‘Alternative Methods for Alternative People’: Facilitated Community Music activities within an alternative healthcare model
Contributing Authors
Nathan Stretch
Niki Kazemzadeh
Abstract
This project describes an innovative, compassionate and practical response to the extensively marginalized in our community (Waterloo Region, Canada): people who would be considered tri-morbid — acutely ill or injured, traumatized and using drugs. The institutionalized medical system has not been able to respond adequately to the emerging needs of this community, and a grass-roots response is underway. Water Street House is located at 115 Water St., Kitchener, Ontario, near the food resource, street outreach, and emergent medical hub of St. John’s Kitchen. Community Music activities will be embedded in the foundation of the alternative medical response integrated into the Water Street House project. The Working Centre (lead organization) and its partners in the Inner-City Health Alliance prioritize barrier-free access to care. Community music activities will further collapse the perceived hierarchy upheld by the established medical system by creating opportunities for community music-making that includes healthcare professionals, support workers, and patients. The need for a practical, meaningful intervention that emphasizes spirit and community is a necessary one, both for the increasingly marginalized of our community and the overwhelmed community healthcare workers that are responding to this crisis.
Hyperlink
‘Alternative Methods for Alternative People’: Facilitated Community Music activities within an alternative healthcare model, Pecha Kucha presentation: https://www.youtube.com/watch?v=j10d3LI1YFU
Keywords
Healthcare, relationships, addiction, reciprocity
Update: 2021-04-20
Water Street house has fulfilled its mandate of housing and responding to the most precarious people in our community. Not only are residents tri-morbid, they are also deeply traumatized and heart-wrenchingly young. Most participants are male with extensive criminal records and fraught relationships with local care, healthcare and justice systems. Community Music activities are sporadic at Water Street House — most residents are caught in the craving/acquisition/use/withdrawal cycle of opioid use: a dangerous cycle made increasingly deadly by the pervasive COVID-19 pandemic. There is little time available outside of this cycle for residents to pursue community and artistic endeavours as a group or on their own. With this reality in mind, The Working Centre and its partners were thrilled when their Safer Supply project — an opioid replacement strategy — received funding. In a timely and complementary report by the Waterloo Region Crime Prevention Council, we see that participants in the study were overwhelmingly supportive of a Safer Supply project. They articulated the effect it might have on their lives as drug-using individuals — including freedom from the cycle of use and procurement. Participants started to look ahead — dreaming about the wrap-around supports community organizations could provide to people who suddenly had time to spend: peer support, lobby, art, music and therapy groups were amongst the activities proposed (WRCPC, 2019).
Water Street House residents continuously support our preliminary findings: participants subscribe to some form of artistic practice — the current group at Water Street overwhelmingly identify as hip-hop practitioners. With this in mind, we engaged with Community Music students at Laurier University who developed facilitated CM activities that responded to the space, needs, profile, and interests of Water Street residents. We look forward to the future where the confluence of safer supply, community music activities, new community partnerships, and the end of the COVID-19 pandemic conspires to improve the lives of the people in our shared community.
Provocations:
Can community music activities realistically contribute to the healing journey of the most complex and marginalized in our communities? Why or why not?
What might hold a CM practitioner back from engaging in CM activities with the group described in this presentation? Are these barriers a result of personal bias, communal biases, risk aversion, imposter syndrome, practical set-backs, or other factors?
Take a moment — a contemplative pause if you will — to reflect on your own comfort level should you be approached to engage in CM with marginalized peoples: how might a practitioner overcome barriers to facilitation in order to contribute meaningfully within the community described?
Is community music a useful lens through which to consider the opioid crisis — wherein practical solutions for increased isolation, dislocation, and drug-use are being solicited? Do CM practices and philosophy contribute meaningfully where other pervasive crises are concerned: the COVID-19 pandemic? The global climate crisis? Indigenous reconciliation and colonial trauma?
Script:
Alternative Methods for Alternative People: Facilitated Community Music Activities Within an Alternative Healthcare Model
By Nathan Stretch and Niki Kazemzadeh
Nathan and I would like to acknowledge that the land on which we live and work on is land traditionally cared for by the Haudenosaunee. Anishinabe, and Neutral peoples. Kitchener/Waterloo is located on land bound by a treaty known as the Haldeman Treaty of 1784. We acknowledge that it is largely because of this broken treaty that Nathan and I are able to live and work here on this land.
Hi, my name is Nathan Stretch. I live in Kitchener, Ontario, Canada where I work at an innovative community-building organization called the Working Center. As a musician and community- builder in Waterloo Region, I'm obviously interested in the intersection of Community Music and the population I work with.
My name is Niki Kazemzadeh. I'm an elementary music teacher in Waterloo, Ontario, Canada. Nathan and I were in the same cohort of the Masters of Community Music class of 2019. This project emerged from a hypothesis developed as part of coursework during our program.
The Water Street House project emerged as a result of the Working Center responding in new and practical ways to work with the extensively marginalised in our community — people who would be considered tri-morbid: acutely ill, traumatized, and using drugs. The goal of Water Street is a place of inclusion, welcome and support. It'll be a place of rest where people can access harm reduction supports, primary health care and a relationship based approach to mental health and addiction supports.
Our response is practically housed at 115 Water Street, Kitchener, Ontario near the food security and emergent medical hub of St. John's Kitchen. Community Music activities will be embedded in the foundation of an alternative medical response here.
You know: alternative methods for alternative people.
There will be three beds for police drop-off, three beds that align to hospital care for those using injectable drugs unable to stay in hospital for treatment, and three respite or rest beds.
The house will offer meals showers and a relationship based model of service for those unable to access mainstream supports. It will have a common space and provide integrated housing and respite opportunities, washrooms, showers and laundry. There will be space for harm-reduction, primary health-care, Mental Health and Addiction supports. Peers with lived experience will be incorporated into the house along with groups and activities that support healing such as: CBT groups; drums, teaching, sharing and music circles.
The Working Center and its partners in the Inner-City Health Alliance prioritize barrier free access to care. Community Music activities will further collapse the perceived hierarchy upheld by the established medical system by creating opportunities for community music making that includes health care professionals, support workers and patients.
Niki and I interviewed people who are or were considered tri-morbid and community workers who work closely with this population. We thought the need for a practical meaningful intervention that emphasizes spirit and community was a necessary one both for the increasingly marginalized of our community, and the overwhelmed community healthcare workers responding to crises.
Here are our hypotheses:
Community Music activities are therapeutic.
People accessing alternative forms of health care would value participatory music activities.
Alternative healthcare settings would welcome having community music facilitation on-site as part of a circle of support.
Both participants and staff would enjoy and benefit from participatory music experiences.
Following a series of interviews with invested parties including potential patients, housing and healthcare support workers, and community partners where we shared our hypotheses, we found overwhelming enthusiasm and support for Community Music activities within emerging alternative healthcare projects. The need for Community Music activities was so desperate that one support worker said “We need this now; we can't wait”.
Potential participants — both workers and patients — consistently identified creativity and songwriting as essential components of the proposed Community Music activities, and planning is based upon a discovered commonality: an active or latent musical practice amongst most potential participants combined with a dire lack of meaningful activities for precarious peoples to take-part in inside or outside of care models.
Higgins and Willingham (2017) describe fundamental principles of Community Music activities. When examining the Tree of Life — a visual representation of the core principles and influences of the Working Center as well as their practical applications — a significant amount of overlap was obvious. This alignment suggests an authentic and fruitful relationship between the philosophies in reality.
When we submitted this proposal in November 2019 construction was ongoing on the Water Street building, and today the construction is complete. In fact, 14 people have been hired and are in the process of being trained to host Water Street house: an alternative health care model that is emerging with Community Music concepts and principles in the mix. A room has been designated as the group room and has been constructed to isolate sound from the rest of the building while creating a hospitable environment for music-making that includes a living wall and plenty of natural light.
Community Music workshops, practices and principles are being woven overtly and obliquely into the foundation of this project as staff develop the operating philosophy together with Community Music in mind.
Medical, relational, musical and social interventions are overlapping in Water Street house as our community works together to meet the extraordinary need of people living on the liminal edge
References:
J. Mancini & S. Mancini. (2015). Transition to Common Work: Building Community at the Working Centre. Waterloo, ON: Wilfrid Laurier University Press
Higgins, L. & Willingham, L. (2017). Engaging in Community Music. New York, NY: Routledge.
Macpherson, A. et al (2012). Tree of Life. The Working Centre. https://www.theworkingcentre.org/tree-life/657
Waterloo Region Crime Prevention Council (2019). Focus On: Safe Supply. Findings From Focus Groups With People Who Use Unregulated Drugs. Waterloo Region Crime Prevention Council https://preventingcrime.ca/wp-content/uploads/2021/04/WRCPC_FocusOn_Safe_Supply_Report.pdf
