whalley Avenue. Or the Dixwell Congregational Church.
After the eight-week program, the project will track participants for six months to see how they fared, in order to draw conclusions about which setting produced what kinds of results.
Jordan began developing her program in 2015.
“I got so tired of seeing people drop out of care,” she said. “They just wouldn’t show up.” She wanted to use her training to create a new evidence-based treatment, one “that brings the care to folks instead of expecting folks who are already marginalized and face racism to find it.” And seeing whether Black churches might work as a setting for people who otherwise weren’t getting the help they needed.
“We focused on trying to figure out what is the best way to take care of the marginalized, historically excluded people who use alcohol and other substances,” said Jordan. “In our community, that’s Black people with alcoholism. We want to affirm people’s value and humanity.”
“We wanted people to think about underlying questions, like why they use in the first place.”
At the core of the program is the cognitive behavior therapy, which participants complete on laptops and tablets.
“It’s not lost on me that I’m less than the one percent of Black researchers who get funding from the NIH,” she said. “People told me I was racist for focusing on the needs of Black people, that I couldn’t create a career with such a narrow focus. It was discouraging, but I didn’t stop.”
Mehul Dalal, the city’s community services administrator, agreed. “There is a long and fraught history with research and communities of color that’s well deserved,” he said. “Projects like this one, with a [principal investigator] of color, could change that narrative.”
Role Of The Church
Younis, at the press conference.
“We need treatment in a place where there’s trust,” said Jordan. A Black church is one of those places.
“Black churches are places where a lot of folks have common traditions,” said Richard Younis (pictured), who has been clean for ten years. Younis helped administer the program, along with 13 others.
He paused, and then asked this reporter, “Can I tell you something?”
“When I was struggling to get clean, I went to the white church on the Green, because no one knew me there. I wanted to talk to God.” Younis said he couldn’t go to a church where he knew people, because they would gossip and see that he was disheveled from the night before. “It’s miraculous to be in a church, to be welcomed.”
“Some people said it had been years since they’d been in a church,” agreed Rev. Jerry Streets, the pastor of Dixwell Congregational Church. “The spiritual aspect of treatment is far easier to incorporate in a church setting.”
Rev. Jerry Streets: Ready to help make it work.
Indeed, some volunteers from the church serve as “church-based health advisors” in the program. They receive extensive training from Jordan, covering “good clinical practice, how to be involved in ethical research, the biological and sociological understanding of addiction.”
“Although people may help because of their religion, they do not aim to spread it in their interactions,” said Reverend Streets. “We know people worry about stigma or feeling judged, but we do not take a proselytizing approach.”
Others agreed with the need for a community-based approach. “[Traditional] rehabilitation doesn’t look at the person as whole, seeing their trauma and worldview,” said Younis. “It’s like walking in without an arm or a leg. You wouldn’t just leave a part of you, would you?”
Kimberely Guy was a crack user. She said she has been clean for almost two decades. She also works for the program, helping participants use technology to complete CBT and talking with them. “We [help] people learn how to deal with their actions and behaviors, and understand what makes them use,” she said.
“My daughter died from an overdose at age 27,” she said. “I wish this program existed back then.”
Younis agreed. “I know someone who signed up for the pilot program, but couldn’t get in,” he said. “He’s already dead.”
“Communities of color oftentimes don’t have access to resources and support,” Mayor Justin Elicker said at the press converence. “And evidence indicates that people of color are less likely to to access the services that are available.” He thanked Jordan for her work, saying it would fill a need in New Haven in a “sensitive, culturally appropriate way.”
“I’m not only looking forward to the results of the work that you’re doing, I’m looking forward to the city learning from what you’re doing,” Elicker said.