My Nerves Are Bad: Puerto Rican Women Managing Mental Illness and HIV Risk

Acknowledgments

xi Acknowledgments This book could not have been written, and the study on which it is based could not have been conducted, without the generous support and encouragement of a multitude of people. First and foremost, it is impossible to convey accurately the debt owed to the women who were the participants in the study and are the personalities portrayed in this volume . Their names, as well as the names of their family members, friends, and providers, have been changed to safeguard their identities and protect their privacy. Street names and specific locations have also been modified. The women welcomed us into their lives, sometimes with enthusiasm and other times with reservations and suspicion, but welcomed us nevertheless . At times, it appeared to require of them an almost herculean effort to get past the paranoia of their mental illness and their fear that we would reject or judge them. A number of the women moved frequently during the course of the study, some to great distances from Cleveland, but, even so, they remained in contact with the study team, resumed participation upon their return, and contributed significantly to what we have learned. Various institutions are to be thanked for their support. The National Institute of Mental Health provided the funding both for this study, R01 MH63016, and for its precursor study, R29 MH58070, which provided the impetus to examine specifically the context of HIV risk among Latinas with severe mental illness. My program officers for each of these grants, Dr. David Stoff and Dr. Willo Pequegnat, respectively, each contributed their enthusiasm and insight to the respective studies. My academic institution , Case Western Reserve University, provided me with the additional resources that made these studies possible. Several individuals, in particular , are to be thanked for their support and vision: Dr. Alfred Rimm, Dr. Nathan Berger, Dr. Ralph Horwitz, Ann Duli, and Edward Bruss. xii “My Nerves Are Bad” Numerous agencies and private individuals participated on our Community Advisory Board, generously sharing their insights with us in matters relating to recruitment for the study, retention of participants, translation of instruments, and the interpretation of data. I list the northeast Ohio advisory board members here, with trepidation that I may have inadvertently omitted a member, and with the knowledge that some of them have since changed their organizational affiliations: Marco Cardona of the Cleveland Department of Health, the late Rev. David Fallon of San Juan Bautista Church, Maribel Garcia of the Cuyahoga County Department of Children and Family Services, Antonia Montijo of the Cleveland Police Department, Katherine O’Brien of the AIDS Taskforce of Greater Cleveland , Nidia Perez of the Center for Families and Children, Rafael Rivera, Jennifer Smith of Recovery Resources, and Luis Vázquez of Casa Alma. Neither the study nor this volume would have been possible without the dedication, insights, and energy of study co-investigators, collaborators, and staff. Dr. Martha Sajatovic provided significant guidance and training to staff members and has collaborated on various papers arising from this study. Nancy Mendez was the best project coordinator imaginable, often “debriefing” the ethnographers to help them process their own responses to the scenes that they had witnessed during the shadowing. The study could not have been possible without ethnographers Jenice Contreras and Ingrid Vargas, who brought their knowledge of northeast Ohio’s Latino communities to the study and connected with the study participants and their family members to earn their trust. Transcription and data analysis were ably performed by Gary Edmunds and Anamaria Tejada, and by Emily Heaphy, who contributed to the statistical analysis for Chapter 8 of this volume. Last, but certainly not least, I owe thanks to my editor, Michael Ames at Vanderbilt University Press. Michael offered excellent suggestions in response to earlier drafts of this volume, waiting patiently for the final version as I sifted through thousands of hours of transcripts to discern and then communicate a meaningful whole. Thanks are also owed to an anonymous reviewer, who provided excellent suggestions and insights. A number of articles focusing on specific aspects of this study have been published in peer-reviewed scientific and health journals: Friedman, S., and Loue, S. (2008). Intimate partner violence among women with severe mental illness. Psychiatric Times, 25(4). Hatters-Friedman, S., and Loue, S. (2007). Incidence and prevalence of intimate Acknowledgments xiii partner violence by and against women with severe mental illness: A review. Journal of Women’s Health, 16(4...