EP25 Working with Incarcerated Individuals with Siddharth Raich

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I AM GPH EP25 Working with Incarcerated Individuals with Siddharth Raich

EP25 Working with Incarcerated Individuals with Siddharth Raich

Deborah Onakomaiya: Hey guys and welcome to another episode of I AM GPH. I am your host, Deborah Onakomaiya. On the show today, we have Siddharth Raich who is a graduate from NYU. He graduated in 2017 with an MPH in Epidemiology. Currently, Siddharth, is the Education and Research Director at the Center for Health Justice in downtown Los Angeles. He supervises health educators that teach topics such as life skills, harm reduction, substance abuse, and anger management to incarcerated and recently released individuals. He's also involved in data management, evaluation and grant writing to serve these populations. Let's go to our conversation with him. Thank you so much, Siddharth, for coming on our show today, it's so awesome to have you on.

Siddharth Raich: Definitely. It's my pleasure. It's my pleasure.

Deborah Onakomaiya: Yeah. So you are the Education and Research Director at the Center for Health Justice and you're also an alumni of NYU. Can you tell us a little bit about the current work you do?

Siddharth Raich: Yeah, certainly. So, as a Research and Education Director at the Center for Health Justice, I'm in charge of supervision for all the health educators. That's part A of the position. I essentially devise the curriculum, I edit and I update the curriculum that they go ahead and go teach inside within locked facilities to incarcerated individuals as well as individuals that have been recently released from incarceration, so that's essentially part A of my job. Part B is a lot of grant writing as well as a lot of statistical analysis of the data that we collect. So the populations that we work with, I want to give you a brief background about it, they're some of the most underserved population groups that exist. Everything that happens on the outside, any sort of outbreak, for example the Hep A outbreak happened recently in Southern California, it happened first inside within locked facilities, and then it hit the outside. Every sort of noncommunicable disease, heart disease, obesity, high blood pressure, everything, all of that is prevalent on a greater degree inside within locked facilities than even on the outside. That's some of the most underserved and the first hit population that we work with. So at Center for Health Justice, we essentially work with... inside men's central jail inside women's jail as well as juvenile hall as well, so we work with youth between the ages of... Some are as young as nine years old inside, to 17.

Deborah Onakomaiya: Oh, that's really amazing. You're working with incarcerated individuals, are you... Do you work one-on-one with them or you're more in a more administrative role? Can you give us a little more detail than that though?

Siddharth Raich: Yeah, definitely. I'm in more of an administrative role, so essentially I supervise the health educators that go inside directly themselves. They're cleared essentially to go inside, they had to do an extensive LifeScan. I had to sign off on all of their curriculum, all the background. So, they essentially go inside and they do both group facilitation, where they'll have a classroom... well there's not technically a classroom inside, but they're a kind of makeshift room where they hold classes for the inmates essentially. So our health educators go inside and they do group facilitation in that, and then the sizes range from maybe from four people to sometimes as big as 26, and then they also do individuals. So if they see a client that really needs help or it's kind of uncomfortable speaking about themselves in a group setting, for example, a lot of the topics are sensitive, they're about sexual orientation, they're about gender identity, and inside is kind of a hostile environment oftentimes for many of those individuals, because there is the threat of getting beaten up or even killed for their sexual orientation. There are some sensitive matters that they're not comfortable talking in a group setting with, so they'll meet with the educators one-on-one and the counselors, and then they'll have an in depth session with them as well. So we do a little bit of both.

Deborah Onakomaiya: Wow, that's so amazing. Are these individuals in maximum security facilities or minimum security facilities? Or are these individuals who are... I'm just trying to see the level of risk involved.

Siddharth Raich: Right, right. So it kind of... it ranges. It ranges. Well the maximum security individuals aren't allowed to interact with a lot of the outside visitors that come in, but we have all the range from low to mid level. We have a couple of people that are in there for minor felonies and one or two felonies, and then we have a couple of people in there that are in there for multiple felonies, and then we also have some AB 109's in there, which are the people that are serving essentially very long sentences, almost life sentences, so we also work with those individuals as well.

Deborah Onakomaiya: Wow. That's really very interesting. These health educators, that are guiding and leading, are these people... Have they been in the field for five years, or are they experienced? What are the type of people that are going in to interact with these individuals?

Siddharth Raich: Right, right. We always like to have a diverse staff. We have individuals that often reflect the population, because the population on the inside is typically minority population, so Black and Hispanic individuals, essentially, so we hire educators that will reflect that population. Then we also have educators that have been in that population, so we also have previously incarcerated individuals who know what it's like on the inside, who know the rituals that go on on the inside. So we also have some individuals with a history of incarceration.

Deborah Onakomaiya: As an alumni of NYU, how were you able to get this job? Were there any useful NYU resources you used? How did you get connected to this type of work?

Siddharth Raich: Definitely. I was moving out here to Los Angeles... I knew I was after graduation because I have family out here and that attend UCLA and other institutions as well, so I knew I was coming out to Los Angeles. So when I went to the resume services at NYU, they were very helpful. They were able to tell me how to cater my expertise and my education towards, essentially, the field in Los Angeles. So I definitely used the resume building services and I found those to be very helpful.

Deborah Onakomaiya: What did you study while you were at NYU? What skills did you gain? What classes were really helpful to you?

Siddharth Raich: Yeah, definitely. I was a Epidemiology concentration, so I really enjoyed that. I really took a lot of Stata courses, statistical analysis, so I was able to learn all of the software end of it as well. Then I was able to balance that out with other public health courses that taught me the infield, but one of my favorite classes by far was Infectious Diseases. I had one of the most wonderful professors. She had infield experience, she had worked directly under the head of the WHO, doing her time at Johns Hopkins, so she was very very knowledgeable. She was able to help me with that. That was one of the most fascinating classes as well, because, infectious diseases, I learned that they're often very overlooked. In the early 1900s everything was happening and those were the main concerns, where everything that could spread essentially by touching people or coughing or things like that. Nowadays, they're kind of overlooked because a lot of the noncommunicable diseases are taking over the top spots as the most prevalent such as heart disease and diabetes, but there's still infectious diseases, especially in third world countries. That class really awakened me to the needs of underserved populations and that even things that we don't worry about anymore here, there's still a lot of problems in other parts of the world as well.

Deborah Onakomaiya: You've graduated over a year ago, obviously an alumni of GPH. Looking back at your experience at NYU, what would you say was the most valuable experience that you got out of your time at NYU?

Siddharth Raich: Yeah, definitely. The most valuable experience was that infield applicability of it all. That's what I would definitely sell. So working with the professors that used real case studies, that was extremely valuable to me. For me, I've always kind of... I've always thought of a mindset, whenever I learn something new, it's instantly I just think of, well A, where did this kind of knowledge come from, and B, how can I essentially apply it directly into my work or...and essentially in the field. So that kind of aspect of learning that... I was also part of the Tobacco Research Lab, which was very interesting because we were… I was essentially going through their social media marketing campaigns and breaking apart how they're advertising to youth, because although legally they're not allowed to, there were still some kind of subliminal messages. They were using candy flavors, and vibrant colors, and Disney characters, or animated characters, to essentially slide through the loopholes and advertise to youth. So I was in charge of taking that apart and identifying all the different ways the vaping companies are advertising to youth. I thought that was really interesting because that was another instance where I was using live information from the field and I was bringing that into the academic world and taking that apart in the academic world.

Deborah Onakomaiya: You mentioned that you were at the Tobacco Lab. Apart from market research what... Can you just expand a little bit more of your role at Tobacco Lab and how you applied those skills?

Siddharth Raich: I was... I essentially learned all the different avenues that tobacco companies grown to encompass. Essentially in the 1920s and 1930s it was just cigarettes, but now, essentially, there's vaping, there's cigarettes, there's multiple methods of, essentially, intake of tobacco as well, so I was able to learn all of the history of how the tobacco industry has evolved with the times and as well as their marketing strategies have evolved with the times as well. So the two parallels and seeing how that's happened was really... that was really interesting to me. Then also future trajectories and seeing how they're heading towards social media, or they're essentially already on social media or advertising, but future... thinking about future directions that they're going to take, that was also very... Brainstorming how we can combat that and educate the population before they essentially try to target that population. That really came into effect at my work here as well, because a lot of the population on the inside, although tobacco is not allowed inside, they often find ways to get it snuck in there, essentially. That population has very high rates of tobacco use, and not only on the inside, but also when they're released they often engage in a lot of tobacco use as well, so I was able to use that knowledge from the lab and integrate that into the curriculum for the health educators to go in and teach. So essentially telling them about the dangers and the harms of tobacco, because a lot of them often haven't been exposed to that type of knowledge because, unfortunately, a lot of the people on the inside, they haven't graduated high school and some of them have, unfortunately, only finished middle school essentially, so they haven't really been able to be exposed to anti-tobacco knowledge that many people in the academic world know second hand already. They know, but they don't... They haven't been exposed to it. So using that knowledge from the Tobacco Research Lab, I really applied that to devising the curriculum... part of the curriculum for our health educators.

Deborah Onakomaiya: Going back to your current position and your current work and you've talked about studying epidemiology and doing data analysis. What type of data analysis are you guys doing at your current work at the Center for Health Justice and were those things that you learned while you were at NYU or... What types of data analysis are you guys doing?

Siddharth Raich: Definitely. So we're doing the... We're using Stata, the software, essentially, to do rudimentary.... There haven't been advanced ones yet, because we're still collecting the data, but it... the problem with working with this population another problem is, essentially, it's difficult to get a complete data set. For example, we're working on a data set for juvenile hall for the last maybe six months to a year, but it's very difficult to get a pretest and a post test, as well as the status admission, because, a lot of times, the kids are released. They're just instantly released and... or a lot of them get their court letters, so they're often difficult to get ahold of even after they're released. So, a lot of the dataset is incomplete, so maximizing the values that we have and to maximize the statistical power we have is oftentimes a challenge. We essentially run multi-variable statistics using Stata to do the best we can with the data set that we get.

Deborah Onakomaiya: Wow. You touched a little bit on some of the challenges to working with this type of population. In public health, we're always told to be flexible, things change in the ground, things like that, and working with this type of specifically vulnerable population. We only learn about these things in school, in the classroom, but right now you're in the field, so... and you can share your experience with our audience. So what are some of the challenges that that you weren't prepared for when you started this job in general? Maybe working with this population or just being out there and... What are some of the challenges that we, as students, might not even realize until we get into the field?

Siddharth Raich: One of the greatest challenges is you have to just learn to be very patient. When it comes to underserved populations, I've discovered that we, essentially, teach them the health education. So we teach them the course one time, and they don't essentially get it. We teach them a second time, and they don't get it. Sometimes it takes the fourth, fifth, sixth time for the message to, essentially, really stick, because a lot of times we'll see them and then we'll see them a month later, we'll see them out... We won't see them because they're released, and then three months down we'll see inside again we'll say, "Hey, what happened? I thought everything was good" and they said, "Oh sorry, I kind of relapsed. I had... I couldn't help it" and we were like, "but you know we touched on these things in class". So we've learned that essentially it takes sometimes a fifth, sixth time and you have to be very patient with the population and that's not essentially... that's not at all their fault because they're just essentially a product of that environment. They've grown up, they haven't had the formal education that many of us had, essentially. A lot of them have also had a TBIs, traumatic brain injuries, because of gang violence or domestic violence or... So essentially, oftentimes, it physiologically and even kind of culturally, the message doesn't stick the first few times. That's definitely one of the challenges I've seen in the... Essentially working with underserved populations in this public health field.

Deborah Onakomaiya: That's... I think it's really important for, as public health professionals, to be realistic about our goals and what we're doing, because I think while we're in school we're like, "Oh, we're going to save the world. We're going to do this," but patience is really key. It's... That change isn't... you're not going to see it for a while and you've got to be patient.

Siddharth Raich: Right, exactly.

Deborah Onakomaiya: Going back to some of the work that you talked about, especially with your educators, what are the range of things that you are teaching these populations? What does that curriculum look like? What do you guys focus on? I know you talked a little bit about tobacco use, sexual health.... what is the range of stuff? Or is it specific to a particular facility, or a particular group or gender? That type of-

Siddharth Raich: There's definitely... Yeah, there's definitely a good range. We try to include everything in there that would have real world implications. So we were not... Our curriculum's not made up of algebra, geometry... it's not like that. We're essentially talking about HIV prevention, we're talking about PrEP, we're talking about STIs, we're talking about condom use, a healthy diet, because oftentimes you're learning the different components of a healthy diet. We're talking about substance abuse disorder, essentially, so how to safely use needles, how to consume.... how to minimize consumption of drugs, essentially, then so that's essentially another topic. So while we were doing the curriculum, essentially, the staff, the correctional facility, told us.... The Sheriff's office told us that, "Hey, would you guys be able to include a component in there about anger management?", so then, we definitely included that in there as well because a lot of the clients have a lot of... they get triggered. They essentially... Something will happen that will remind them of a traumatic event in the past, or they'll be unable to contain their emotions, so oftentimes they have anger management issues. So we also put in a segment to essentially help alleviate... how to deal with the triggers, how to alleviate some of the stronger emotions. So that's definitely another component as well that was a request by Sheriff's department. Then the other holistic approaches are just a healthier lifestyle. How to... Essentially keys to tools to helping find sustainable employment; what things to do when they're released, how to essentially find stable housing. So, that's definitely some of the... Those are some of the topics that the curriculum touches on.

Deborah Onakomaiya: Wow. That is really amazing. I'm so impressed that you're from NYU and you're really applying all these important skills that you gained during your MPH even outside that in the field. I would ask what advice would you have for a student just like you, interested in an MPH at NYU, what mindset should they come into the program with? What should they be leveraging? That sort of thing.

Siddharth Raich: Yeah, definitely. So looking back, I would definitely say... I would definitely tell the students to come in with a mindset of "What am I going to essentially do with this knowledge?" so not just learning it all, essentially. Also, applying it while you're simultaneously learning it as well. For example, I was... I did some tutoring as well as doing my MPH, and then I was also part of the Tobacco Research Lab. So, definitely getting involved in a lot of things while you're also taking your classes is something I would definitely suggest to incoming students. Then I would also suggest if they could essentially get employment while they're studying, or at least part time employment, that would definitely... I think that would definitely be key to their success afterwards as well.

Deborah Onakomaiya: We definitely have to ask, why are you so passionate about this work you do? Where does this motivation come from?

Siddharth Raich: Definitely. It comes, essentially, from my own background as well. Being born in India and I... we emigrated, me and my family, to America when I was about eight years old. When we first came here, we lived in one of the most underserved areas in Los Angeles. I mean... Sorry, in Las Vegas, actually. So we essentially... We lived in the apartments, I went to public schools where I saw a lot of drug use among middle school and high school students and so I kind of grew up in that environment, essentially, so that's where my passion essentially came from. A lot of these kids, they didn't have the chances that I had, they didn't have the proper education that I had, so it's kind of my responsibility, really, to help even the playing field and give them all the knowledge, at least the most basic, important, useful, knowledge to them as I can. So that's definitely where, essentially, my passion for public health comes from.

Deborah Onakomaiya: Yeah. To our listeners that are, listening to the type of work you do, is there any way to get involved with this type of work? Volunteer work, employment work? Do you have any information on how to volunteer, especially with this type of vulnerable populations?

Siddharth Raich: Yeah, definitely. So I would definitely say internships. We're actually taking on a couple UCLA MPH interns. I'll actually be supervising them in the summertime, as well. So, I would definitely say internships are probably one of the best avenues to get into this position, but I would recommend that if anyone is interested in this position, they plan ahead of time, because it does take about three months for the cleaners process to finish. For example, if they're aiming for a summer internship to be able to work inside Women's Central Jail, for example, they'll need to plan three months ahead and submit all the paperwork because the LifeScan, the interview, the background check, does take a while. So I would definitely say, yeah, internships.

Deborah Onakomaiya: Yeah. In general, how can people reach out to incarcerated individuals and just want to help, even if it's not like an internship? Are there other avenues, or you think internship is usually the best to work with these types of populations?

Siddharth Raich: Well, I would say... Well, ideally, I would say if someone can secure a health educator role... employment that would... that's associated with incarcerated settings, that would be ideal. Otherwise, internships are often easier to get. I do understand internships are easier, but I would definitely recommend getting in employment as a health educator either.... or a health coordinator, because those are in field, you're applying the curriculum, you're inside. Those are essentially the hands on roles, and I think working with that population hands on, it really kind of opens your eyes, so I would definitely say that. Then if someone was interested they would contact the EBI, the education based services, essentially, for incarcerated individuals. They have, often have, EBI offices within the jails themselves, so they would be able to contact them and say, "Hey, how can I get involved in the health education inside?".

Deborah Onakomaiya: Wow. That's really important information. I would ask, now that we're winding down, what are your ultimate public health goals? What is the change that you want to see in the world?

Siddharth Raich: Definitely. I want to see I'm all... I'm interested in the larger kind of the policy side of it, as well. So, I see that I'm essentially helping these individuals, on a group basis, maybe from, 10 individuals every week or so, so we're giving them help, giving them this information, but I definitely think that there needs to be a larger change as well. I would see myself kind of in an administrative role in, either the Los Angeles Department of Public Health or the LA County office, so essentially, administering a larger change essentially to a greater.... to widespread population, because I do... I have the infield experience, so now I understand how... what the needs of... the specific needs of the population are. I'm helping them in small clusters, but I essentially want to institute some sort of change throughout Los Angeles, Southern California, or that might be even applicable nationwide, some tools and tips that definitely need to be done. So, I definitely see myself in kind of an administrative role and I really enjoy public health, so I definitely want to... definitely want to stay.

Deborah Onakomaiya: That's amazing. Final question: so what's next for you, Siddharth?

Siddharth Raich: Definitely.

Deborah Onakomaiya: In the next five, 10 years what are we going to hear about you? What's next? What's up on the radar?

Siddharth Raich: Definitely. So I want to definitely continue to get this infield experience. I really make this kind of job, essentially, into a career, because this really is my passion working with underserved populations. So, as I plan to climb through the ranks, I hope to head an agency, essentially, that works with this population, and then I can, essentially, guide the needs of the agency as based on my own experiences and my own education. So, I definitely want to head an agency. That's in the next five to 10 years that would... that's the plans.

Deborah Onakomaiya: That's the goal. Awesome. Thank you so much for coming on our show today. We've learned so much from your work and we hope you come back on and tell us more about the amazing things you do.

Siddharth Raich: Thank you so much. Definitely. It was my pleasure.