General Statement of Needs
During the 35 years of Unitas’ operation, a large number of Polish alcoholics were in the clinic. There is no other place in New York City, not even in the entire estate area that is able to serve the needs of this particular population. In addition, a majority of the Polish psychiatric patients treated in Unitas have dual diagnoses: psychiatric and alcoholic/substance.
Among the Polish and Ukrainian residents of the New York Metropolitan area, the most neglected are the services for the family of alcoholics, services for alcoholic women, service for alcohol and substance-abusing youth, as well as services for geriatric alcoholics.
The majority of Polish and Ukrainian immigrants to New York State live in the five boroughs of New York City and their vicinities. According to the estimation of Polishâ€‘Slavic Center, Brooklyn, NY, there are about 500,000 Polish residents in New York City and its suburbs, and about 60% of them are Polish-born. In New York City and its vicinities, there are approximately 40 Polish parishes of various denominations, but predominantly Catholic which often refer to alcoholic families to Unitas.
The Lower East Side, as well as the five boroughs of New York City, has a considerable Slavic population including Ukrainian, Slovak, Russian, Serboâ€‘Croatian, and Czech. Unitas is the only mental health outpatient clinic in this area with a special program to serve this population. There are some psychiatrists who speak various Slavic languages, but the treatment they provide is limited to office visits which usually consist of medication. Other established substance/alcohol clinics or hospital centers cannot reach this population because of the language and cultural barriers. These Slavic groups need a considerable amount of psychiatric and alcohol services which till the opening of Unitas were not available to them.
SPECIFIC NEEDS OF THE POLISH POPULATION IN NEW YORK CITY AND ITS VICINITY HISTORIC PERSPECTIVE
In 1987, The New York State Office of Mental Health conducted a survey of needs for culturally appropriate mental health services which were revised and published in March of 1988 in the three-part edition entitled “Mental Health Needs of Refugees in New York State.” This document estimated that 8,787 refugees from Eastern Europe settled in New York State between January 1, 1979, and June 30, 1987. Out of this number, the Poles constituted 3905 or nearly 45%. Thousands emigrated during the last three years and settled in the New York Metropolitan area. The attraction of New York, likewise, is generating secondary immigration. Those people who came into different regions immigrated to the great city centers for a better job as well as cultural opportunity. The same publication reports that 13.6% of Eastern Europeans in New York State had mental health problems.
This report, however, did not take into account alcoholism and substance abuse which is one of the most devastating physical and mental problems in the Polish and Slavic community.
Prevalence of Chronic Alcoholics in Slavic Population
Chronic substance addiction could be defined as causing problems when it interferes with work, family, and daily living. An informal survey done by the Polish Psychiatric Association estimated that more than 11 percent of an adult population was affected by alcoholism in Poland.
In terms of an absolute number, even the most conservative estimate, would be about 20,000 Polish alcoholics who remain without proper treatment in the New York Metropolitan area.
Specific Problems of the Target Population
The religious and the social life of these immigrants were, and still are, traditionally centered on the Polish Catholic parishes. The majority of them can communicate in English to satisfy their daily needs; however, their ability to speak effectively is insufficient. The old immigrants could not learn English because they were uneducated laborers, often illiterate in their native language, living in ethnic ghettos. The new immigrants simply did not have enough time or opportunity to acquire good language skills. Naturally, their children, educated in US schools, do not differ in their language skills from American children, and they would not need special, ethnically oriented facilities. However, the old and the recent immigrants, due to their historical background and lack of proper communicative skills urgently need an alcohol clinic oriented to their needs.
It is a well-known fact that so-called low economic classes experience more alcohol, mental, and other health problems than the middle and upper economic classes. This situation is not different within the Polish low economic class. However, the number of Polish people treated in local alcohol substance abuse clinics is negligible. This fact could be explained, in part, by their specific historical and political background. They were conditioned throughout the last 200 years not to trust “outsiders.” They were consciously and deliberately trained to be distrustful, cautious, and very careful in dealing with “others.” They are afraid to be betrayed or ridiculed by “strange agents.”
For most of these people, English-speaking counselors are “outsiders” not being trusted? This distrust is so deeply ingrained in the psyche of Polish peasants that some would not even consider depositing their money in the banks. English for many is an insurmountable barrier. There are some older immigrants who have lived for more than 50 years in this country and still do not communicate in English. Even if they do, their English is poor, just enough for shopping and daily routines but, not for discussion or the free exchange of ideas. These people live in clusters around their churches and gravitate to neighborhoods saturated with Polish immigrants. They live in virtual ghettos, separated from the mainstream of American life by the impenetrable wall â€‘ English. They are segregated, often poor, and unable to mix in the American melting pot.
The most recent immigrants, though more educated, are the most disadvantaged of them all. They were brought up under totalitarian government, totally alien to them, imposed by the Russian communists at the end of WWII. They despise the system, fight it, and avoid its representatives as much as they could. Back in Poland, their families, neighbors, and the church, through the years conditioned them not to trust the government. Their whole survival strategies were based on the development of means to circumvent the “state.” When eventually they came to the USA, logically and on the conscious level they “knew” that there is freedom in this country. However, they were not able to throw away all the psychological ballast and conditioning acquired in the past. Often they live in poor neighborhoods, where street crimes are rather high. So the fear of the government from the past is transformed into the fear of the society they live in. Add to these different races, strange languages, and customs, and the former paranoia toward social institutions returns in its full strength. Although most of the new immigrants are very proud of being “Americans,” they have difficulty trusting anything that is not Polish.
Considering this background and poor English proficiency, one can easily perceive how difficult it is for them to go for help to a “Nonâ€‘Pole.” They would rather suffer than to seek help from somebody who “could laugh at them.”
Chemical Dependence treatment demands trust and understanding. In all therapeutic contacts, a lack of trust is the biggest hindrance to a psychotherapist. This is why the alcohol/psychiatric clinic for this population is more important than any other health establishments. For physical illness, they can always go to a local hospital or a clinic, but, for social, psychiatric, and alcoholic illnesses, the situation is not that simple. The most important elements are language, communication and trust.
COMMUNITY VIEW ON THE NEED FOR AN ALCOHOLISM TREATMENT CENTER FOR THE SLAVIC POPULATION IN NEW YORK CITY
The need for an alcohol treatment clinic became apparent to the health professional at Unitas immediately after it was opened. Lack of funds prevented Unitas from opening an alcohol treatment program earlier. Further, the Polishâ€‘Slavic Society continuously pointed out to Unitas how much an alcohol treatment program is needed for Polish speaking clients. The Polish Slavic Society in conjunction with Polish and Ukrainian churches expressed this need to Dr. Roman Pabis and his associates. They indicated that none of the existing agencies had attempted to develop a full-scale program for the treatment of chemical dependence with the needs of the East European population in mind. In various meetings, a number of leaders of the Slavic population in New York City indicated the urgent need for a mental health clinic oriented toward the mentality, culture, and language problems of Slavic people. They strongly underlined a severe shortage of professionals who speak Slavic languages. In the whole metropolitan area, there is not a single alcohol program where Slavic people could be helped in a meaningful manner, where they could understand, and where they could feel comfortable.
Reverend Michael Zembrzuski, a widely known leader of the Polish Community has underlined that there was no resource to refer alcoholics, especially deteriorated older ones and young immigrants. He wrote in his letter . . . “behind these words will be my effective help, as much as is possible in my situation, toward creating and maintaining this institution.” Henry Bielawski, the treasurer of the Polishâ€‘Slavic Credit Union, Brooklyn, further pointed out . . . “our engagement in the social work of different aspects amongst old and new immigrants of people from Eastern Europe shows us how much such a program is needed for these tens of thousands of people who, unfortunately, are so neglected in this land of the free.”
The New York State Senator, Thomas Bartosiewicz, on Jan. 14, 1983, wrote to Dr. Prevost, Commissioner of Mental Health in New York State, “I can tell you from firsthand experience that many people of Eastern European background are discouraged from seeking help provided by government agencies because of language difficulties. I have no doubt that this situation also exists in the area of mental health and would certainly recommend that a facility sensitive to their language problem should be available to serve them. I am, therefore, requesting that you favorably consider the proposal of Dr. Roman Pabis to establish a mental health center.”
The founder of Nowy Dziennik (Polish Daily News), Mr. Marian Sawicki, wrote to the attention of the commissioner of Mental Health: “For more than 30 years, I have been involved in various services to the Slavic American communities in New York; I am fully aware of basic lack of Alcohol Care for Slavicâ€‘Americans.”
The President of the Ukrainian National Association in his letter to Dr. Pabis: “The urgent need for such services by the inhabitants of the Lower East Side is undeniable. It is our hope that such an application will receive favorable consideration.”
Father Emil Altmajer, the President of the Polish Credit Union in Greenpoint, Brooklyn who has worked in the Polishâ€‘Slavic Center for more than ten years, wrote to Dr. Pabis . . . “I am overwhelmed by the need for alcohol treatment especially for the old Polish people and the recent immigrants from Poland. I tried to refer a considerable number of highly disturbed alcoholics to local professionals and hospitals but besides emergency services, they could not offer any program due to the inability to communicate and because our people would not go to the government or nonâ€‘Polish institutions. This is a tragic situation. Is there anything that could be done to alleviate this problem?”
RECAPITULATION OF THE NEEDS FOR THE PROGRAM
We believe that the establishment of an alcohol treatment program which is clearly linked to the Polishâ€‘Slavic and Ukrainian Communities will have the credibility necessary to reach the members of these communities. These services would initially draw its clientele from the extensive referral network which has already been well established from both the Lower East Side and the surrounding metropolitan area.
Applying the above information to our proposal, it is evident that the need for the services we propose is overwhelming and clearly perceived by the Slavic Community leaders. The East European and Slavic populations are the most neglected clients in the chemical dependence and mental health care system. We feel there is a strong need for the services we offer among the indigenous and immigrant populations. The existing Slavicâ€‘Polish Center, the parishes with their support services, and the Polish Army Veteran’s Association currently provide social support for many seniors, but they lack the professional psychological and psychiatric capabilities to provide the extended services of an alcohol program for whole families.
In addition, it is evident that early treatment and intervention with chronic alcoholics will save tremendous resources in the long run. Alcoholics, left untreated, may develop a variety of serious medical problems, destroy their family, often become aggressive and hostile which may lead to incarceration, and finally when driving becomes dangerous to others. In short, alcoholics are a social liability that costs everyone something. If at all possible, early treatment can prevent some of these individuals from becoming more serious liabilities and instead return them to productive lives in their community. The proposed program will be the first step in creating a realistic alternative for the treatment of these alcoholics.
In order to meet the needs of these people, we propose an alcohol treatment center with an extended combination of psychiatric support, meaningful socialization activities, and planned vocational rehabilitation. We are convinced that such a program will work if the clients receive support in a socially and culturally meaningful way for an extended period of time.
These services will be offered to the alcoholics who come from both indigenous as well as ethnic groups. The attempt to meet the needs of the special ethnic groups in this area will fulfill long-standing, unmet requirements for these services (1990â€‘1991 Update to the New York City Five Year Comprehensive Plan for Alcoholism Services 1989â€‘1994, June 19.