Understanding the Psychology of Place in Community Health
By Susan A. Messina
Mindy Thompson Fullilove '71
Photo by: Rodrick Wallace
While earning her master’s and medical degrees at Columbia University, Mindy Thompson Fullilove ’71 became critical of the physician’s traditional biomedical approach to patients. “The problem,” she explains, “is that you are not there to listen to a patient’s life, but to drive the conversation to rule in or out an illness. Doctors instantly focus on symptoms; I wanted to hear stories.” By listening to the stories of poor, urban African Americans, Fullilove has built a wide-ranging career that explores the effects of HIV/AIDS, urban renewal and violence on impoverished communities.
Treating the Community
Currently a research scientist at the New York State Psychiatric Institute and a professor of clinical psychiatry and public health at Columbia, Fullilove began her career as a community psychiatrist after completing her training at New York Hospital-Westchester Division (1978-1981) and Montefiore Hospital (1981-82). “When I came out of training, my vision was very broad,” Fullilove recalls. “In my view, community psychiatrists take care of the whole community, trying to make a community feel better.” Later, community psychiatry began focusing primarily on providing services for the severely mentally ill who were being deinstitutionalized, and Fullilove began to look for new opportunities.
By the mid-1980s, the HIV/AIDS epidemic was beginning to have a devastating impact on inner-city communities. Fullilove joined the Center for AIDS Prevention Studies at the University of California, San Francisco, in 1986 and returned to New York in 1990. Together with her husband Robert, associate dean for community and minority affairs and professor of clinical sociomedical sciences at Columbia ’s Mailman School of Public Health, she pioneered studies of HIV/AIDS and other major health problems in urban black communities. The Fulliloves have published more than 100 articles in leading journals, such as the American Journal of Public Health and JAMA — Journal of the American Medical Association; their research was recently chronicled in The Secret Epidemic: The Story of AIDS and Black America (Pantheon, 2004).
Psychology of Place
Fullilove’s research on the impact of HIV/AIDS spurred her interest in the “psychology of place” — how social communities are formed and sustained within an urban environment, and how those communities are affected by upheaval and displacement. As co-directors of the Community Research Group of the New York State Psychiatric Institute and Columbia’s Mailman School of Public Health, they lead a team of researchers examining the links between the structure of cities and physical and mental health. In particular, she and her husband have investigated the effects of federal urban renewal programs on business and residential communities in depressed urban areas.
Their research in Newark, N.J., Pittsburgh, and Roanoke, Va., formed the basis of Fullilove’s latest book, Root Shock: How Tearing Up City Neighborhoods Hurts America and What We Can Do About It (Ballantine, 2004). In the book’s introduction, Fullilove states, “I wanted to understand displacement through the words of the people who suffered it…. Between 1995 and 2003, I logged thousands of air miles, walked hundreds of city streets, examined archives, collected photographs and talked to people who had stories to tell.” Her work provides a compelling look at the lingering effects — on individuals, families, cities and regions — of the destruction of solidly established urban neighborhoods and the displacement of the social, familial and spiritual contexts that support these communities.
In 2001, Fullilove co-founded NYC RECOVERS, a coalition of 1,000 organizations spanning five boroughs of New York City that was dedicated to the social and emotional recovery of residents in the aftermath of the terrorist attacks of Sept. 11. “The loss of even one building is important to the block where it is located, and the loss of one block affects the entire neighborhood surrounding it,” Fulliove notes. “The loss of the World Trade Center block on 9/11 affected the world, not just New York.” For two years, the coalition advised hundreds of organizations on how best to help their constituents acknowledge, cope with and honor their feelings of profound loss.
While at Bryn Mawr, Fullilove was able to study with Herbert Aptheker, a visiting lecturer in history, whom she credits as one of the major intellectual forces in her life. “All of Root Shock comes essentially from what I learned in my classes with him,” Fullilove states.
An internationally known American Marxist historian, Aptheker was a pioneering scholar of black history. Because of his longstanding membership in the Communist Party, Aptheker was unable to obtain an academic position during the McCarthy and Cold War eras. His temporary appointment at Bryn Mawr was due largely to the activism of Fullilove and other students to establish a black-studies program at the College.
“I was also deeply influenced by President Katharine McBride, who negotiated with us very respectfully throughout our protests,” Fullilove recalls. “She understood our position — and wasn’t afraid to hire a Communist!”
Susan A. Messina ’86, M.S.S. ’90, M.L.S.P. ’91, writes on health and human services issues.