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'As long as someone is alive, there's hope': Teams help break down recovery barriers in rural towns

Virus Outbreak Rural Indiana
Posted at 5:27 PM, Feb 03, 2021
and last updated 2021-02-03 17:27:10-05

INDIANAPOLIS — Soon after Andrea Jones called her grandma, a jail commander, for help, a recovery support specialist met with her to help get her into a rehab facility.

She was able to get Jones into a recovery treatment center helping those who are pregnant. But there was one problem.

She was on house arrest.

She reached out to her probation officer to talk about the treatment she was able to get through the program.

Instead of getting help, she found herself spending another night in jail, facing a pregnancy in prison.

It wasn’t until the recovery support specialist at Choices in Southeastern Indiana went to court with her that she was able to get into the treatment program.

After 75 days in rehab, she had a healthy pregnancy and delivered a baby with no drugs in their system. Two years later, she is the manager at a bakery.

andrea_jones.jpg
Andrea Jones

As a young adult, Jones found herself using prescription drugs, a domestic violence survivor, and isolated from her family.

The only people she was with were her friends, who were also using drugs.

When she got out of jail after being arrested for the first time, she went back to using drugs.

“Even when I was arrested, I just could not get out of my addiction,” Jones said. “It was the only thing I cared about. Even as soon as I got bonded out of jail, that’s the first thing I did was go back to drugs.”

It wasn’t until she made the call to her grandma that she was able to start getting the help she needed to start recovery.

“It really took me really breaking down to that point where, you know, I felt completely hopeless before I reached out,” Jones said.

Before her grandma helped connect her to Choices, Jones said she wasn’t aware of many organizations or resources to help with recovery.

“I’m just very grateful and at the end of the day, it does happen when you don’t think it ever will,” Jones said. “Because there was a time in my life where I thought for sure I was going to die in my addiction. I’m just very grateful Choices really, really did make a huge impact in my life.”

Indiana University Analysis

The challenges Jones and Choices face in the rural communities of Southeastern Indiana aren’t unique to them.

A recent analysis by the Indiana University Public Policy Institute Center for Health and Justice Research found several barriers these mobile crisis teams are facing.

The analysis by IU looked at two mobile crisis teams funded by the 2016 21st Century Cures Act and the State Opioid Response.

Mobile Crisis TeamManagementCounties servedTeam composition
CERT: Choices Emergency Response TeamChoicesDearborn, Decatur, Franklin, Jefferson, Ohio, Ripley, and Switzerland

3 recovery support specialists with lived experience focusing on mentoring and engagement,

3 clinicians who screen clients for appropriate treatment

1 clinical director

OCRT: Opioid Crisis Response TeamCenterstoneBartholomew, Brown, Morgan, Monroe, Jennings, Lawrence, and Jackson

2 recovery coaches focusing on connecting people to resources

1 clinician who screens clients for appropriate treatment

1 program manager

(Source: Indiana University Public Policy Institute Center for Health and Justice Research)

The teams have been able to connect with hundreds of people, like Jones, in the state’s rural communities and connect them with treatment services.

Mobile Crisis Teams consist of treatment clinicians, peer recovery staff, and nurses. Their goal is to enhance access to treatment for people.

“Rural areas have barriers that urban counties sometimes don’t have to deal with,” said Staci Rising, program manager for the Center for Health and Justice Research at the IU Public Policy Institute.

The analysis found the teams are facing a high volume of clients, a narrow window of engagement with people, and a shortage of treatment providers.

You can read the full analysis below or by clicking here.

Choices Emergency Response Team

Stephanie Hartman, the clinical director of the Choices Emergency Response Team, works to help connect people with whatever resources they may need.

Once someone calls the 24/7 emergency hotline, the team works to help address the needs of the person, even if they aren't ready to start recovery.

"We try to provide them with the resources to immediately address the need to make sure they survive," Hartman said. "As long as someone is alive, there's hope."

The team works to help people overcome the barriers of living in a rural community. The biggest issue, Hartman said, is transportation.

"People are very creative in how they get around, just even if you don't have a substance abuse problem in rural communities," Hartman said. "You really rely on your supports in the community that help you. So when they've damaged the relationships, they don't have those resources."

When the team meets with someone, they work on addressing even their most basic needs, like food and shelter.

"If they are unable to have a place to sleep, they don't have food, they don't have transportation, they are in poor health, struggling with mental health issues, all these other things are contributing to the situation they're in," Hartman said. "They're not going to be ready to focus on recovery if they don't know where they're going to get their next meal."

Living in rural communities means sometimes the resources people need aren't local and if they are, they are overburden. Some communities don't have harm reduction measures, like Naloxone or needle exchange programs.

Watch the video below to learn more about how the team works to help meet people's basic needs.

Helping people with recovery in rural communities

Moving Forward

The team at IU published the following recommendations in the analysis for other communities, both rural and urban, if they were operating similar mobile crisis teams or if they wanted to start their own.

  • Socialize the mobile crisis teams to local agencies: There is no on-size fits-all approach to these efforts. Each agency should tailor their efforts to their individual communities.
  • Find local evidence-based treatment providers: Teams should identify adequate treatment providers using medicated-assisted treatment and do not require people to be sober to get services.
  • Prepare to meet the basic needs of the team’s clients: Be prepared to make referrals and help meet clients basic needs, like housing, transportation, and insurance.
  • Embrace a harm reduction philosophy: Teams should be able to help clients who aren’t ready to engage in traditional treatment by including hard reduction tools like access to naloxone or a referral to a syringe exchange program.
  • Integrate technology into the team’s operations: Using technology can help teams reach clients, enhance recovery, and collect data to track clients and their outcomes.

“The Choices and Centerstone team members explained there was a lack of professional recognition of their team’s treatment staff by other agencies,” Rising said. “The best way that they found to fix these issues with working with other agencies was just education.”

She said the teams are educating local police and fire departments, councils, and the community about treatment and the nature of substance use disorders.

“I think the biggest piece is really the stigma,” Rising said. “I think once stigma is gone and people are open to learning about substance use disorder, the experiences of people with it, I think there is a little more compassion there and we can connect people to things they need, like harm reduction, until they’re ready for treatment.”

Once Jones was able to get in contact with Choices, she was able to quickly get a place in a treatment program. But she wasn’t aware of programs to help her until she reached out to her grandma.

She thinks organizations should increase their publicity of the resources available to people.

Hartman is encouraging people to continue having conversations and educating themselves about addictions.

"Even if you don't think you have anything to contribute, ask," Hartman said. "You might have something to contribute that you didn't even know was needed."

Resources

If you or someone you know is dealing with a substance use related emergency, call 911.

You can contact the Choices Emergency Response Team 24/7 at 317-205-8302.

You can contact the Centerstone OCRT here.

For more information on a recovery organization near you, you can visit the Indiana Recovery Network website.

You can call 211 for help 24/7 in Indiana.

You can call the Indiana Addiction Hotline at 1-800-622-HELP (4357).

To find where you can get Naloxone near you, click here.

To view more resources from NextLevel Recovery Indiana, click here to visit its website.

Learn More

Choices Coordinated Care Solutions Emergency Response Team

Click here to learn more about substance use disorders.

Substance use disorder related data from the state.

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Andrew Smith is a Real-Time Editor for WRTV. You can reach him at andrew.smith@wrtv.com or @AndrewSmithNews on Twitter, or on Facebook.