Monday June 13th, 2011 - Post #3

First day at the clinic complete. It was my first time being in the South Bronx, and it was definitely as "rough" as everyone had told me it would be. It looked kind of similar to where my apartment is in harlem, but about 5x worse. You can see the difference in poverty just by the people walking around and the stores and buildings in the area. The neighborhood that the clinic is in is called Mott Haven, and as the Children's Services Director explained to me today, the neighborhood consistently falls at the very bottom of the rankings of NYC neighborhoods in terms of income, poverty level, and overall child life outlook.

The clinic itself is really nice, and very secure (every single door in the whole building is only accessible with a key card, and there's a security guard who stands in the lobby from starting at 12pm for the rest of the day [and not like one of the fat, donut eating, barely fit into their chair while "watching" the cameras on a monitor security guards]). There are 5 different programs housed in the clinic building, and I'm going to be involved in several of them throughout the summer. My time is going to be divided doing some billing/insurance/paperwork stuff; involved in the clinic itself, helping with some paperwork there, and possibly overseeing the children while their parents are in therapy sessions (a lot of families that are referred to the clinic primarily for the kids are also suggested that the parents seek some additional therapy as well); and then helping out a couple days a week with the summer program they have for kids, whose main goal is to get the kids out of their troubled homes and provide them with something productive to do, while at the same time keeping "therapy" the main focus.

In order to avoid trouble with HIPAA, I'll try and keep the personal information of the cases to a minimum, but I can give the general statistics of the kids who come through the clinic. They have to have an IQ over 70, or else they are deemed incapable of benefitting from any kind of therapy they'd be offered. The most common disorders diagnosed (and all children who are seen in any way at the clinic need to have a diagnosed mental disorder in order for their insurance to be billed) are ADHD, depression and other mood disorders, anxiety, post-traumatic stress disorder, bipolar disorder, conduct disorder, and oppositional defiant disorder. 85% of all children seen are raised by a single mother, 5% raised by another relative, 4% by a single father, 2% other living arrangements, and only 4% have two parents with custody...4% of the kids live with two parents. And while a single parent can in many cases provide just as good care as two parents, put them in this neighborhood, and the story changes. In a general survey conducted of all the kids seen in one year (median age is 10-11), 90% had heard gun shots that weren't in a movie or on TV, and a majority had seen a dead body, aside from one in a funeral parlor, and not on TV. Now, I have never heard a gun shot in real life before, besides those coming from the woods or fields by my house or in Geneseo (and there certainly aren't woods or fields around here where people are hunting), and I have definitely never seen a dead body, outside of one at a funeral. And I'm twice the age of the average child that comes through the clinic. The difference between these kids lives and my own is ridiculous to me. Yet, when I looked at the kids who were coming in and out of the clinic today, they look like typical kids. Coloring in coloring books on the table in the waiting room, listening to iPods, running around the hallways. But when they leave the clean, air-conditioned, safe clinic, their lives are probably like nothing I, or many of us, could imagine.

When looking at the evaluation forms used during the therapy sessions, I got really excited. While it's obviously very sad, I can really see myself doing this and enjoying it. Evaluating a child's family history, drug usage (and yeah, they have elementary and middle school aged kids with substance abuse issues), family drug usage, educational background, sexuality issues, peer issues, sexual or physical abuse history, history of trauma or other traumatic events. And then a treatment plan is molded to address the major issues the child deals with, and progress is marked very specifically over a long-term period (a couple months to a couple years). And progress doesn't usually mean progress in the normal sense of the word. Progress for these kids may simply be talking about the issues they deal with at home, and simply realizing that it's actually not the norm for 10 people to be living in a one bedroom apartment, or to have an absent father, or to have parents addicted to drugs, or to only eat 1 meal a day, etc etc. It's also major progress for the children to realize that, unlike their family members (in most cases), there are people who care and can remain constant in their lives and are willing to listen and help them. I definitely find it really, really exciting.

While it's definitely sad that areas like this still exist (and it certainly doesn't stand alone as far as that goes), it's the perfect place to have a clinic such as this one, and as the clinic expands its services into schools throughout the neighborhood (which they have been in the process of doing for a couple years now) and become more well-known and reputable, it can eventually make a large impact.