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In the very first weeks of my job at The New York Academy of Medicine I barely had time to settle in before I was sent out into New York’s vast network of neighborhoods to conduct focus groups with community members about their health and related needs. It was August and the days were long and hot; the rooms we borrowed from community organizations to gather people together were often small and poorly air-conditioned. Yet people came, sometimes in far greater numbers than we anticipated, in order to share their stories and experiences.

The conversations we had in these community rooms were broad; focused on health, of course, but open enough for people to share their feelings about the issues that mattered to them most. And although mental health was the topic we planned to cover, there were many times when those in the focus groups brought it up before we even had the chance to ask.

The way people talked about stress, anxiety, and depression was striking; the stories they told weren’t often about major depressive disorders or serious mental illness. Rather, they talked about everyday things: how they had watched neighbors flounder under the stress of making rent, suffer from depression when they could not find a job, or felt anxiety when they had trouble feeding their families.  

In Brooklyn one person told us, “Some people can't get jobs, can't feed their kids, like that's pressure and stress. … And when you don't have an outlet or proper resources, you are going to … take a turn for the worse.” Another in the Bronx said, “A lot of people are out of work. ... They want to earn their own way but they look and they look and you know, none of them are qualified. Even ones that are qualified can’t find work and it’s stressful.”

None of this is surprising if you are someone living on a low income in New York City, or if you are a social service or health care provider in one of New York’s low-income communities. But it is notable how people came out to give voice to their lived experiences, choosing to share their stories with a couple of researchers in a hot and crowded room, knowing that this was an opportunity to be heard. Given their trust and generosity, my colleagues and I now feel an obligation to share their stories with the public, with providers, and policy makers in our new report, “Mental Health: Context Matters,” part of the series “City Voices: New Yorkers on Health.” We sincerely hope that those with the power to make change do their part and listen.

The series is part of the Academy’s effort to use research and evaluation to inform policy in ways that will improve the health and well-being of New Yorkers from all walks of life. The rare personal narratives featured in “City Voices: New Yorkers on Health” were taken from an extensive community needs assessment that spans a wide range of health issues, including transgender community health access and disparities, access to physical activity, and the challenges faced by older adults and people who have recently immigrated to the city. The series is part of the work of the Academy’s Institute for Urban Health. Watch for the next installment in January.