The Grady Nia Project offers culturally competent care to low-income, abused African American women who have attempted suicide. The program combines an evidence-based empowerment group intervention, along with access to a full range of support (suicide, domestic violence, spirituality, interpersonal, parenting) and skills-based (dialectical behavior therapy, acceptance and commitment therapy, compassion based meditation, seeking safety) group, individual therapy, and family therapies. The women are assisted in securing health and behavioral health care, as well as financial, legal, educational, and childcare resources. The program’s overarching goal is to assist women in leading violence-free lives so they are no longer being abused and no longer feel suicidal. In addition, the program is designed to help women feel more self-efficacious so that they have less psychological distress, feel more capable of securing requisite resources, have more positive social relationships, and are more able to be productively involved in their communities including becoming gainfully employed. Outcome evaluation data demonstrate that women who participate in the Grady Nia Project are extremely satisfied with the services; feel less suicidal, depressed, and hopeless; experience less intimate partner violence; have more positive self-esteem, better coping, and greater meaning in their life; and are more likely to become employed.
The Grady Nia Project is the only program designed for this high-risk population, who have limited access to quality services. The program’s cultural competence, the fact it is designed and implemented with the assistance of a Community Advisory Board, and the attention to resource attainment along with the provision of psychosocial care, makes it an innovative undertaking. Our networking with the community enables us to offer the women opportunities that they have never had, such as attending a professional orchestra concert or spending the day at the botanical gardens with a meditation and food provided. Another creative element of the program is our fund raising efforts including clothing drives, Christmas provided by “Santa Nia”, partnering with Miss Spelman and receiving contributions from Spelman College students, and wrapping books for the holidays at local book stores while simultaneously educating the public about intimate partner violence and suicide.
Dr. Nadine Kaslow, President-Elect of the American Psychological Association and a national expert in suicide and family violence, leads the team and is known affectionately as “Mother Nia.” The leadership team is comprised of diverse mental health professionals, community members (e.g., Chief of Police, clergy, attorneys, leaders of relevant community organizations), and current and former participants. This leadership team provides the best in the field with regard to community-based participatory clinical-research and practice. This team prioritizes disseminating program findings in professional and lay publications, at conferences, and through community talks. They consult to behavioral healthcare systems interested in utilizing the program. Recently team members won a national $50,000 prize through the Substance Abuse and Mental Health Services Administration for ReliefLink, a suicide prevention app. They are partnering with local cellular companies to provide smart phones for program participants who cannot otherwise afford the technology needed to utilize this app.
This team has built an infrastructure that facilitates sustainability, as evidenced by the close to 20 year duration of the project. This includes incorporating trainees at all levels of development, volunteers, and paid staff. The program is a popular practicum site for local graduate and undergraduate students. We have creatively applied for and secured research and community funding to sustain the project’s multiple components. Our annual fundraiser helps ensure program sustainability and our donors contribute to innovative elements of the program, such as funds to support attendance at educational/vocational programs for Nia participants. Moreover, there is considerable leadership and administrative support for the program through Grady Health System and Emory University School of Medicine, as it is considered a flagship program given all the awards that have been granted to Dr. Kaslow and the Nia Project. However, additional resources are needed to grow the program.
The empowerment-based group intervention has a flexible treatment manual, which allows for its replication both at Grady Hospital and at other organizations that implement the program. We share this manual and its associated materials for free with any party who requests them. Measures of treatment fidelity are performed, which help to ensure that the manual is adhered to appropriately, which in turn supports the intervention’s replicability. A protocol detailing the other therapeutic services and resources associated with the Grady Nia Project and the 24-hour on-call system ensure the replicability of the other components. Some of the other therapeutic services offered to the women involve evidence-based protocols, such as dialectical behavior therapy, which facilitates the replication of these additional services.
Based in a clinical-research tradition, the Grady Nia Project assesses women’s psychological functioning and quality of life before the program, at the completion of the 10-week empowerment group intervention, and every 6 months after that time to determine its effectiveness. This assessment involves a comprehensive battery of reliable, valid, and culturally relevant measures and diagnostic interviews. Treatment outcome data are published in relevant and high-impact empirical journals. Key findings are highlighted in our quarterly Nia Newsletter and are presented in a fashion that is understandable to participants, the lay public, and a professional audience. Major findings include the fact that the intervention is helpful in reducing suicidality, ameliorating psychological symptoms such as depression, promoting resilience, improving coping, and supporting individuals in leading more violence-free lives. The intervention is superior to standard care on virtually all outcome variables. There is ongoing evaluation of treatment outcomes.