News — The Alliance

“Voting is Everyone’s Responsibility:” a Conversation with Lillian Cotto-Anglada

Q: Lillian, a lot of Alliance folks might not know that our Luis and Lillian Outreach Center, or LLOC, is named for you. What’s the history there? 
I was in the second Peer Leadership Training Group in 1992. I was hired the next year as a women’s health advocate, special events coordinator, and outreach worker. In 1995, I contracted tuberculosis while doing outreach. I was in and out of the hospital a lot, because of complications from tuberculosis. Luis Morales, another of the first employees at Alliance (then AIDS Service Center of Lower Manhattan) and a member of the Peer Leadership Training Group at the time, was sick. He passed away on October 17, 1995. The community center where LLOC is today was still 150 First Avenue. Our CEO Sharen and the board decided it should be dedicated to us: “In hope for Lillian. In memory of Luis.” I thought that was beautiful.

Q: You’ve had a lot of different roles over the years at Alliance. What do you do now? 
Yes, I’ve done a lot of different things. I was a staff member from 1993-1999. Since 2002, I’ve been the President of our Consumer Advisory Council, hearing from our participants what’s working with our programs and what they want us to consider changing. But I also help plan, organize, and decorate our Thanksgiving events and other events like PREP graduations and World AIDS Day. And I co-facilitate our Arts Class on Thursdays with Ms. Louise. We used to have Valentine’s Day and other events that I’d coordinate. I’ve always wanted people who had lost family and friends to the virus to attend life-affirming events.

Q: You told me you’re a poll worker coordinator in this year’s election cycle. What does that mean, exactly?
Me and my co-coordinator teach poll workers who ensure voting is fair. We’re in charge of making sure all the processes of a fair election are followed for the thousands of people in my voting assembly district. We’re trained how to set up polling places, which can be in schools, community centers, or anywhere that has space. I work during the early voting period, which begins October 26, and goes every day through Sunday, November 3 (8:00am-5:00pm weekends, and 8:00am-8:00pm weekdays). Then I work all day on Election day (Tuesday, November 5), from 5:00am until the last ballot is cast. I work at JHS 56 in the Lower East Side and P.S. 184.

Photo: David Nager/Alliance

Q: Are there any little-known voting rules you have to enforce?
Hah! Yes. For example, if you get an absentee ballot sent to your house, you can’t show up at a polling location and vote in-person. They monitor the polling locations to make sure no one is inside or right outside with campaign signs or shirts—that’s called electioneering. You can’t enter a polling location as a walking ad for a candidate. We keep the election process fair.

Q: I imagine some people get really upset about that?
Oh yeah, most of us have been confronted, or threatened for saying “you can’t be here with that shirt, you need to turn it inside out and come back.” As the supervisor, I try to prepare poll workers for that, and help de-escalate things, and help people feel comfortable after the confrontations. My poll workers appreciate that. They’ve told me, “If you don’t come back next election, I’m not either.”

Q: So you train poll workers. What do they do?
They do a lot of things, because voting is so misunderstood. Some can be interpreters, some are accessibility clerks. They maintain the long lines, and there are other roles. Poll workers check-in voters and show them how to vote.

Q: When did you become a poll worker, and why?
In 1987, when my mom’s best friend was running for Democratic representative of her district. The Democratic and Republican parties can have representatives from every district. I always cared about voting, but knowing someone who was running for office made me more interested in how it happens.

Q: Is there any overlap between your work at Alliance and as a poll worker supervisor?
Alliance helped me become a leader. My work here showed me how to deal with all kinds of people, to really explain stuff in a way that helps them, and not to take things personally. Sometimes people have an attitude, and our work can be stressful, just like working the polls, so I kind of learned to just remind myself that their issues aren’t related to me or my work.

Q: In all these years, what was the strangest election you worked?
Definitely 2012, because it was just days after Hurricane Sandy. So many neighborhoods were destroyed and transportation was impossible, so people were allowed to vote anywhere in New York City. Poll workers and the Board of Elections had to check records to make sure nobody tried to vote twice.

Q: It sounds like a tough job with lots of procedural changes from election to election. Why do you keep doing it?
Well, I don’t do it for the money, I do it because voting is everyone’s responsibility. I think it’s a requirement. It’s your duty. A lot of people in the world don’t have the right to vote. And this year, you could really say that democracy is on the line. I don’t care who you vote for, but you have to vote. You can write in anyone; you can even vote for yourself.

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Community Promise Stories: Daniel

Can you tell us a little bit about yourself?  

Sure. I’m Daniel. I’m 52. I’ve lived in the city all my life. I keep myself busy by reading books, watching movies. Go meet up with my friends and socialize. Beyond that, I don’t go to clubs or big places.   

What do you do for work? 

Right now I’m not working. Over the years, I worked at a bank, then I did some teaching at The Princeton Review. My last job was working at my family’s restaurant, up until 2021. 

Can you tell us about your history with substances and what brought you here? 

I started smoking marijuana as a teenager. I few years later I tried some cocaine and a few years later opioids like heroin. Cocaine wasn’t as big a problem for me as heroin. Heroin is tougher because of the physical effects.  

Have you overdosed before? 

Yes, recently. About a year ago. I got something from a new supplier. I didn’t do that much, just half a bag, but 15 minutes later, I was in a store shopping and fell over. The staff called 911 and they came right away and saved my life.  

How did you find Alliance for Positive Change, and when? 

I knew about LESHRC back when it was on Allen Street. I was living in Brooklyn.  

I’ve been living in the LES for a few years. I have my own apartment that I inherited from my parents. In a tenement building. My mom left me some money when she passed and that's paying the rent. 

What services do you access here? 

I come here for syringes, for clothing, food, and other support. I like going to groups, to hear different perspectives. It can go both ways, some people need to just cut out anyone they know who reminds them of the drug world. But for me, it has been healing. 

What have been your triggers that made you use drugs—whether while actively using, or after a long break? 

People I used to use with. And grief. My first relapse was when my fiancé passed away.  

But I’ve also stopped and stared a lot. I’ve tried methadone programs four times. I’d stay sober for a few months, one time for two years.  

And now you just started Suboxone? 

Yeah. There was some problem with health insurance not covering it, but Alliance worked with Medicaid to get started.  

I think I have realistic goals. it depends on how I feel. Maybe I will still need to use a little bit, but still use less, but my goal for sure is to stop using. If I put my mind to it, I know I can do it. One step at a time. I can’t over-predict.  

Do you have a vision of what that will look like? 

Get back to work. Improve my life situation. Be a normal person again. Go to work, go shopping for groceries, mundane things like that, but them being easier. 

What is your philosophy in life? 

I have a few. Treat people the way you want to be treated. You have to be self-reliant. To hear both sides of a story before I have an opinion on something. Everyone has their flaws, so be kind and cordial. 

Community Promise Stories: Cisco

Can you tell us a little bit about yourself?

My name is Cisco. I came up with a very close-knit family. And I’m blessed to still have a loving family after everything. I have a daughter, whose life I’ve been mostly absent from because I've served a total of almost 30 years in prison, I’ve been on Suboxone for ten years to stop using heroin and cocaine. I’m sharing my story with you because I hope it helps someone, somehow.

 

What are your interests?

I love to work out. I ride my bike to Blink gym a lot and work out. I like to watch TV and catch up with family members on my support system. My mother-in-law is my spiritual sponsor, so I love catching up with her. Idle time is bad for me, so I like to wake up with a game plan and direction for my day.

 

Can you tell us about your history with using substances?

When I was a kid, I found the neighborhood gang lifestyle pretty appealing. I was sexually active from a young age, and I would do the drugs that the girls I was with were doing. I was part of a gang.

Cocaine and heroin were the drugs that I was the most into and most dependent on. It all progressed until it started getting out of control. I had a problem with addiction and authority. I got into a lot of fights. I found myself in a bad place, and I started sticking up drug dealers. I had God looking over me in that they weren’t able to kill me.

I’m disabled from getting shot when I robbed two drug dealers in 1988. That was rock bottom and made me stop using drugs for a while, but I needed a few more rock bottoms.

I always heard prison was terrible, but for some reason, I wasn’t scared. I was about that gangster life. I had people bring me cocaine and heroin and smuggle it in for me. The first time I came home from prison in 1996, I almost died from an overdose.

 

What were your triggers in your recovery?

Sex was my biggest trigger, and the women I was with used a lot of drugs, so I did drugs with them. Boredom, too. That’s why now I like to try to make sure I don’t have time to waste. But it was also just pure addiction, medication—I couldn’t think or function without it.

How did you become introduced to Alliance for Positive Change?

I came home April 15 of this year, and Eugene from the Corrections Health Initiative program picked me up. He gave me the welcome home backpack. I had been in prison for almost 20 years straight, that time. I had had a few 5-6 year bids before, but this was my longest time I spent in prison.

 

How was such a long sentence different from your shorter sentences?

Well, I had a lot of time to think, and frankly, a lot of people I used to know on the outside forgot about me. So they stopped bringing me drugs like halfway through my sentence: I guess they forgot about me. I had to do something else with my boredom, so I got my food handler’s certificate, and hospice nurse training. I did it to impress the parole board, but I also liked the work.

 

What did your recovery look like while you were incarcerated?

I became the Chairman of the AA meetings in prison—there was no NA—and a few people were actually from the outside, who came there for the meetings. It was bullshit that there was no NA, so I would run the meetings and say, “I’m Cisco, I’m an alcoholic AND a drug addict.” I guess people liked that I was talking about something real, but that we weren’t supposed to talk about.

Without heroin, I needed to take something for the pain because I have these chronic injuries from my incidents with gangs and beatings I had from the correction officers in prison. I stopped using heroin on August 16, 2014. People stopped bringing me stuff because they thought I was never coming home. The prison wasn’t prescribing Suboxone, so I got it from another prisoner. I was getting it like this for over eight years, until January 2023, when the prison finally allowed us to get Suboxone.

 

How is your experience with Suboxone treatment at Alliance?

My body is used to it. I don’t have the physical or emotional cravings for heroin, and I think I’ve been over the psychological cravings for a while, really. When I was using a lot, I felt physically weak; I didn’t eat right, I didn’t sleep right, and everything hurt. That’s all much better now.

 

What other services are you accessing at Alliance?

The recovery group with Emily Levine (Project Manager, and Counselor), in Midtown Central is good for me. I don’t really like sharing in groups so the one-on-one sessions with Emily and Ana are good for me.

 

Since your recovery journey, have there been any other changes in your mentality?

I’ve also been super reserved about sex, too. I knew that was my biggest trigger, so coming out of prison, I thought I’d be all over the women who showed interest in me, even though I knew that could be bad for me. I’m actually impressed with myself because I haven’t been that guy—I’ve been patient. Sex has been cheap for me a lot of my life, but now I want something more meaningful.

 

What are your goals for the future?

I want to be of service. You can probably hear it in my voice, but I’ve got a lot of regrets, man. I feel like I wasted so much of my life. I’ve missed most of the moments with my daughter, but maybe I can help someone because of it. My daughter is in my life. I remember so many important dates, like the day she got out of the hospital after she was born with complications, the day her mother died, and the day I got arrested the final time. She resented me at one time, but she’s forgiven me, and that makes me so happy. She’s amazing, so mature and wise. And she’s made me a grandfather. She lives in the city, so I see her again now, which is a blessing.

I’m interested in becoming a Peer Worker at Alliance. I love the work you guys do here, and I’ve got the lived-experience. I’ve been where so many people Alliance helps have been, and I want to be able to help them. I’m interviewing for the next Peer Recovery Education Program training.

Community Promise Stories: Luis H.

Can you tell us a little bit about yourself?

I’m 48 years old. I’m an artist. I never went to school for it, my highest level of education is a GED, but I’ve been doing graffiti art for a long time, and I loved it since I was a kid in New York and Puerto Rico.

 

So you spent your childhood between those two places?

Yeah, I was born here, then moved to Puerto Rico and back a few times, coming back for good when I was 13, after my mother left my father. That last move was really bad for me, because I felt so alone here, and didn’t have friends in school. I missed the countryside of Puerto Rico.

 

When did your drug use start? And what were your drugs of choice?

When we moved back to New York the second time, when I was 13. I had no friends over here besides my cousins. One week in New York and I’m already smoking weed with my cousins, who were just a few years older than me.

I tried heroin at 15 with an older cousin, and didn’t try it again until 22 or 23. I was snorting it.

 

What was your drug use like in your 20s?

When I was younger, I was pretty successful, things were going well, I was kind of a playboy.

Heroin enhanced sex for me, so I liked that. I didn’t do it every day, because I knew I’d get addicted to it. I’d use on a Saturday and then not pick it up for weeks. After a couple years, I started liking it more and more, and then I was totally addicted. And cocaine was more or less the same thing.

 

So sex was a trigger for heroin?

Back then, yes. Now, it’s more just that if I don’t use, I feel in pain.

Cocaine was more to function, because at times      when I was trying to work to earn as much money as possible, I was always tired so I had to take cocaine to stay awake.

 

What do you do for work?

I’m an artist. I get paid for making the graffiti murals on      campuses. Apparel, painting, and all sorts of other work. You can follow me on Instagram @kerznyc.

It sounds like you’ve always been conscious of not building a dependence. Have you tried Medication-assisted treatment before?

I started taking Methadone in 2013, but I’m trying to cut down to a small dose and eventually transition to Suboxone. I’ve reduced my heroin use, but I’m still using, so I want to get off heroin. Especially now, with all the new chemicals in the drug supply, I can feel the xylazine and fentanyl in the batches I take.

Have you overdosed before?

I’ve overdosed at least 12 times, all before I started Methadone in 2013, and back then it was just heroin, none of the stuff in the supply now. Sometimes it was friends, sometimes paramedics who revived me. One time I was in a park and I was super out of it, and the only reason I lived is because a lady walking her dog saw me, and called the ambulance. If she hadn’t seen me, I would’ve died. God had that lady walking through there at night for a reason.

 Every year, I go back to the park where this happened, in the Bronx, and I touch the tree where I was when the lady saved me. I call it the tree of life.  

 

That’s beautiful. So if you’re still actively taking heroin, and sometimes cocaine, but haven’t overdosed in 11 years, is that just good luck, or what?

Now I ALWAYS test my drugs. If I don’t know my supplier, I’ll just take a half a bag at first, to make sure it’s cool. And being able to test my drugs with the test strips you’ve got here at Alliance, that’s big.

 

How long have you been coming to Alliance for Positive Change?

I found Alliance about 5 years ago, when you were on Allen St. I came here for the syringe exchange, because I never wanted to share needles, and I appreciated that the people running the syringe exchange never judged me. Actually, they congratulated me for being safer about my use, getting sterile syringes. I used to come here just for needles, now that’s the thing I need the least here. I probably come here for needles once every 40 times. I come here for coffee, for a safe place to hang out, especially when it’s super hot or super cold, because I’ve experienced homelessness for a long time, and I can’t stay on friends’ couches all the time.

  

A lot of the people we serve are experiencing homelessness. That’s a tough situation when you’re trying to change behaviors.

Oh yeah, the shelter system is really tough. You’ve got to find a good place where they actually treat you like a person, not like your parole officer. I’ve stayed at places like that, where every few weeks they’ll move you around—if you don't do this you lose your bed, it’s really messed up.

Now I’ve got a room in a shelter that doesn’t make you check in all the time, it’s pretty cool, and I applied for Section 8 housing. Some of the case managers here are helping me take the housing vouchers to try to find an apartment. I want a safe place to live, so I can take care of my physical health.

  

How has your drug use changed since you’ve been coming here?

My drug use is way down, and when I use, I use way less.

I’ve done a bunch of one-on-one sessions with Ana, talking about my traumas and what led me to take these steps to stop using. I’ve had to deal with the fact that I’ve lost friends to overdoses, one guy injected himself in the neck because all his other veins were all used up. He died right in front of me. It takes a while to process stuff like that.

  

What do you want to do when you’ve completely stopped using?

I want to travel. Right now I’m restricted, because of the methadone. I can’t go to a graffiti competition in Chicago, because I don't want to have to deal with the backlash from missing a few sessions of Methadone.

I want to go back to Puerto Rico, I have so many great memories of being there, in the countryside. Because I really love nature. I grew up around horses and roosters, and I loved it. I want more time to focus on those things.

  

You’ve mentioned being around nature, and animals. What are some of your other hobbies?

I love being outdoors most of all, and everything outdoors, like fishing, camping, hiking, horseback riding, all that stuff. I have an aunt down in Maryland that I’d visit because she was near all these different rivers so I’d swim all these places, anywhere! I’ve held big snapping turtles, and alligators, it’s exciting, man! I love nature.

Remembering Edwin Krales, aka Dr. Broccoli

Edwin Krales, aka Dr. Broccoli, Alliance’s Nutritionist, passed away last month. Dr. Broccoli was a staple of our Alliance community, equally beloved by program participants, Peers, and staff. He earned his nickname 30 years ago when he relentlessly promoted eating veggies—going out of his way to bring fresh veggies to outreach events across New York City, many of which were held in food deserts without reliable access to produce.

Because his work at Alliance was so special to him; his wife, Marcia, and two daughters, Alex and Amelia, suggested a memorial gathering at Alliance during the time Dr. Broccoli would ordinarily be holding his first of two Wednesday nutrition classes, the week after his passing. They shared stories and photos of Dr. Broccoli, and Alliance staff, Peers, and participants packed the room to share their own stories, photos, and insights. In their own words, here is how the Alliance community remembers Dr. Broccoli:

“His convictions were strong. He helped me grow up. He will be deeply missed. A great man. An original." —Vladimir

"He would tell me to portion my meals, because he knew I wanted to take better care, but he knew cookies were my vice. He sent me notes and I frames them. I love that man. He was like a father to me." —Sylvia

“He was a powerful force full of knowledge, empathy and courage. I admired how he nurtured our clients with love and patience allowing him to sustain a unique relationship with each individual. His actions and words showed how deeply he cared for people. Even after I parted from the Alliance, he called to check in on me. Dr. Broccoli is one of my greatest memories at the Alliance." —Abeer

"He gave me his favorite bowtie... and a blender." —Joey

“We all look forward to Wednesdays with Dr. Broc. We'd talk about fishing. And he's saved my life by helping my diet." —Joseph

"I met doc years ago and he helped me figure out what to eat and not eat when I got to a certain age. Because of him... I’m healthier. I miss him.” —Mike

"One thing I loved about [Dr. Broccoli] was the reminder calls on Tuesdays... knowing that someone had me on their mind and wanted to make sure they saw me the next day. And I started going to the gym because of him. He instilled in me class, how to behave and dress.” —Abdullah

"He always looked out for people who didn't have a way to escape the heat and cold and would tell people where to go for shelter." —Marcia

Thank you, Dr. Broccoli!

Community Promise Stories: Wilson R.

Can you tell us a little bit about yourself?

My name is Wilson R. I’m 54 years old. Haven’t used drugs in seven months, and I’m feeling good about myself, saving my money. Back in the day I was a kind of bad boy. I got into a lot of foolishness, and my problem with drugs was a big part of it.

 

When did your drug use start? And what were your drugs of choice?

I was like 13 years old when I started smoking weed and taking heroin. I started slinging it at 13, too. I spent 17 years in prison, but I’ve been out since 2005, and proud I haven’t been back.

 

What were some of your triggers? Did they change from when you were a teenager, first starting to use heroin, to last year?

No, not really. The people, places, and things that triggered me might’ve changed, but it was always anxiety, anger, and pain. I lost important family members and friends close to me from a young age. I don’t like talking about it.

 

Okay, of course. Sorry. Can you tell us how you came to find Alliance for Positive Change?

Yeah, I was hanging out in the library up the block and saw signs for the harm reduction center. This was about June 2023. I was already taking Methadone to try to quit heroin, but it wasn’t working. I talked to some of the people here, they were really cool, and I started sitting in on the daily groups here. I don’t really do N.A. (Narcotics Anonymous) but I found it easy being with the people here. I hang out here when I’m not at work, I feel a sense of—I don’t know—community.

Oh and I took the Narcan training here, and a few weeks later I saved someone’s life because I saw them overdosing and gave them Narcan.

 

Was it a friend?

No, just a total stranger. I was just in the right place, right time.

 

Wow. So did you say you made the switch from Methadone to Suboxone last year?

Yeah, I think it was November. Dr. Hopping talked to me about treatment options. I wasn’t liking Methadone, because I could still get high from heroin while taking it. He helped me transition to Suboxone, which works better for me because on Suboxone I couldn’t feel the high from heroin, so that kind of removed the temptation (*Editor's note: some people report this side effect, while others do still feel the high from opioids while on Suboxone, a Medication-assisted treatment that consists of Narcan, and Buprenorphine, an opioid receptor blocker which blocks cravings.*)

I started out at a dose of 100mg and I’m now at 50mg.

Congratulations. Is the temptation to use totally gone, or—

No, no, definitely not, it’s still hard not using, but it gets a little less hard every day.

 

It sounds like Suboxone isn’t the only change you’ve made it your life to stop using. What else have you been doing?

I don’t hang out with the people I used to when I was high. It really is true that the people, places, and things you associate with drugs are the most tempting. But also, working with Ana, my Recovery Coach, has changed my mindset. I see things differently now. I learned to think things out more, instead of just reacting. I can be impulsive, so she’s helped me slow down and think.

 

Are there any other changes in your life lately?

Yeah, the two big ones are financial and housing. Well, I got a job in sanitation with a private company last year, and I just got promoted. Honestly, if I had been offered the job when I was still using heroin, I would’ve turned it down. Now, though, I kind of think things through. I got a promotion there, which is more money, but changes my shift from nights to mornings, which is going to be a tough change—at first. Like anything, change is always hard. But yeah, I’m getting my first debit card, and trying to find some financial literacy classes, to save my money a little bit. 

 

Congrats. What’s the other big change?

I got an apartment. I started the process after I was released from prison in 2005, but never finished it until last year. Let me tell you, it’s way easier to be sober with a roof over your head. I come here, listen to people’s stories, and then I go to work, or I go home.

 

Lots of changes: sobriety, housing, more money and financial literacy. Is it overwhelming?

It’s a lot of change, but it’s good, you know? I think the biggest change is just my mindset. I try to really think things through more, not just be impulsive. I think every day, the hard things get a little less hard.

Alliance for Positive Change Celebrates 62nd Graduating Class of Peers

On Wednesday, May 22, Alliance for Positive Change celebrated the 62nd graduating class of its renowned Peer training program. The ceremony was held at Alliance’s  Midtown Central location, with over 50 guests in attendance. 

You can find photos and videos from the moving ceremony here.

For over three decades, Alliance’s renowned Peer training program has provided New Yorkers living with and affected by HIV/AIDS and other chronic conditions with leadership and economic mobility opportunities. Peer graduates become community leaders who use their lived experience and training to help fellow New Yorkers facing health challenges. 

Alliance’s Peer program is an intensive eight-week capacity-building and skills training program that harnesses the power of mentoring to help others initiate and maintain healthy behaviors. Through the program, participants learn how to help break down barriers to health care access, and to become leaders in their communities. Alliance employs over 100 Peer Workers—the majority of whom are graduates of its Peer training—who provide prevention education, HIV and hepatitis C screening, linkage to care, harm reduction support, overdose prevention, accompaniment to appointments, and more to thousands of New Yorkers across the city.

"Fifteen years ago, I graduated from the Peer Training program, and now I'm a full-time staff member. Alliance never judged me for my experience but instead provided me with harm reduction tools to lead to positive change. My graduation from the Peer Training program was one of the biggest steps I made towards making a difference in my life," said Ashley Johnson, Assistant Director of Trainings & Interventions, who spoke at the graduation.

"The success of Alliance’s Peer Program highlights the remarkable potential for positive change within individuals and communities,” said Sharen I. Duke, Alliance CEO & Executive Director. “We are thrilled to honor our graduates, who have dedicated themselves to developing their skills and knowledge and will now use their personal experiences to help others."

For three decades, PREP has provided New Yorkers living with and affected by HIV/AIDS and other chronic conditions with leadership and economic mobility opportunities. Since its first class, more than 1,500 people have graduated from Alliance’s renowned Peer program.

During their training, Peers developed skills to coach and support New Yorkers to overcome health challenges, navigate systemic inequities, and achieve health and well-being. The Peer program connects low-income people to care and support; reduces the burden on under-resourced healthcare institutions; and creates more economic mobility for people who need it most.

Avita Pharmacy was the presenting sponsor of the graduation. Other generous sponsors include Aurora Private Wealth and Nationwide

“We’re beyond proud to sponsor Alliance for Positive Change’s Peer education program again this year,” said Avita Care Solutions CEO Michael Yount. “Congratulations to this year’s graduates who are leveraging their experience and leadership to help others initiate and maintain healthy behaviors, and to Alliance for empowering change that fosters community wellness in the face of historic health inequities.”

About Alliance for Positive Change

Alliance for Positive Change is a leading multiservice organization that provides low-income New Yorkers living with HIV/AIDS and other chronic conditions with access to quality health care, housing, harm reduction, coaching, and our renowned peer training and job placement program that cultivates leadership and economic mobility. Alliance opened in 1991, at the height of the HIV crisis—a welcoming community of transformation and opportunity. Today, we deliver on the promise of Positive Change with services and resources that equip people to navigate systemic inequities and achieve health and well-being. Learn about all the ways we inspire Positive Change at www.alliance.nyc.

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Mental Health Month Insights: Emily and Tannya

To commemorate Mental Health Month, Alliance asked some of our licensed social workers to share their insights and tips for mental health care. Interviewed here are Emily Levine, Project Manager, MHC, and Tannya Rosas, Assistant Director of Harm Reduction, MSW.

What does mental health actually mean?

Tannya: Mental health includes our emotional, psychological, and social well-being. It influences our cognition, perception, and behavior. It affects how we feel, act, and helps determine how we handle stress, relate to others, and make choices.

And how can you or I assess our mental health at a given time?

Emily: Check in with yourself! Ask yourself, "how am I feeling today? What emotions are arising in my body? Where might these emotions be stemming from?”

Consider things like when was your last full meal and have you been drinking enough water? How did you sleep last night? Our physical and mental health affect each other so much.

 

What are some signs to pay attention to that someone may be struggling? 

Tannya: Someone that is struggling with mental health might have constant feelings of worry, depression, guilt, or worthlessness. Changes in appetite, weight, sleep, and personal hygiene tend to be signs of this, too, or struggling with substance use and unable to stop.

 

What does self-care mean to you? 

Tannya: Anything that brings positive feelings and that is healthy for your own health can be considered self-care, particularly during periods of stress. It can be as simple as going for a walk after a long day of work, meditating every morning before work or school, working out to release stress, or having a healthy meal.

Tannya

What are some common mental health care plans or strategies?

Emily: Common mental health care plans or strategies typically encompass a combination of therapeutic, medical, and lifestyle approaches designed to support and enhance mental health. Talk therapy, especially when combined with medication and/or lifestyle changes, can be highly effective. 

Therapeutic techniques that work for some individuals may not be effective for others. Additionally, self-care practices, stress management techniques, social support systems, and maintaining a healthy lifestyle are all essential components of comprehensive mental health care plans.

 

What are the benefits of having a support system?

Emily: One of our psychological needs as human beings is a need for relatedness. This refers to the need to have a support system. A support system offers numerous benefits that significantly enhance both mental and physical well-being. Emotionally, it provides validation, empathy, and stress reduction through shared understanding. Belonging to a supportive community reduces feelings of isolation and loneliness, boosting self-worth and confidence.

During crises, support systems offer immediate help and act as a safety net, providing security and peace of mind. Additionally, they contribute to personal growth through feedback, insights, and shared experiences, deepening relationships and building social skills. Overall, support systems contribute to increased happiness, life satisfaction, and the overall well-being of individuals.

Emily

What are some helpful things a caring friend or relative can do to check in on or support another person’s mental health?

Emily: Be a listening ear and let the individual vent as much as needed. Listen to understand instead of listening to answer. Listening without judgement is key. Acknowledge and validate the person's emotions, showing understanding and empathy.

Tannya: I think a helpful thing a caring friend or relative can do is to be sensitive to the other person's feelings, being a good listener and be present during difficult times. Also saying things like " I am here if you need me" and/or I care about you . Asking questions like " How can I help or support you?" "What can I do to make you feel better?" "What are your thoughts about asking for help?"

And what are some unhelpful things to avoid doing?

Emily: Avoid comparing their struggles to others' or suggesting that someone else has it worse. Refrain from making their struggles about yourself or sharing your own experiences unless it's helpful for them to know they're not alone. Dismissing their feelings or suggesting they should just "get over it" invalidates their experiences and emotions. In addition, avoid giving unsolicited advice or suggesting simple solutions without fully understanding the person's situation. Allow them to make their own decisions about their mental health journey without imposing your opinions or solutions.

Tannya: Being critical or judgmental of what the other person is feeling—instead understand that each person processes emotions differently and on different pace. I would avoid saying "that happens to all of us" "you are dramatic " "just think positive.” Its always important to be mindful of the other person's feelings during difficult times.

 

What role can burnout play in mental health care?

Emily: As a mental health care professional, I cannot provide my clients with the best care possible if I am burnt out and not feeling mentally well. Burnout can lead to emotional exhaustion, making it difficult for providers to maintain empathy and compassion for their clients. Prioritizing provider well-being not only benefits individual mental health care professionals but also enhances the quality of care provided to clients and promotes a more sustainable mental health care system overall.

 

How do you personally avoid burnout—personally and/or professionally? Or what tips can you offer to someone else?

Emily: I prioritize work-life balance by making my time after 5:00pm as meaningful as my 9:00am—5:00pm job. When I leave work, I strive to leave any work concerns behind so I can fulfill my personal needs. To avoid burnout, I remind myself that my job is only a small fraction of my life and identity. Additionally, I regularly speak with my own mental health therapist and incorporate self-care activities into my routine, such as exercise, relaxation techniques, hobbies, and spending time with loved ones when I'm not at work. One tip I can offer to avoid burnout is to establish clear boundaries between work and personal life by avoiding work-related emails or calls outside of designated work times. I also recommend getting enough sleep each night to restore energy and promote mental clarity, as well as seeking support from your support system and/or professional therapist.

Mental Health Month Insights: Angela

To commemorate Mental Health Month, Alliance asked some of our licensed social workers to share their insights and tips for mental health care. Interviewed here is Angela Arias, Director of Care Management, LCSW.

 

This may sound very elementary, but what does mental health actually mean?

Mental health includes our mental, social, and psychological health, and all the events and choices in your life. Think of a triangle. The top of (Maslow’s hierarchy of needs) effects everything above and beneath it.

Maslow’s hierarchy of needs




And how can you or I assess our mental health at a given time?

It’s an everyday thing. It involves checking in with ourselves, to see how we’re feeling about our work, our family, and most importantly, ourselves. Are you feeling like “yourself?”

 

We'll talk in greater depth about creating care plans for folks experiencing serious mental health challenges, but are there any basic "hacks" for helping one's mental health?

There are so many things you and I can do to “reset” and get back to feeling like ourselves. Exercising, being in nature, taking a hot bath. Maybe all of those things sound relaxing and feasible to you, or maybe none do. When my program participants don’t necessarily know what helps them, we brainstorm.

I was working with someone recently who was very depressed. He told me liked to play the card game spades, and I asked him if he thinks he’s happier when he’s playing with his friends. And of course we did a risk assessment, and felt that since he wasn’t playing for money, there was no risk for him to do more of that.

 

So that interaction with friends helped. How can someone build a strong support system?

Close friends or family can be a support system—obviously sometimes you can love someone but being around them can be triggering. So, it’s important to ask yourself: who—if you’re in crisis—who will answer, and listen. I always recommend having multiple people for different things in your support system. Not someone who asks “why would you do that?” but instead “how are you doing”? If friend A is really great at giving advice but not so good at just listening when you need that, can you turn to friend B, or your neighbor, or relative?

I’m amazed at how many people I work with at Alliance list me as an emergency contact, which I think speaks to how we make people feel. We’re not just someone helping them with applications for housing or food assistance, they trust us with their emotional well-being.

 

What are some helpful things a caring friend or relative can do to check in on or support another person’s mental health?

Just being present can go so far. We live in a busy city, in a busy world, in a busy time. Sending a random text. But be present. Don’t initiate a text message if you’re not willing to lend a listening ear. If they tell you they’re having a bad day, don’t go silent on them.

Make plans with someone, if it works for you.

 

And what are things to avoid doing regarding another person’s mental health?

Giving advice, haha. You may think you’re being helpful, but if it’s not asked for, you may not be helping. Sometimes people don’t really listen, they’re just thinking about what they’re going to say next. If you want to give advice, ask permission first, or let them tell you what works for them.

 

What mental health advice is important for people in recovery?

Living with people can be triggering. So getting in spaces that make you feel more in control or even supported can go a long way. As well as being around people who can relate to your situation. Most people find it helpful to be in support groups (that Alliance offers, or elsewhere). They can be inspired by stories from people who seem to have it “worse” off than themselves or just knowing that they are not alone in their journey and that there is indeed, true hope.

 

What mental health advice is important for people in shelters?

Knowing that they are making an attempt at bettering their situation, like motivating them to fill out housing applications. Feeling a sense of accomplishments can be great. And getting them out during the day, because typically being in shelters may not to be too great for one’s mental health.

In today’s age, everyone has a phone, even a lot of people living on the street or in shelters. Helpful podcasts and safe things to read or listen to can be key.

 

Is depression-free always the goal? Many people have chronic depression or mental health disorders, but still have strong mental health regimen. Can you explain how that is?

I feel like there’s never a perfect cure for depression, anxiety, etc. The end goal is management or maintenance. You can learn how to manage it on a daily basis, and some people are naturally good at it while others need a bit more assistance.

Self-care, having a support system in place, and management look different for everyone.

 

What role can burnout play in mental health?

Speaking professionally, burnout looks different for everyone. The important thing is how do you identify when someone’s burning out. In our environment you can see someone working all the time, through lunch. I try to make sure I tell folks that are working so much that they should stop what they’re doing, and go for a walk, get away from their desk. I’m proud of that, gently saying “I noticed you haven’t taken a day off in two months. Do you think you could use one?”

Those are some good ways we can identify stress and prevent burnout.

Someone can be overwhelmed but still “functioning” but when they’re burned out, they’re actually crashing, and you can see it.

 

What are some symptoms of burnout?

Irritability is a symptom of burnout. If you’re getting sick more, or going to the bar more after work, or maybe you’re just going through the motions.

 

How do you personally avoid burnout? Or what tips can you offer to someone else?

Making time for the things I enjoy. In my spare time, I manage my own self-care by making jewelry. I love making jewelry. I make things. Soldering, mixing, and combining metals.

Angela at a market with her jewelry (L), and in her protective smoldering mask (R)

But also, it’s important to not get wrapped up in all of my identities. At work, I know my role as supervisor, but I don’t want to present as a supervisor all the time. I want to be me. And when I’m off work, my friends don’t want a social worker as a friend, they want to laugh and be inappropriate with Angela and have fun.

 

Why did you want to work in this field?

I’m interested in why we behave in certain ways, and most of the time we’re unaware of it. So I’m curious about human behaviors, that’s why I went to social work school. That’s why I got into this, the fascination with the brain.

Being a social worker has made me more self-aware. That’s kind of a generic answer but we are all so “defined” by our identities: sister, partner, mother, colleague....in social work school I was so fixated on my specific identities, and I’d get wrapped up in it. Now I accept I am all of these things in one and I’m okay with that. I don’t have to go into a conversation as “Angela the social worker” or “Angela the sister,” I can be myself, Angela, and not worry about how I’m presenting.  

Alliance CEO Sharen Duke Recognized as a Nonprofit Trailblazer

Our CEO and Executive Director Sharen Duke was recognized as a Nonprofit Trailblazer by City and State. The 2024 Nonprofit Trailblazers list recognizes a diverse group of visionary leaders who are carrying out this critical work at mission-driven nonprofit organizations across New York. The list, presented by City & State and its sister publication New York Nonprofit Media, features social services organization officials, executives of philanthropies and activists at grassroots organizations pushing for legislative change.