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Faculty Spotlight: Glen Milstein

Colin Powell School for Civic and Global Leadership

Faculty Spotlight: Glen Milstein

Glen Milstein is an associate professor of psychology at the Colin Powell School for Civic and Global Leadership and a licensed clinical psychologist. Dr. Milstein’s research focuses on the intersection of religion and mental health, culture and health, and psychological resilience.

He is known for his work studying the ways clergy and clinicians can work to facilitate care for veterans and other mental health care consumers and for examining interventions to reduce stigma. 

Among his publications, he coauthored A Pastoral Education Guide: Responding to the Mental Health Needs of Multicultural Faith Communities (New York State Office of Mental Health, 2011). In addition to being a thoughtful, dedicated researcher, Milstein is an active writer, community volunteer, and engaging teacher. His courses include “Identity Formation across Cultural Frontiers” and “Prevention Science and Reducing Risks for Mental Disorders.” In this Faculty Spotlight, Milstein talks about the evolution of his work facilitating care for veterans, his interests in cultures, and a recent volunteer project.   Glen Milstein
One of your major areas of research has focused on the role that clergy and clinicians can play to facilitate wellness in the community. Can you talk about the evolution of your research in this area and what you have learned?  
If you are going to look at what it means to get better in the context of mental health, you have to look not just at what happens in a clinical setting, but where people are headed when they leave and what the concept of “home” means for them. For many people, that concept of home includes religion. When I was in the Peace Corps in the Dominican Republic, I worked in a small village that had nine churches, so I saw firsthand how central religion was in people’s lives. I also spent a year in Jerusalem, and religion was certainly central in people’s lives there. It is the organizing principle of many cultures. 
That got me asking what clergy know about helping people with mental health problems. Simultaneously, I was asking what clinicians knew about the role of religion in people’s lives. I was pursuing a Ph.D. in clinical psychology, and at the time, religion was essentially never talked about in my training. 
In 2010, I published a model designed to improve the continuity of mental health care through collaboration between clergy and clinicians that I developed with Amy Manierre, a hospital chaplain. The COPE model focuses on issues of when clergy choose to contact clinicians and when clinicians could contact clergy. I had always known that I wanted to study this model’s validity within the military. There, clergy and clinicians are under one roof, and I was well aware of the rates of suicide, post-traumatic stress disorder, depression, and traumatic brain injury among veterans. I was interested in finding out if the COPE model could be of help in this context. I was invited to be part of a small work team led by two researchers at Duke to do a national survey of military and Veterans Affairs (VA) chaplains. We asked: how could we get Department of Defense chaplains to make mental health referrals to chaplains in the VA, and who would refer veterans to clinicians? The idea was to create an additional path for mental health care. Mental health professionals in the military were often avoided because until a few years ago, you would lose your security clearance if you had a psychiatric referral. 
Since 1996 I have done more than 20 community lectures connecting mental health professionals with community clergy. We were able to have meaningful, wonderful conversations, and I was able to convince people of the idea to have more interaction with one another. But in doing this community outreach work and in working for the Department of Defense, I learned that we’re not going to create a sustainable incentive for clinicians and clergy to regularly be in touch with one another. What we need instead is to encourage clergy to be open to talking informally with clinicians and to making referrals. Clinicians, meanwhile, need to assess for the role of religion in people’s lives. If someone has had a negative experience about religion, that is powerful, and you need the cultural competency to deal with it, and if religion is a positive factor from early in a person’s life, then you’ve got a powerful resource. Importantly, I’ve also learned from psychiatric outpatients that what they want most from clergy is help in reducing the stigma of mental health care.
Recently we brought together three panels of consumers of mental health care along with their clinicians and clergy for a conference in Denver, which I developed with an educator based at a psychiatric clinic there. The consumers told extraordinary stories, and the day showed they needed to present their whole self both to their clinicians and to their congregations. We also learned from the panelists that the job of a congregation is to give a solid welcome to all persons, including those with mental health difficulties. 
In light of your findings regarding the difficulties of formally connecting clergy and clinicians, have you explored other avenues to encourage wellness among service members, veterans, and their families? 
This year I worked on a project to assess self-guided dialogues among service members to facilitate their readjustment at home and in their communities. Vets aren’t talking. The paradigm is the veteran in the basement playing video games with Uncle Jack Daniels by his side. And because of this isolation, many veterans have returned to their houses, but they’re not “home.” 
Through Stephen Clark, the Acting CUNY Director for Veterans Affairs, I met Leslie Robinson, a clinician and entrepreneur, who created an interactive dialogue program to facilitate talking about one’s military experiences, first with fellow service members or veterans, then with friends and family. Warrior Spirit/Mission Homefront is based on a deck of cards with questions. Some are funny and some are more serious. Veterans start out talking in small groups of four, which is ideal because infantry are organized in four-person “fireteams.” 
We partnered to study the program’s efficacy and piloted a questionnaire with veterans at City College in the summer of 2013. Our team then took the study to four different bases and had nearly 300 personnel take the 80-question survey. It included a “mental health wellness” measure, a “social involvement” measure, and a “willingness to talk to others” measure. They did the activity for 45 minutes and then answered additional questions. In our preliminary paper, which is scheduled be published in the journal Psychiatric Services in March, I describe how the sound of the room changed once service members began playing the game. I saw them laughing and I saw them become reflective. I watched their emotions fly, and saw that the process was working.
Now we are looking at the data in more detail. What we know is that answering the funny questions made service members more comfortable about answering the serious questions, and the dialogue made them feel more open about talking about other issues. The data also appear to show the importance of getting people to talk among themselves. The clergy may or may not be part of this. The last part of the article talks about how the job of the clinicians is to put people back to their families and communities in a healthy way. That’s my work with the veterans.     
Beyond your work with veterans, you also look at concepts of immigration from the broader perspective of culture. What has motivated this work?   
The next large area of research for me is asking, fundamentally, what is culture? When I arrived at City College 14 years ago, our Chair, Brett Silverstein, asked me to create a course looking at immigration from the perspective of psychology. I’ve always liked Erik Erikson’s ideas of stages of development, and it hit me that when you immigrate there is a developmental disruption from the place where you grew up. All of the things you’ve learned, you’ve learned to thrive in that place. How do you make it in the new place? This led me to concept of “Culture Ontogeny,” which is the process by which, through interpersonal relationships, the abstract ideas that comprise our culture become material in the neurophysiology of the developing human brain. Two years ago, through a Mellon fellowship, I began exploring this concept. This semester I have a fellowship with the CUNY Dominican Studies Institute to explore that idea in the context of immigrants from the Dominican Republic. 
You recently worked on a community project that links ideas of community, culture, and diversity. Can you tell us about the project and how it connects to your work, past and present?
One day I was walking up 138th Street between Broadway and Amsterdam. I saw a large mural on the eastern wall of the Schiff ball field —the Harlem Peace Wall—which was produced by CITYarts, and designed by the artist Peter Sis. The wall shows 84 individual faces with symbols interspersed among them. In the middle is a face with arms stretching to either side of the 200-foot wall. The mosaic ingeniously creates an image that says we are incredibly diverse, and one species. I contacted CITYarts—the mosaic was having problems—and asked if they could help fix it. Last fall, we organized students and professors and staff of City College who teamed with CITYarts, members of the community, and volunteers from the Allianz Foundation for North America and Davler Media to repair the wall. CITYArts asked me to speak. I pointed out that above the mosaic you could see City College, a place where we have students from 106 countries speaking over 100 languages. We live this extraordinary diversity every day. And the long embrace of the mural speaks to this diversity and to our common humanity. So I see my previous work as trying to help people come home from different types of suffering. I see my job now as helping to show how many kinds of homes there are, and how little we need to be threatened by how many different types of homes there are and will be.