Welcome to the first edition of the Northwest TI-ROSC Collaborative newsletter!

The Northwest TI-ROSC Collaborative is comprised of member organizations in Lake, LaPorte, Porter, and Starke counties who participate in monthly county stakeholder meetings reviewing best practices, continuous improvement, and strategic action planning in support of reducing opioid and substance use mortality and increasing treatment and recovery access.

The contents of this first newsletter include:

• Article on Stigma: The Silent Suffering
• Spotlights on TI-ROSC Leadership by County
• Events Calendar

Newsletter will be published Fall, Winter and Spring each grant year.

Northwest TI-ROSC Collaborative appreciates the support of HealthLinc and the Division of Mental Health & Addiction. Funding for this newsletter is made possible through the Mobile Integrated Response Systems grant, a part of the State Opioid Response grant.

Stigma: The Silent Suffering

Issue 1: Stigma

In 2020, nearly 92,000 persons in the U.S. died from drug-involved overdoses, according to the National Institute on Drug Abuse. How many of those people died because the stigma related to their substance use silenced their calls for help?

Psychologists define stigma as the negative social attitude attached to someone that may be regarded as a mental, physical, or social deficiency. It’s something that invites social disapproval, exclusion, and discrimination.

For many years, stigma was used ineffectively in an attempt to “shame” substance users out of their habits. Those lead to more punitive—and less rehabilitative—solutions that fail to see substance use as a brain disease, and rather, a choice.

Unfortunately, the shame created by stigma has done more to drive those most in need of help deeper into isolation and silence than into treatment. Stigma can negatively affect the healthcare a person receives, the support a mother is willing to seek for fear of losing custody of her child, the law a policymaker won’t support to create real solutions, or the Narcan that isn’t stocked for fear of encouraging substance use. When someone with substance use disorder continues to use in the face of death, incarceration, and loss of family support, deterrence through shame is unlikely.

Modern approaches to substance abuse continue to value ongoing, evidence-based treatment for a compensatory disorder that likely stems from trauma. Recovery professionals are more likely to recognize the pain at the center of addiction, and its enduring companion, mental health disorders. Ultimately, a listening ear, an open heart, and ongoing treatment now, tomorrow, and at the inevitable relapse are key to enduring recovery.

STIGMA & ART

Continue the conversation by watching this video by the National Institute on Drug Abuse, “Breaking Down the Stigma of Addiction: A Witness’ Story Through Art.

Watch Now {link: https://youtu.be/Ky8e_aP_dL8}

Meet the TI-ROSC Stakeholders

In this first newsletter, we introduce you to TI-ROSC leadership supporting Lake, LaPorte, Porter and Starke counties.

PORTER COUNTY

Meet Tammy O’Neill, Director of Porter County PACT

Tammy O’Neill has been a proponent of Porter County PACT, a unit of PACT, Inc., since before she even worked there. During college, a friend began working at PACT, and O’Neill fell in love with its mission. She volunteered before working as a community service caseworker and finally, its director. PACT turns 50 this year, and O’Neill has worked there for nearly 30 of those years.

“It is such an incredible organization. We’re constantly looking at how to be responsive to our community’s most pressing issues, and PACT always represents a solutions-oriented approach,” O’Neill said. “The belief in people’s ability to change is in our DNA. Our organization relies on research-supported practices to reduce the risk of re-offense and relapse, and one thing that amazes me about our staff—beyond their dedication—is their ability to balance support and accountability with those we are privileged to serve.”

Porter County PACT offers a wide variety of assessment and case management services that evolve with the needs of the community and the justice system. This includes a dozen programs for men, women, and adolescents to address domestic violence, substance use, recovery, mental health, and reentry. O’Neill also serves as coordinator for the certified problem-solving courts in Porter County, and she’s the director of the county’s Community Corrections and Certified Alcohol and Drug Program. She says the strength of Porter County PACT is its ability to adapt to the changing needs of its community and justice system.

“When our community began experiencing the effects of the opioid crisis, we realized through discussion with community members and colleagues that comprehensive recovery support wasn’t readily accessible, so we chose to create a recovery center in the heart of our community,” O’Neill said. “We want to serve as a hub for people, whether they need to talk, or need help regarding alcohol and substance use issues, or they need to learn life skills, or access recovery safe social activities, they can come to us. We can connect them with services and be that liaison to reduce barriers to treatment and recovery support, even to something as basic as food.”

O’Neill likens their work at Porter County PACT to teaching someone to fish so they can be fed for life, as opposed to giving them a fish and be fed for a day. She says the work begins by understanding that we are all the sum of our stories. In everyone’s story, she says, lies clues to their strengths and what’s preventing them from moving forward.

“By learning their stories and what’s happened in people’s lives, we can better understand the tools they need to live life successfully. Many times, people don’t feel heard or connected with others. In this job, every interaction provides an opportunity to change that,” O’Neill said.

According to O’Neill, the community has many resources, and they are better when they collaborate. “Working together, we can achieve a healthier, safer community by reducing barriers to needed services and reducing stigma through a shared vision that promotes healing, reparation, and inclusivity.”

PORTER COUNTY

Meet Mitch Peters, Public Defender on the Mental Health Restoration Court and Co-Founder of Respite House

Most professionals who work in the substance use disorder field have a passion for helping others. Some, like Mitch Peters, also do it because they’ve lived it. Mitch is an attorney—a public defender on the Mental Health Restoration Court—and the co-founder and board member for the Respite House, a halfway house for men.

He’s also 34 years sober this October.

“I have a long history of childhood trauma and substance abuse,” Mitch said. “From 1986 to 1989, I was homeless. Even once I got clean, I was living on a basement floor, struggling to find a job, even though I was an attorney. It wasn’t until another local attorney took a chance on me that I was able to become employed.”

Mitch has never forgotten his experience, and in 2008, he helped address the need for additional housing for men experiencing addiction and alcoholism. He and community partners collaborated to build Respite House, and quickly realized the 15-bed facility wasn’t enough. In 2020, Respite House opened a second location in Valparaiso. Mitch says the need hasn’t necessarily grown, but the community’s approach to it has evolved.

“The need has always been there, but I think that as a community, we have appropriately redirected our focus to treatment because we recognize that treatment is more beneficial and effective than incarceration,” Mitch said. “That’s why there’s a need for more housing – we understand solutions better. Plus, as we add more problem-solving courts, we need more housing for people participating in those programs.”

In addition to his work in the Mental Health Restoration Court, Mitch previously worked in the drug court. He says the two issues are inseparable, as are their solutions. And these solutions must begin much earlier in life.

“In mental health court, almost every case has a connection with substance use disorder, all of which relates back to trauma – primarily childhood trauma,” Mitch said. “That’s the missing piece at this point: How do we effectively address childhood trauma?”

Mitch believes the answer lies in an honest, open-minded, and supportive focus from the community. As a person in long-term recovery, Mitch understands how difficult it is to approach substance use disorder with compassion, but he says it’s the only way to support those who need it most.

“As a community, we need to model those principles of gratitude, humility, acceptance, and unconditional love. If we get caught up in the cycle of resentment, justification, entitlement, and self-righteousness, we’re not going to address our fellow community members’ substance abuse disorder, homelessness, and childhood trauma,” he said. “We need to recognize these people are people, and they need our support.”

LAPORTE COUNTY

Meet Micki Webb, LCSW, Program Director of the LaPorte County Drug Free Partnership

If she had a slogan, Micki Webb’s would be “There’s ‘we’ in ‘Webb.’” As program director of the LaPorte County Drug Free Partnership, Micki works toward creating an inclusive approach to bring more people’s authentic voices and lived experiences to the table when it comes to creating solutions for mental health and substance use issues in her community.

“We want to disrupt the programmatic silos and create a multi-sector community infrastructure that reduces recidivism and addresses disparities in access to mental health and substance use services by engaging all community stakeholders, including youth and those with a lived experience in recovery or mental health challenges,” Webb said. “We need that authentic voice to collaborate on how we can increase access to services, reduce barriers, and change policies and practices.”

A licensed clinical social worker and former school administrator (she opened the first alterative school in Michigan City in 1989), Webb’s career has largely focused on children and families. “Many families with mental health issues may have co-occurring substance use disorders,” she said. Webb wrote her doctoral capstone dissertation on building trauma-informed communities, and she has long noted the unique challenges faced by children who face mental health and substance use issues at home. Webb sees her role as working to better the community she calls home while supporting an issue she cares about personally.

“The average living wage in this county requires parents to work multiple part-time jobs, which reduces that protective factor of family oversight that keeps young people safe. I enjoy working with young people because on a personal level, I was that kid who went through trauma and family dysfunction related to addiction. I think every family is touched by either mental health or substance use trauma,” Webb said. “When I work with patients, I take a non-judgmental approach. It’s important to recognize that behaviors may be trauma rooted, and children’s behaviors may be influenced by what’s going on at home.”

The LaPorte County Drug Free Partnership hosted the regional Trauma-Informed Recovery Oriented Systems of Care training for community coalitions from LaPorte, Porter and Starke counties. The teams recognized that law enforcement often encounter children and family members while responding to mental health or substance use fatalities. The LaPorte County Drug Free Partnership was recently awarded a $1.6 million dollar Community Catalyst grant from the Indiana Department of Mental Health to create a standing Crisis Intervention Team of credentialed law enforcement officers representing every law enforcement agency in the LaPorte County jurisdiction. This formed the LaPorte C.R.I.S.I.S. Outreach Program Network.

“In order to have everyone involved, we had to plan schedule alignment for officers to attend and still have their shifts covered,” Micki explained. “To maintain that element of inclusivity, our officer training includes a panel of individuals with lived experience—personally or through family—the challenges with mental health and/or substance use, and how that leads to crisis.”

On each shift, officers trained and certified in the 40-hour Crisis Intervention Team (CIT) by CIT International are dispatched through 911 and serve as the first point of emergency response and de-escalation. Peer recovery coaches will be trained in mental health, substance use, and co-occurring disorders provide primary and ongoing peer support under the direction of a licensed clinical social worker. The goal of the C.R.I.S.I.S Outreach Team is to enhance the quality and access to mental health and substance use prevention, treatment, and recovery services across LaPorte County.

“Through grant funding, the state has identified our effort as a potential model for replication in other counties via the development of the C.R.I.S.I.S. Outreach Program Network, and its documentation as a curriculum for state and national replication,” Webb said.

The first law enforcement CIT training is scheduled for January 23-27, 2023. The grant was made possible with significant match support from HealthLinc and TechServ, technical assistance from Indiana National Alliance Mental Illness (NAMI), as well as practicum placements from Indiana University School of Social Work.

LAPORTE COUNTY

Meet Tyra Robinson-Walker, MSW, LCSW, Clinical Assistant Professor of Field Instruction at Indiana University Northwest

For social workers responding to mental health and substance use crises, the best way to learn is by doing. Tyra Robinson-Walker, clinical assistant professor of field instruction at Indiana University Northwest, leads about 30 students a year in completing their bachelor’s degrees in social works by earning placements at different sites around northern Indiana to gain experience through a practicum. Some of those students are placed in case manager field practicums through TROSC and MIRT facilitation—under the guidance of a licensed social worker—to respond in mental health and substance use response.

“When students are in this type of triage treatment, it builds stronger and higher-quality social workers who are equipped to deal with the very real challenges in our community,” Robinson-Walker said. “It’s how we’ve trained them in the past, but we’re facing a shortage of social workers, and the ones we do have are spread thin. Many haven’t had the hands-on patient experience to manage crises in the moment like this.”

Robinson-Walker is also a commissioner for the Michigan City Human Rights Department, a board member for LaPorte County Drug Free Partnership, and one of the clinical team members on LaPorte County’s Veterans Treatment Court. With a lifelong passion for advocacy, Robinson-Walker says social work “chose” her. Her work has spanned a variety of settings, from juvenile detention centers and youth residential facilities to behavioral med floors in hospitals, elementary schools, and a county jail. Robinson-Walker says wherever she goes, social work is a team effort.

“In a hospital, you work with the doctor, nurse, and case manager – a team of people ensuring all pieces come together,” Robinson-Walker said. “That’s how we see this entire project with student social workers – it’s part of a larger team effort. We’re evolving our response to get all the players who encounter a person experiencing crisis on the same page to ensure all the layers of need are addressed.”

Student social workers must complete nine levels of competencies to earn their degrees, which includes experiences like being exposed to diversity and social justice or understanding data gathering. For example, a student could collect data for the state on the number of people hospitalized, deemed unsafe, and could benefit for more of a therapeutic intervention than going to jail because their mental health was more of a triggering factor than criminal behavior.

“Another competency is engaging in individual and family support, which can be achieved on the scene of an incident,” Robinson-Walker said. “A person having anger outbursts because of a home situation could be arrested for disorderly conduct. Or the student can link that person to supportive resources or agencies in the community to address their needs.”

Robinson-Walker is hopeful that this program can provide the social work that law enforcement must often do in the moment. If a social worker is present with police, they can begin to connect the dots differently to expedite the person’s connection to support they need.

“Ultimately, I hope we can reduce the amount of people in jail for mental health issues. Incarcerating them creates additional mental health issues and a criminal background that delays the process of getting treatment,” Robinson-Walker said. “My hope is we can handle these issues on the front end instead of the back end.”

LAKE COUNTY

Meet Dr. William Mescall, Mental Health Director of the Lake County Jail

When a person living with substance abuse disorder is sentenced to jail, it may offer their first opportunity at detox. And the Lake County Jail isn’t ready to give up on them. William Mescall, PsyD, is the mental health director at Lake County Jail, which offers a specialized unit for mental health treatment.

“Most people with substance abuse disorder also have trauma, so if we can address their trauma, we can help them be successful,” Dr. Mescall said.

A psychologist by training, Dr. Mescall offers behavioral interventions for up to 80 inmates in the Lake County Jail’s specialized housing unit, as well as crisis services and medication management for more than 200 inmates throughout the jail. Having always gravitated toward mental health work, Dr. Mescall was drawn early to the idea that societal structures drive development of mental health and substance use issues.

“For example, if the cost of living rises and wages are stagnant, it creates a situation where an everyday person may suffer more stress and despair, which makes them more likely to develop a mental illness or substance abuse issue,” Dr. Mescall said. “Here we are uniquely positioned to help those people who’ve fallen through the cracks, or for whom the pressures of everyday life have become too much.”

Dr. Mescall worked in community mental health in adolescent homes for boys before joining the jail in 2017. Lake County now offers two important initiatives to help inmates in recovery: a Vivitrol program to assist opioid users in recovery, and naloxone training.

“We started working with Overdose Lifeline on a naloxone project that includes training anyone with a substance abuse disorder on how to administer the medication. If they complete the training, we include a dose of naloxone in their property when they leave jail. This can save lives if someone has a moment of weakness or is in the company of someone else who is actively overdosing.”

Dr. Mescall appreciates that the many local judges are sensitive to mental health issues and are working to create a substance abuse court in addition to the mental health court already in operation. After solving the legal issues, these efforts help people avoid reentering the justice system in the future. His hope for Lake County is to pursue additional work in harm reduction, such as needle exchange programs, safe-use centers, and additional housing for people with substance use disorders.

“We could give you all kinds of treatment here at the jail, but if you return home, and your person you live with uses heroin every day, you’re walking right back into that environment.”

For any questions about the Lake County Jail programs, contact Dr. Mescall at (219) 755-3026. For naloxone assistance outside the jail, contact the Lake County Sheriff’s Police-Assisted Recovery (PARI) Program at 219-755-3405.

LAKE COUNTY

Meet Jennifer Homan, RN, Trauma Services Manager at Franciscan Health Crown Point

“Trauma can be a physical injury, as well as psychological.”

Jennifer Homan, RN, has spent most of her career treating trauma patients in emergency medicine. She worked as an emergency room nurse for years, and now serves as the Trauma Services manager at Franciscan Crown Point. She can identify trauma in many of her substance use patients.

“Many times, we see patients who are injured in falls, car accidents, or suicide attempts who have substance abuse disorder,” Homan said. “They go hand in hand. It was natural to bring the two programs together.”

Through the ECHO Project for Lake County, a peer recovery coach and a social worker joined Franciscan Health Crown Point to round on patients who have substance abuse issues, allowing them to begin recovery while still admitted to the hospital.

“This pulls together a patient-centered model of healthcare in which we’re treating the whole patient – not just the physical injury. It’s been so impactful for our patients,” Homan said. “We receive great feedback about how helpful it is to have the peer recovery coach and the social worker in the rooms, talking to the patients daily. It’s been meaningful to that patient-provider relationship because we’re really focusing on healing people.”

Homan serves on several committees related to this work, including the Regional Trauma Committee and the Indiana State Trauma Committee that oversees substance abuse tracking. Through the Indiana EHCO project for Lake County, several evidence-based prevention programs offer community training, including Finding Good Choices, Why Try, and the alcohol Screening, Brief Intervention, and Referral for Treatment (SBIRT) program. SBIRT can be used in almost every specialty of medicine to help address substance abuse issues when a patient is receiving healthcare treatment. Medical professionals use a system to identify patients and discuss high-risk behavior.

“Most people using opioids on a large scale are likely aware that they have a substance use disorder, but sometimes alcoholism—which is often more socially acceptable—may be harder to spot,” Homan said. “We’re providing this training for healthcare providers to make sure we’re using a standard approach for screening patients, being prepared to ask those questions, and knowing how to react when the patient needs additional support.”

Developing a more trained medical community—and community at large—is Homan’s vision for Lake County. She would like to see more local businesses, schools, and other places where overdoses may occur become trained in administering (and have access to) naloxone kits as a means for harm reduction. Ultimately, she’s a proponent of primary prevention – she’d like to see substance use disorder headed off by more parenting classes and greater support for new parents to reduce the likelihood of adverse childhood experiences, or ACEs.

“Parenting does not come with a handbook. Quality, live, interactive parent education throughout a child’s life could be helpful, especially when children go through challenges like divorce,” Homan said. “Parents need more education than a two-hour class. We need ongoing training, and even parent-engaging classes on basics like how to play with your children, the do’s and don’ts of parenting. If we can prevent childhood trauma, we’re moving in the right direction.”

Homan is preparing to provide SBIRT training for the local medical community, including physicians and nurses. A Trauma Symposium is scheduled for October 14, 2022, from 8 a.m. to 4 p.m. at Franciscan Health Crown Point. For registration links or for information on our other programs and education, contact Marissa Adcock at 219-488-1380.

STARKE COUNTY

Meet Jennifer Lambert, APRCII, CRS/CHW, Re-Entry Team SUD Program Director

Each year, thousands of people in Indiana leave jail and prison to reenter society. Some are destined to return to the justice system, others may have help with reentry. That is the work and passion of Jennifer Lambert, Reentry Team SUD Program Director for Stark County Jail. Lambert and Becky Gould are navigators for the 20-week Substance Use Disorder Program that helps justice-involved people begin planning for life after incarceration.

“We are asking them about their plans, where are they going? Where can we help? We assist them in getting birth certificates, social security cards, and provide progress reports for their attorneys to show how they are doing,” Lambert explained. “We offer guidance to help them begin to change their thinking. I have a similar lived experience, and I can relate to what they’re going through.”

Lambert previously served as the HealthLinc coordinator for Starke County. She has been in recovery herself for 13 years and became a peer recovery coach in 2019. Lambert was attending 12-step meetings and realized there was a lull in newcomers. She knew they existed, but where had they gone? Ever since, Lambert has worked to help support others in recovery.

“I get to help somebody who’s been where I was. Back then, I didn’t know about all the resources that were available. I want to be able to share those resources and tell someone, ‘You don’t have to struggle the way I did. There’s help here, there’s hope,’” Lambert said. “The best part is giving back to people who are struggling. Just because you were raised in dysfunction doesn’t mean you are stuck in dysfunction. I got out, and so can you.”

Participants are referred to the Reentry Program either by self-referral or through the courts. Lambert refers some needs to HealthLinc and MIRT and meets regularly with participants to work through their next steps. She’s very proud of those who’ve managed to reenter society recovered.

“One participant completed the program, got a second job, and participates in 12-step meetings. During a checkup call she told me she can’t believe how good life is now. The message is working!” Lambert said. “I had another participant who entered the system as a juvenile with a difficult childhood. He surprised me with a phone call to say he stayed at the sober living environment for nine months, he’s kept the same job he had since getting out of jail, and he’s looking for an apartment and preparing to go to college. That is powerful.”

Ultimately, Lambert says she’d like to see more residential recovery resources in Starke County. Recovering and preparing for reentry in rural communities has unique challenges, such as transportation issues, which Lambert would like to see addressed through recovery homes.

“My vision for Starke County would be that these people don’t have to leave home to stay clean and sober. In such a rural area, people struggle for rides to and from work and meetings,” she said. “If we offered recovery homes, they’d be able to stay closer to work and their support systems so they can focus on healing and perhaps help the next person who needs it.”

Events Calendar

Learn more about upcoming events hosted by TI-ROSC member organizations.

Recovery Arts events invite creativity, conversation, and collaboration.

The Recovery Art Series hosted by the Valparaiso Police Department’s Police Social Worker, Samantha Burgett, MSW, LSW, offers community members a chance to connect, heal, and overcome the stigma of substance use through art therapy. Funded by a yearlong grant from the Hub Coalition Porter County, these free art events encourage conversation about recovery and connection with resources in the community.

Each month, a free art event is held at a different location in the community, either to highlight an agency’s services or for visibility to engage passersby. Each participant paints a small, pre-stenciled canvas that ultimately connects with others to create a large, recovery-themed mural. Recovery coaches are among the attendees, offering gentle introductions, support, and conversation.

“Walking up to a group of people painting is much less intimidating to join than walking into an AA or NA meeting. Plus, people enjoy art – it’s shown to be therapeutic,” said Burgett. “We have recovery coaches on hand to engage with people as they paint. If someone wants to talk about their struggles or recovery, creating art together helps spark the conversation and form more natural bonds. These events really soften that intimidating step of asking for help.”

The next Recovery Art Series will be in October:

 

Wednesday, October 19, 2022

5 – 7 p.m.

Valparaiso University

Harre Union, Ballrooms B&C

Food and refreshments are provided

Learn more at http://in-valparaiso.civicplus.com/1744/Police-Social-Work

Peer Recovery Training Offered Throughout Northwest Indiana

The need for peer recovery coaches is growing, and The Center of Workforce Innovations, through its operations of the WorkOne offices in Northwest Indiana, is offering ongoing training scholarship opportunities throughout Northwest Indiana. A peer recovery coach is someone who has experienced substance abuse or mental health issues (or both) and works with others in recovery as a role model and catalyst for healthy behaviors. Increasingly, more private companies are seeing value in retaining peer recovery coaches to support their employees.

“During a recent training class, we had several individuals looking for employment in non-healthcare fields. We are working with employers to promote recovery-friendly workplaces,” said Becky Raderstorf, manager at Center of Workforce Innovations WorkOne. “Employers are starting to see the value in having a peer recovery coach on staff to support those struggling with recovery, especially as employers work to retain talent.”

Peer recovery coach training is offered in a weeklong session that covers the ethics and responsibilities involved in the role. Those who successfully complete the course earn a credential and job search, résumé, and interview assistance from a WorkOne Career Advisor.

Candidates must:

• Be at least 18 years of age.

• Have lived experience and gone through recovery.

• Have been through recovery for at least a year.

• Be willing to be available 24/7 to offer support.

WorkOne will be offering multiple trainings throughout the fall, with a planned online training September 19-23 and an in-person training planned for November 14.

Learn more and get connected at https://gotoworkonenw.com/peerrecovery/.