You work as a telehealth coordinator with West Tennessee HealthCares’ Pathways to Behavioral Health Services, and you are a certified peer recovery specialist (CPRS). What does a telehealth coordinator do, and how do you incorporate your peer recovery certification in this work?
When they started this position, our company had some big telehealth hubs, and we got a grant to cover several of them. We were going to have teleservice provider hub locations, allowing people we serve to connect virtually to staff who were onsite. However, just about when we got started, the pandemic hit, and our ability to use those machines became null and void, since staff couldn’t come in to use them, and they couldn’t take them home. We had to switch resources and purchase iPads to use the Zoom platform. By adjusting our plans, we could stay connected with people throughout the pandemic and help provide support for them.
My role as a certified peer recovery support specialist allows me to have a level of empathy. I have found that in some of the personal conversations that I have with people, the rapport and trust we build are invaluable. I think me having lived experience and being able to utilize that in my role is so important.
One of the most memorable moments when I realized the importance of my recovery was when I was once helping a young woman going through our medication-assisted treatment program. She came up to me later, after we had known each other for a while. She asked me if I remembered the first time we met and our conversation. I remembered meeting her, but I could not remember what was said during the conversation. She said, “Well, we were in a clinic, and you were having a conversation with me about your recovery,” and she said, “I’ll never forget that conversation.” And I was happily surprised by the impact that conversation had on her and her path to recovery. That felt so important, because just that tiny moment of whatever I said helped her, and she remembered that.
How has the use of telehealth evolved during the COVID-19 pandemic, and do you foresee more changes with the passage of the Infrastructure Investment and Jobs Act, which contains provisions to expand broadband access?
One of the things that I explain to people is that I look at life as a balance. I don’t believe everything is all good or everything is all bad. There is a balance to it—even with this pandemic, as tragic as it has been, with the lives lost and the effect on people’s mental health. Some of the good that has come out of it is that it has pushed and propelled mental health programs and the government to recognize critical changes that were needed to move forward, such as utilizing technology to continue to support people in need.
I think this pandemic allowed us to get innovative in our approaches. We had to learn to stay connected with people. The way we thought we were going to do telehealth isn’t how it turned out, and we ended up reaching more people. Our show rate (people making it to their scheduled appointments) actually went up, because one of the challenges working in a rural area is that if a client can’t get a ride, appointments are missed and must be rescheduled. Now, with the help of technology, clients have the option to connect just by using their phones.
There can still be barriers, however. Many people experiencing mental health challenges and substance use don’t have minutes on their phones and lack other resources like that. So, by providing them support services like Wi-Fi, or letting them use our phone to make appointments, we enable them to access much-needed services. And when people have challenges like transportation, little things like that can make a big difference.
Giving back to help others in recovery is something you model (for example, you raise funds for the ARCHway Institute to help cover services and treatment for others who need it). How does giving back support your recovery?
Giving back allows me to have a will and desire to continue to be able to do more. I think it’s this kind of exchange—there were so many opportunities given to me in my recovery, and I believe those moments and those times fueled me to continue. Now I can be a part of that process for others. In those moments where somebody may be giving up or may be unsure, I can give them the kind of support I needed during my recovery, and I may make a difference that saves a life. I’ll give an example: one day when I was at work, I got a call from a young woman, and she was stressing out because she had a problem with her financial situation. I think she lost her job and would be kicked out of her sober living house if she couldn’t pay her rent. I was able to tell her to go to this website, the ARCHway Institute, which offers hardship assistance services. It’s moments like that that make me want to continue to be available and let people know it’s okay to ask for help. There are resources and options for connecting people to those resources.
The ARCHway Institute has what they call HOPE Funds, a program where people in recovery conduct personal fundraising for others. I have a HOPE Fund I contribute to each month, and during your birthday, you can ask people to donate to your Hope Fund on your behalf. I got a report the other day that they utilized my Hope Fund to help a person with housing in another state. And that feeling of, wow, those efforts that I put in, seeing it in action, that makes me say, man, I want to do more! I believe it keeps me in line and keeps me wanting to do more.
In your role as telehealth coordinator, you help your organization provide support to people transitioning from jail to the community. What are two services or supports that are most critical for people with mental and substance use disorders during that reentry process?
The first important service in my experience is engagement, meaning getting clients established with a provider as quickly as possible. Getting people connected and established with that at pre-entry helps the success rate for them to be already connected once they get out, and it can even make the difference between whether that person will end up being able to survive reentering or recidivating.
Another service that is a considerable challenge, especially in rural areas, is housing. Many people have burned bridges with family and friends, and sometimes even some of the hotels that they stayed in won’t allow them back. It is impossible to be concerned about your mental health when you must worry about where you’re going to lay your head at night. One of the counties we are working in doesn’t have any transitional housing programs. Agencies must tell their clients to travel an hour away for housing. When you’re experiencing homelessness, trying to get reestablished in another county doesn’t make much sense. You might not even have a car that can get you back and forth.
To expand local options, I had to go to one of the hotels to meet the manager and build a good rapport. Sometimes hotels are reluctant to even go through the process of setting up a direct deal, but this hotel was willing to do it. We got all the paperwork in order, and now we have at least a temporary resource, where you know we can put a client for a week or so and allow us a little bit of time to try to get some other things worked out and get some of the connections made for them.
Research indicates that nearly 97% of people who need treatment don’t perceive the need for it (Table 5.39A). You have shared that you didn’t initially see a need for treatment for your substance use. Can you describe what changed for you to help you recognize and embrace the need for treatment and other supports for recovery?
As I look back on my past, my educational experience, and my work in the field, I believe the most significant thing is understanding. Understanding those stages of change; pre-contemplation, contemplation, action, and maintenance, and understanding how applicable that is in moving people through that process of recovery and becoming more engaged. Allowing a person to have autonomy is the biggest way to allow that person to move from one step to the next. I mean that pushing the person along the process doesn’t give them the strength and support to continue on their own. When people are forced into treatment or the court requires them to do things, I don’t want to say it’s not effective, but that person’s mindset is, “Okay I’m here, and I’m just going to get this done and over with then I’m going to do what I am going to do.” That doesn’t give them the self-drive or the self-motivation to be able to continue. Something within that person must be ignited to get the internal fuel they need. The only reason I say that is because I can look back at myself and evaluate what it took for me: I got to the point where I recognized something was going on. That’s part of that process. Some people can’t even recognize that they have a problem, everybody else may see it, but until that person sees it, not much will happen. Then you get to a point where you recognize the problem, but you may not be ready to do anything about it yet.
Allowing a person to have autonomy is the biggest way to allow that person to move from one step to the next. I mean that pushing the person along the process doesn’t give them the strength and support to continue on their own.
For me, one beneficial thing is motivational interviewing. Motivational interviewing is a tool that I can utilize when working with a person—a process to understand where the person is and what they are thinking in a nonjudgmental way. And allowing them to see some of the benefits of moving forward. It has to come from their perspective; they have to connect the dots. That person must see how to get from point A to point B and why. The “whys” and “hows” are things they have to work through, personally. However, like I tell people all the time, you must do it, but you don’t have to do it on your own. When a person feels that support, that can be that bridge that can help them go a little bit further.
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