Brother Elder Amado Jimenez-Diaz enters the front of the room of the church. Blue and white tiles and lavender walls blush slightly under the light, turning the cool room rosy. Music pulses from a speaker set up next to him. Brown and tan fold-out chairs surround several tables around the room. As participants file in from the cold, they take off their thick jackets and settle into the chairs.
“Heavenly Father, I thank you for this evening of having us in your house of worship,” Jimenez-Diaz says. “Thank you for our volunteers in Imani, thank you for the food so that we can be nourished… in the name of our Lord Jesus, amen.”
Jimenez-Diaz is a facilitator for the Imani Breakthrough Project, a church-based treatment program for substance abuse recovery which focuses on community support as a mode of healing. It is just past 6 p.m., the start time of each week’s session, which lasts until 8 p.m. This group of participants is on week 6 of 22. Jimenez-Diaz tells me that sometimes over 25 individuals come to the nightly sessions––even though the sessions are capped at 25 people, with only those registered receiving a $10 stipend for attendance at each session. All ten churches across Connecticut that host programming from Imani have the same cap on participant numbers; the project’s creators designed it so that groups could remain tightly knit. Jimenez-Diaz still ensures, however, that all who attend are allowed to participate, eat a plate of hot food and warm up.
Jimenez-Diaz’s co-facilitator, Xavier, joins him at the front of the room. “I love you guys,” Xavier says. “I’ll be here for anything you need.” He steps away to watch Jimenez-Diaz deliver today’s workshop. Later, he tells me, “I like seeing people smile.”
Jimenez-Diaz moves a large, poster-sized legal pad to the center of the room and flips to a new page. Today’s topic is social awareness, which he writes and underlines with black marker at the top of the page. His voice is calm and warm as he asks the participants what the elements of social awareness are; the audience calls out answers. As he speaks, he interweaves discussions of each point with advice and faith. As he writes congregation, he says, “Being selfless speaks volumes. One thing that God does is be selfless.” As he writes #1) sacrifice, #2) commit, he notes, “It will be negative 20 degrees Celsius soon. If our friends don’t notice, it will be 1 o’ clock, and they will be freezing. The drugs will warm you for some time before, but make sure you get to a warming center by nine.”
Quickly, the session melts into a conversation. Participants add on to what Jimenez-Diaz says; others voice agreement. Some share anecdotes from prior experiences that leave the room in attentive thought. Lulls occur as the room considers particular memories and stories. As Jimenez-Diaz continues building the theme of social awareness, he fuses biblical allusions with his discussion of how substance use affects one’s mind: “The Devil puts thoughts in your head: you can’t go in that church… you smell… you’re homeless. The gospel that we teach says differently. We pray for you; we receive you. That’s the God that we serve.” He addresses one member in the audience, discussing how they received him; conversation flows, back and forth, and envelops the room.
‘Developing skills of how to live’
The Imani Breakthrough Project is a treatment program for individuals using opioids, alcohol, and other drugs held in churches across Connecticut, with some of its first partnered churches located in New Haven. Weekly workshops are run in church spaces across denominations for local residents who are in recovery, open to all who register within the first five weeks. These 2-hour workshops, led by pastors and Imani-trained facilitators who are themselves community members already active in the churches, encompass teachings that are followed by discussions in which participants can share their own experiences.
Some facilitators, like Jimenez-Diaz, integrate faith directly into their teachings, allowing biblical scripture to heat their words about self-definition and healing, but not all––each church adapts the particular style of their teachings to their participants. Such wraparound services aim to buoy the independence of those in recovery, addressing the complex social and economic struggles they may face; the design was born directly out of continuous conversation with Connecticut community members throughout the years.
Imani was created by Chyrell Bellamy, director of the Yale Program for Recovery and Community Health and professor in Yale’s department of psychiatry, and Ayana Jordan, an addiction psychiatrist and assistant professor adjunct in Yale’s department of psychiatry, in 2017 to address disproportionate death rates of people of color––particularly Black and Latine communities––in the opioid epidemic. In the five-town region composed of New Haven, Hamden, North Haven, Woodbridge, and Bethany, the overdose death rate for Black residents was 71.0 per million residents; for Latinos, 63.2; and for white people, 51.2, in 2023, according to a report from DataHaven. Bellamy and Jordan sought to understand how to best address the root causes driving these disproportionate death rates for people of color living in Connecticut; to do so, they had conversations with the community to hear exactly what would serve them best.
Through a six-month period, Bellamy and Jordan, alongside their mentor, Larry Davidson, a clinical psychologist at Yale, began to connect with New Haven community leaders who worked closely with individuals in recovery. One of these leaders was the Reverend Robyn Anderson, who continues to serve as the liaison between Yale researchers and Connecticut-based religious leaders today. Anderson hosted a series of roundtable conversations in Midtown open to any Connecticut residents with interest in the topic of how to create effective treatment for substance use. Through those conversations, which many people of different experiences attended due to the open invitation, they learned that people of color in these local communities who were using substances often lacked the financial ability to access traditional psychiatric care. Furthermore, Black and Latine individuals felt mistrust towards their psychiatry providers if they did seek out professional help, due to a history of the medical establishment not properly addressing the needs of Black and Latine patients, as well as the lack of sufficient representation in the demographic of Connecticut-based psychiatrists. Another cause Imani directly aims to address is the social stigma amongst Black and Latine communities associated with speaking about one’s substance usage and openly seeking treatment.
“Speaking to the level of secrecy that happens in Black and Latine communities, there are so many vulnerabilities that people are experiencing, related to those social determinants of health,” Bellamy said. Sylvia Cooper, a facilitator at the Varick Memorial A.M.E. Zion Church in New Haven, also noted that many men of color grow up being socialized via substance usage, which leads to difficulties exiting social circles oriented around ignoring health challenges produced by usage. This, she speculated, contributes to the high proportion of male participants in her groups. She also told me anecdotes about how many who struggle with substance use can find themselves unemployed, unhoused, or incarcerated, which disturbs their independence and can fuel a cycle of usage, which in many ways are also affected by racial bias in hiring, housing, and criminal justice.
Through these conversations, Bellamy, Jordan, Anderson, and other psychiatrists and community leaders involved in the creation of Imani concluded that treatment for substance use must not only be accessible beyond a doctor’s office, but also address psychological and spiritual issues as well as physical ones. This group of initial founders developed Imani’s structure with hopes of addressing these social determinants: for example, they chose to host programming in community churches because they were already centers of refuge for many Black and Latine individuals, particularly those seeking a sense of spiritual healing.
“A lot of people, especially people of color, feel safe in the church,” Anderson said. “They feel that the people facilitating the Imani group are also persons in the community… It’s really about healing, transformation.”
SOAR is the first program that Imani’s founders developed. Designed to last 22 weeks long, SOAR features weekly sessions that include teachings on wellness and workshop-style discussions, where people share their own experiences. The latter half of the program also features individualized coaching to help participants create and reach personalized goals. In recent years, Imani has also received federal funding to create a second program, ImaniYOU, which runs for 24 weeks. ImaniYOU adds onto the key elements of SOAR with telehealth meetings with psychiatrists of color, urine testing, and additional medical services. As many participants have faced financial and logistical barriers to meeting their basic survival needs, such as receiving steady income to purchase food, Imani provides a variety of services at their sessions: many churches also double as warming centers, clothing closets, or needle exchange sites, and serve hot food to attendees.
“We understand that when people are using substances, that bridges might be burnt, and relationships are splintered,” Bellamy said. “How can we help people feel like they can gain skills and focus on their dreams? Some of these are recovery-oriented goals – reuniting with family members and children. How can we help them move towards those things?” Through Imani’s coaching, participants often set goals such as rekindling familial relationships or finding suitable employment.
Imani’s facilitators are already involved with the churches and known by many attendees; many of them have directly experienced or observed substance use’s effects in the community. Jimenez-Diaz told me that he was once a part of a gang, and that when he returned as a church leader, he was a “completely different man.” Part of ImaniYOU’s success comes from the fact that psychiatrists of color are chosen.
“This is the first time that these people have actual doctors they are able to access and have conversations with…and that look like them,” Anderson said.
Facilitators are trained in understanding the harm reduction model in order to address the psychological needs of community members in recovery. Focusing on encouraging safe and limited substance use instead of imposing full abstinence, the model aims to support individuals in a way that feels appropriate and doable at their current stage in their recovery journey –– it is a healthcare approach and philosophy that focuses on “meeting people where they are,” Bellamy emphasized. “By saving lives, we give people another day to hold onto hope, and perhaps that’s another day we get to reach them in some way.”
This idea of giving individuals the ability to generate and share a sense of hope –– and continuously bolstering their sense of independence and agency –– underlies Imani’s philosophy of care. Historically disproportionate death rates reflect the lack of attention previously paid to this approach: the harm reduction model is unique in its capacity to walk beside people instead of in front of them. Rather than enforcing a diagnostic hierarchy, Imani’s horizontal support structure helps humanize.
“[We are] focused on bridging people back to their communities,” Bellamy said. “Harm reduction is about teaching people how to live, how to develop the skills of how to live. That’s something that takes place over time.”
Concretely, facilitators are trained rigorously for three days on the philosophy of the harm reduction model, where they are taught practical skills like narcan administration and urine testing for fentanyl, as well as two particular psychological frameworks that they are told to concretely plan their teachings around. The first is the 8 Dimensions of Wellness––a model created by the psychologist Peggy Swarbrick in the 1990s, which includes emotional, environmental, financial, intellectual, physical, occupational, spiritual, and social health. The second is the 5 R’s of Citizenship, which stand for rights, roles, resources, responsibilities, and relationships.
They are not taught explicitly to include faith in their teachings, Bellamy told me, but she says each church has developed their own style in the workshops, some of which explicitly include biblical text. To leaders in Imani, spirituality is something far larger than, for example, belief in Christ.
“It’s love,” Cooper said simply, explaining to me the precise reasons why Imani has had such an effect on community members. “You can feel it.” Jimenez-Diaz told me that he includes every name of each participant he has ever worked with in his personal prayers to God; he writes them down on a list and prays for them — but religion is more a vehicle for Imani’s goal of connection than its foundation.
Imani’s spirituality is not defined or enclosed by traditional religion; rather, it arises from a deep intimacy with one another and the self. The church serves as a space for this togetherness to emerge, but it is the people who make the program what it is.
‘The right words for the right moment’
Creating a space that thaws the distance between people is a responsibility that rests heavily on the shoulders of the facilitators. As they lead workshops over the course of 22 to 24 weeks, depending on the program, they are tasked with becoming closely acquainted with each participant and ensuring that the environment they exist in is welcoming. Something that is not scientifically definable is the key cause of success in this psychiatric treatment program: the interpersonal bonds formed are what bring people back, week by week.
At the Casa de Oración y Adoración in New Haven, the church where Jimenez-Diaz works, senior pastor Hector Caraballo will sometimes start workshops with sermons written for the participants. When he first moved to New Haven, he said, it was “overwhelming” to see all the participants in recovery with the responsibility of responding to their needs. But when I spoke to him and others leading the events, their eyes were firm, unquestioning, and lit with desire to understand others.
“It’s a big responsibility,” he says, of writing words to be delivered to those going through recovery. “You want to be able to have an impact––to deliver the right words for the right moment. It’s a burden; at the same time, once you start writing, and you have the inspiration of the Holy Spirit, everything works together.”
The effort placed into responding to spiritual needs has fostered love for the program among participants. Many participants lack jobs and are unhoused, and sometimes enter and leave the prison system; as such, a significant proportion of alumni do not have personal phones or periodically change their phone numbers. Despite these difficulties, many participants have tried to stay connected with the program. At the Varick A.M.E. Church, for example, alumni from past years will attend the graduation of the newest class, where the most recent graduates give comments. Cooper tells me how moved she is by this. “I get texts,” she said. “They’ll come back, asking me how I am.” Cooper herself recalls these participants with fierce compassion: she tells me about bringing her group to a class field trip to the Shubert Theatre in New Haven, where one man watched a play for the first time in his life.
Sometimes, she said, losing participants to overdose during the course of the program happens. People have the space to share their grief––to let it live, and watch it move towards and away from themselves.
Post-graduation, word-of-mouth referral from alumni is often the main channel by which new participants are recruited to Imani. According to Bellamy, at least 70% of individuals coming into Imani programming are not receiving any professional substance use treatment. Imani’s rapid growth over the years is a testament to its ability to reach individuals––and continue reaching those they know––in communities normally distanced from the medical establishment: it has graduated 1,500 participants in Connecticut since its inception in 2017, and expanded to 11 churches in the state. Four Black churches were the first to pilot the program: Varick in New Haven, 224 EcoSpace in Hartford, Mount Aery Baptist Church in Bridgeport, and the Burning Bush Family Life Center in Waterbury.
One year later, expansion occurred to 4 Latine churches––New Beginnings Baptist Church in Hartford, Casa de Oración y Adoración in New Haven, Prince of Peace in Bridgeport, and Oasis of Blessings Christian Center in New Britain, although the New Britain partner has since changed to Greater Harvest Church. Beyond the 8 initial programs, expansion has occurred to Mount Olive African Methodist Epispocal Church in Waterbury, the Blackwell A.M.E. Zion Church in Hartford, and the Spottswood AME Zion Church in New Britain, both serving predominantly Black communities. According to Anderson, they were chosen “because they were working in the community,” aligning with Imani’s harm reduction model. Expansion occurred to Rhode Island in 2021 and Louisiana in 2022; a third church in New Orleans recently completed its training.
Imani’s longevity — now at seven years of operation, with more participants registering each week, and new churches being trained in different states –– is unique. Frederick Altice, the director of the Yale Center for Community Research, which assisted Imani with advice on community engagement in its earliest days, told me that a common but problematic feature of Yale’s community-oriented programming is known as “parachuting,” in which Yale researchers will begin healthcare initiatives in New Haven, often with good intentions, and then allow the programs to peter out. Funding structures with limited terms of two to five years can prevent further extensions. But Imani’s earlier success allowed it to receive the National Institute on Drug Abuse’s U01 grant, which now funds ImaniYOU.
“We talked to the people who were going to be using our framework,” said Mark Costa, a Yale research scientist who is a co-investigator for Imani. Having reviewed the results of the earliest roundtable conversations from 2017, he assisted with the design of the project and the collection of the data on recovery, where baseline intakes are compared with qualitative interviews three to six months out. “Many times, people design a solution for people without consulting them, and when it doesn’t work, they blame the people. That’s structural racism.”
The fact that word-of-mouth is Imani’s dominant means of attracting participants speaks to the capacity of feeling –– of love –– to bring people through its doors, to feel transformed, and to tell their loved ones to do the same. This fluid, person-to-person transfer reflects well on Imani’s style of treatment.
‘There’s plenty more’
As Jimenez-Diaz’s session draws to a close, a chorus of amens rises from the crowd. He encourages all to seek freshly-prepared food from the kitchen. Church members lay out the food on the back counter––steaming yellow rice, crisp servings of salad, freshly sliced bananas, vanilla and strawberry cookies, and hot coffee. Participants take rolls of bread from white boxes labeled Imani. As plates are handed out, participants settle back into their original seats.
The music, still faintly playing from the speaker, is now overlaid with murmurs of interaction. Participants make small talk with their tablemates; they offer each other resources they no longer use. Hot steam rises from the plates of rice. They drop off and pick up items from a communal resource table, where warm clothes, and even two boxes of makeup, are laid out. I hear laughter on top of the music, and the sound of Spanish and English rising and falling. The words run together, like honey. Threads raised from the workshop are re-opened, wrestled with, and re-knit. I have forgotten the January chill outside.
“Half of these people don’t eat,” says a woman helping serve the food, referring to the food insecurity faced by many who struggle with substance use in New Haven. As we speak, a participant walks up, asking for more. She smiles at him. “Of course, there’s plenty more.”
After some time, the number of participants begins to dwindle; it is already past 8 p.m., the session’s end time. They take covered plates of bananas to-go and tuck away hoodies from the communal table. They re-adorn their hats and scarves. “I love you,” several say, to one another and to the facilitators, as they leave the room. One by one, they slip through the doors.
As the room mostly empties, I hear the cadence of Spanish. One of the participants is still sitting at the front of the room with Jimenez-Diaz, discussing the Bible. Jimenez-Diaz is reading verses from his phone; he moves from chapter to chapter, citing lines and interpreting them for the participant, who responds. They are rooted there for several minutes, timeless. Finally, when they part, it is with a fist-bump and a handshake.
I walk outside. The tall red cross on the beige exterior wall of the church is there, but I do not notice it. Instead, I see a participant singing Hallelujah to himself as he bikes away into the night. The lamplight catches his red knit cap and sets it aglow.