Taking Action Summit: Bridging the Gap: Utilizing Peer Support Services Every Step of the Way
All right, well thank you everyone for joining us for this session, Building the Right Team: How prevention, treatment, recovery and workforce sectors can work together. So my name is Madison Ashworth and I'd like to welcome all participants who are joining through the virtual platform, and those who are joining us in Rochester at the Eastman School of Music. I would like to let everyone know that there will be a question and answer period at the end of the session. So hold all of your questions until that ending session, for both in person and online attendees.
If you are online, we would like you to submit your questions in the chat specifically to the Psych AV5 presenter. If you send it to the host of the- if you send it to the speakers, we will not see your questions, so please make sure you're sending it to the right person in that Zoom chat. We will not be able to answer all questions because there are so many attendees, both in person and virtual, so you can submit any additional unanswered questions to the Rochester email. So now I would like to introduce our three speakers for today.
So first we have Yara Castro. For more than seven years, Yara Castro has served as the Health and Social Services Manager at Mariposa Community Health Center, located in Santa Cruz County, Arizona, along the US Mexico border. She also leads the Santa Cruz County Overcoming Substance Addiction Consortium, a collaborative of providers and organizations working to increase the availability of, and access to culturally and linguistically appropriate substance use disorder prevention, treatment and recovery services. With close to 20 years of experience and community service, Castor has a passion for her community and the work that she does with a team of Community Health Workers.
In 2019, she was awarded the emerging leader in Rural Women's Health Award from the Arizona Rural Women's Health Network. We have another speaker, Martin Felix, who is a Jail Liaison from the Santa Cruz County, Justice Court in Arizona, bringing innovation to this newly creative position that uses the peer support model. He links people with substance use or mental health disorders to services and support while in jail, and upon release to support their recovery with attention to their individual needs. He started work in peer support at Wellness Connections Inc.
and has been the outreach specialist and site coordinator at Hope Inc. Felix is a certified Forensic Peer Support, certified Peer Support Specialist, and a certified instructor in Smart Recovery and Moral Recognition Therapy curriculums. Felix has been in Recovery for seven years. And then our final speaker of this session is Kassandra Figueroa, a peer navigator for Hope Inc.
And is actively involved in the Santa Cruz County Overcoming Substance Addiction Consortium in Arizona. She provides support services to people in recovery and with a behavioral or mental health diagnosis. She has been in the peer support field for almost three years, including with Wellness Connections. Cassandra is a certified Forensic Peer Support, certified peer support specialist, and a certified instructor in Smart Recovery and Moral Recognition Therapy curriculums.
In recovery for more than four years, Cassandra's using her journey to inspire and guide others through treatment and recovery. So now I am happy to turn it over to our awesome speakers so we can listen to their presentation. (audience applauding) - Good morning everyone. So no more introduction this is us, and we'll just go ahead and get started.
Thank you everyone for choosing the session. I know that there were other options and here you are. So we're happy to have you and hopefully this is fun. Oh, my mask, I'm sorry.
Hopefully we're able to make this fun and interesting for everyone. That's who we are. Those are our fun little logos. There we are.
So today after the session, we hope that you will be informed on how to assemble a network of community partners to address the needs of the substance/opioid use population in rural predominantly Hispanic community to create systems changes. We hope you're able to discover how utilizing peer support is critical, both for individuals in recovery and to strengthen coordination of care across systems. And we hope you'll be informed on a system develop that integrates prevention, treatment, recovery services to address the overall needs of individuals with SUD/OUD. So like we mentioned, we're from Arizona, we are located in Santa Cruz County.
Those are some pictures of our community. (audience laughing) Those were some pictures of our community. (audience laughing) Okay. So I was so excited to talk about those pictures.
(audience laughing) So Santa Cruz County is the smallest county in the state. And we're right on the border, the US Mexican border of Nogales, Sonora, Mexico. Like I said, we're about 50,000 in population throughout the whole county. Our main city area or the main part of the county is Nogales, Arizona, and that is literally on the fence border and it's about over 20,000- the population in the city area is about over 20,000 and it expands.
The next nearest county is is Pima County, which is north of us and we have a really neighboring other border community Cochise County to the east of us. The West County is closer to California, so it takes a while to get there. In the Nogales, Sonora side, the Nogales Mexican side, it is huge compared to us. So based on census data, it's over 220,000 people, but we know there's probably more than, last I heard it was more than 500,000, technically now it's probably more than 700,000 people right across that fence.
Obviously with deportations and with immigration that changes every day. It's really difficult to really get an accurate census data point on the Mexican side. But we do know it is huge and it's very diverse as well. So some of the pictures now that we could go back there, I hope you can see.
That is the fence that runs across our main city, which is Nogales, and that's pretty much our downtown area. You'll see that there's the wire on the fence, but don't let that scare you. We really aren't that scary at the border and it's not scary to live there either. I'm born and raised in Nogales, I did go to the University of Arizona and moved for a while and then came back.
But it's not that scary. It's not what you see on border wars that's, I mean, there's not, I mean if you cross the Mexican side you might see trucks and soldiers with their big machine guns and that could be a little bit intimidating, but again it's not that scary, maybe because we've grown up seeing this. But on the US side, I could tell you it's really safe. We have a really high law enforcement presence, including with Border Patrol, US Customs, Department of Public Safety, our Sheriff's Department, our Nogales police.
We have a really strong law enforcement presence, which really makes it safe. Anything happens within seconds it's taken care of. So really not what you see in the news. It's really not what you hear all that negative stereotype about being on the border.
I know there was a tunnel discovered recently. We walk over tunnels all the time and it's more of a trafficking, it doesn't stay there. Like the violence doesn't really stay there in a lot of the things that we hear on the news. It's very family oriented, even on the Mexican side.
And it's different to other border communities. So like I mentioned, we're Cochise County is to the east, Yuma is a little bit farther west. And those communities are also very predominantly Hispanic, but we're all different. Just like Hispanic, the Hispanic population is different across the country, and we'll get into that a little bit later.
So that's the map of where we're at. As you could see we're tiny, tiny, right in that V-neck. It's 27% of the population is under 18 years old. You could see some of our demographics there.
Our poverty rates are pretty high. We have, since this data came out, we have a really higher high school graduation rate. I think it's like 95% now, which is huge for our community. We are very proud on both our high schools do great.
We have a really high graduation rate. We could do a lot better in income for our families and job growth and community development in that sense. And like I said, the majority is Hispanic, so almost 85% of our population is Hispanic and more than 50% is female. 33% is about foreign born.
I could tell you that the three of us are not foreign born, but there is a large foreign born population. And I could also tell you that not everyone is an immigrant that lives in Santa Cruz, most of us are either second, third, fourth generations and even more in the community. In terms of our substance use data, we have a low number of overdoses compared to across the state, across the country. Of course, we're the smallest community, but we also know that Latino tends to- Latino data shows is lower on the charts and graphs that we see about substance use with our population.
And we do feel that- and we've had multiple discussions with our State Department of Injury Prevention on data collection and reporting and some of the challenges there. And of course the huge issue of under reporting, especially with our population. And as well there's the fear and the huge stigma attached to it that that leads to the under reporting issue as well, especially with our immigrant population. But we know that's increasing and we know that that data could be different.
So here's some more data to kind of paint a picture of the prevalence of substance use disorder in our county. I talked a lot about how we're a border community and what that looks like. And most of the drugs are passing through, we could say that. It's a corridor to the rest of the country, the rest of the state.
Here are the top 10 seizures in Santa Cruz County and you'll see that the number one seizures are meth. Meth and fentanyl are our biggest problem in the area, and they're really hand in hand in what's happening locally. And we could see that with some of this data and the seizures happening. Fentanyl, even though it's ranked here number four, it's growing by the second.
And again, this is what's actually being caught, so imagine what's not being caught, and and that's traveling through our country. We have just kind of thinking towards the end, we think it's very important that service providers, whoever's doing this work knows what's happening on the streets. It's very important to know what the cost of- what is the prevalent drug on the street? What is the cost of it?
How accessible is it? I mean, we could tell you that in our area and coming here and speaking to a lot of you, we learned that for us it's the fentanyl pills, they're called blues, M 30s. And we come to find out that we're at right now, it's not like very common as it is where we're from. Right now, blue pill, a blue costs about $2, which is cheaper than a bag of Hot Cheetos, right, that our kids love.
So that just kind of puts some perspective on that and they're very accessible. So the blues, M30's is something that we're really trying to increase awareness, especially with our youth. So it's important to educate ourselves on that. And like we mentioned, we are part of HRSA funded RCROP Grant.
We're short for Santa Cruz County Overcoming Addiction Consortium, We call ourselves SOSA. So as part of SOSA, we have had many accomplishments in the last almost three years of that we've had our implementation grant. And we we're also grateful that we had a planning grant as well. And through that process we've come to learn a lot about the needs of our community.
But I think the biggest accomplishment that has come out of that is the relationship building. Even though we are a tight knit community and we kind of all know each other, we know who's related to who or who went to school with who, a lot of the time, that helps, that really does help, but at the same time it presents its challenges. So even though our biggest success has been the growing relationship that at the same time that process has been one of the biggest challenges. There Mariposa Community Health Center, where I'm coming from, we're the lead for the HRSA Grant.
So it was our job to tackle and try to get everybody aro around the table and really talk about this and go through the process. In a small community like that and with limited funding, we know that that could be- there's competing priorities, there's different barriers to that, and that- just kind of that process. There's a lot of, maybe because of the size, there's territorial issues and competing priorities, right? Because we all want to get funding, we all wanna continue, we all wanna make sure that things are being done right, and we we're used to at the same time working on silos even though we find it's important to connect.
And then there's been a historical mistrust on peer support. So then as we're talking about increasing peer support and working through that, we also had to work through that challenge of breaking down that mistrust with peer support. And of course during the same time Covid hit and we were trying to navigate through all of that while we're doing with Covid. But I think we've done a pretty good job with that.
We've really increased the trust among partners, with time and consistency, making noise and following through. If we say, I mean, you know, we're gonna do something, it happens, and that of course with any type of relationship starts creating that trust and belief. And addressing stigma at the same time. So just some real accomplishments.
You can see them on the slide. Real quick accomplishments. We work very closely with our EMS department. We've done a leave NARCAN behind program.
When they go out on a call, they also do a treat and refurb. If they go out to an overdose call, they'll connect the individual if they're ready to peer support right away. Peer support's able to engage 'em in treatment right away. We took it a step further and most recently we've established safe stations with our local fire departments, where people can access NARCAN, our NARCAN distribution site while providing treatment and recovery resources for individuals.
So we're really proud about that. Our law enforcement agency, our Sheriff's Department has really upped their game recently. They recently had a trauma informed training. They trained about more than 40 officers on SUD and policing, and deescalation and really trauma informed, which is huge.
Working on updating their protocols and possibly establishing a deflection program as well. Extended the drug program and the Jail Liaison position that Martin has did not exist before. And through some of the partners in collaboration that has come to light, which is huge. And of course increasing coordination of care and screening.
And we're also currently working with our local hospital to see if we can establish Emergency MAT services there. So those are just some few accomplishments that we're gonna continue to work on whether or not we have the RCORP HRSA funding to have that. And we're open to discuss any of that further 'cause I could do a presentation on each of them as well. And the partnerships have also extended beyond Santa Cruz County.
So we do work very closely with our department, our Health Services Department office of Injury Prevention, we have statewide partners like Sonoran Prevention Works, which is also HRSA funded program in the neighboring county of Cochise. We also work very closely with Tucson Police Department, which they have really grown the movement of deflection and trauma informed policing. And we're really trying to model and customize for us and our population. So those are some of our accomplishments, some challenges.
But the biggest piece of that I was talking about trust and the piece of just kind of rebuilding that peer support because we understand and we know the importance of that. And in terms of our culture in Hispanic and being so tight knit, peer support has been key. Peer support has been key in this movement, in this change. And with all the changes with peer support and that process in that system has really led us to be more successful and open-minded with a lot of these changes.
And it really connects well with our population. And I'll just let- Martin will tell us more about that.
- Good morning. We don't need introduction, I think you did an amazing job introducing ourselves. I wanted to come running down there and be like, hey, hi-five. (audience laughing) Yeah, wanted a to do a grand entry, right.
For me it's something big to be here as a peer support, to be honest. In New York, outside of my community, representing to peer support community means a lot to me, to be honest. And I don't wanna leave New York without saying that peer support is the special sauce for treatment. If you really wanna help individuals get yourself tied in with peer support.
We're able to connect to individuals in a way that a lot of people might not be able to connect. How so? My lived experience experiencing to peer support wasn't- I wish I would've had peer support services available to me sooner, and maybe things would've been different. But I didn't have it sooner, I think it just came in the perfect timing.
First time I had experience with peer support, I was at a detox facility and I was withdrawing and someone wasn't saying a word to me, but was side by side with me and was helping me clean the sheets while I was doing all my things, and I was like, this person's giving me love, you know, and I'm like, why are you doing this to me? And he kind of told me what he was. I could tell he had lived experience, I could tell the tattoos and stuff like that. So he told me a little bit about peer support and it kind of clicked in me like, if one day I get, wow, that's what I want to do, you know, it gave me hope, like I wanna do something with.
And I wish I could tell you, oh yeah, it was right there once I got clean, no, it took me a long time after that, you know. But once I did, I was able to become a peer support certified and it wasn't that easy. I had to travel 70 miles away to receive peer support services. Just to get certified, I had to travel, and good thing that I had the availability to do all those things.
So I remember when I did become certified, it was hard for me to get employed in my community as a peer support certification because, all Yada was saying right now it was- there was stigma, I don't know, maybe it was a little bit like, I've been in the system for a long time, so like, really hire you, you know? So yeah, it was hard for me to be honest until I was given the opportunity for, I'll be blessed for that opportunity. I don't know where I would be today if I wouldn't have given that opportunity. So my goal was to try to bring, learn from my experiences and try to make it easier accesses for people that I was working with.
And I was reaching out to neighbor communities on Pima County. There's a University of Arizona that had a curriculum for peer support training, reached out today to them and continue encouraging to bring that curriculum and certify some of the people in our community, and we were able to do that. We were able to do that, we were able to bring peer support into our community, get people certified, and hopefully working in the field. That was one of the main things.
And I think peer support was just a magical thing, you know, it's just to have 'em included there. I know there's things that we might not be able to do as a therapist, as a doctor, as a counselor or some things, but just having them included in treatment, even if it's employment, substance abuse, mental health, include 'em all the time. And I'm also very grateful that I was given the opportunity to do this in my community. Because it wasn't available then, even though that peer support that touched me, he was from a outside community, so his experience wasn't the same as mine.
The culture was different, his race was different. So it was good that he had a lived experience, that he was gone through addiction, been incarcerated and stuff like that where I could relate. But still it was different because the culture was different and the race was different. So for me to be able to go back to the community, speak the language of the heart.
So I'm Spanish speaking first, so I'm getting better at English, but five years ago I wasn't that good. So be able to speak to them in that language and relate to 'em in the label from our community. And it helped a lot, and I thought that was pretty cool as walk too. I'm looking at my notes, okay?
I don't know if you guys could see. (laughing) Oh, and then I think it was cool for me to be that face for peer support, because they did not believe in us, right? So I was sitting at Yara's Consortium, right, I had the social consortium. And with people had seen me gone through the system, right, that once was my case manager, the other one was my therapist, right?
The other one was the police officer that arrested me. You know, so thinking like, what is this guy doing in this table, you know? And be able to give that insight, be able to give that input what I needed or how is it that I could help in any way with my experience related to MAT, incarceration, rehabilitation, outpatient services, groups, one on one, whatever it could be, I felt like I had something to give. I have a barrier to break and I would offer it with a loving heart just to help people, you know, that's what I was trying to do and I was grateful that I was doing that in my community.
And it just gave me hope to be honest how I told you, I didn't know- I had no purpose in life for many, many years. I couldn't get a job, I couldn't hold a job and I was having a hard time. So when I heard peer support, I'm all like, I'm gonna grab to this and run with it, you know? Right now I'll get more into my start, but I just wanna give it, I'm going to school, I'm getting a bachelor's in Chemical Dependency.
I probably put that certificate with my other certificates in the binder and I'll put peer support, leave it hanging there because that was my school of 20 years, you know, even though four years of learning a little bit about myself addiction, Chemical Dependency, it's gonna be good to help me help others. But still my lived experience is it's what really has been helping me. And with my lived experience, I think I've been impacting other lives. And with that, I'll pass it with Kassandra, where she has something else to say more about that.
- Hi everyone. So to piggyback on when Martin was saying, Martin was actually the first peer support that gave me hope when I got into the field, and when I got into early recovery, which wasn't- it didn't stick right away, but he was the first person to believe in me when I needed help. So we really wanna get into the assumptions about the Hispanic community, accessing healthcare, behavioral healthcare and treatment, and rural versus urban communities. So we're not all related to EL Chapo.
We're not all criminals, me and Martin are felons, but Yara isn't. (audience laughing) So two of the three. My grandparents didn't come with a coyote from Mexico. There's a lot of those stigmas and there's a lot of those misconceptions, because we do live right next to the border and a lot of the assumptions are correct, that's the hard part, and that's where we were struggling.
52% I think it was, is below the poverty line in Nogales right? But that doesn't make it, that's not all of the Hispanic community. My grandpa graduated from the University of Arizona and he's an engineer. My mom's a nurse, my aunt's an accountant, right?
So not all of us have that same story. When accessing healthcare we wanna go into the doctor's office and we wanna feel warm and cuddly, and we want them to talk about their grandkids and offer us a cup of coffee, and we wanna talk about our grandkids and make it like, oh yes, we know the doctor and the doctor's wife and they go to our church and we're all just loving friends. In reality, healthcare isn't like that. There's a line that healthcare providers have to follow and that's what we expect when we're seeking treatment.
I also have a cabinet full of teas that are gonna solve all of these symptoms that I'm having. And my grandma has a closet that has all these herbs because she believes in natural medicine. So when we're going to the doctor, there's an expectation, they're not gonna help you, they're just gonna keep you sick and they're gonna prescribe you things 'cause they want the money. That's what I was taught, right?
With behavioral health treatment, (speaks Spanish), that's where the crazy people go, you can't go there. Oh, why would you go there? You guys just hang out. In the program that I work now we get a lot of stigma, oh, you guys just go to field trips, you guys all just hang out there, the drug dealers hang out there to be able to sell drugs.
No, that's not what we're doing as peer supports. And in the rural versus the urban community. So I started off in Nogales, my mom moved us to Chandler and that's where my drug addiction kind of spiraled out of control. When I was accessing treatment there, I felt like I was just another number.
I would sit with my counselor and he'd be like, all right, tell me your strengths. And I'd start talking, you know, I wanted to have a whole conversation, he'd be like, you're resilient. And he would type that up, I would have 10 minutes for a phone call and I was sent off to go and do my thing, right? I never felt that closeness and that warmness until I was in Nogales and I started having people that actually believed in me.
I remember Martin saying like, there's something about you. And I'd just be like, yeah, yeah, yeah. Let me just come to services, let me play the part until I find the perfect opportunity to relapse. There's also a lot of myths that are tied to the substance use in Nogales.
So just a quick share, there's a story out there that says that El Chapo unleashed the blue demon because he swore that if he was gonna get extradited to the United States, he was gonna 'cause us suffering, right? In my community, that's like a strong story, everybody talks about it. Like if they were right there, Chapo told them personally, and we're all like really big drug traffickers and connected to the cartels because that's the idea that's behind it. I can go to Mexico, get connected with somebody that's selling drugs, larger amount of drugs, it is larger amount of drugs, but they're nobody in that timeline of the cartel.
But when you're talking to that person, they're just like, yep, we sit down with Chapo's kids and he gives us the material. So it made me feel like I was great big drug dealer, right? Not until I got caught on the border and that's when my life changed. So there's a lot of irrational beliefs.
There's a lot of like that, that Grand Joe City that comes with the whole lifestyle and drugs in Nogales. But it's really that just revolving doors, it's a human trafficking, right? There's illegals that are trying to come, that are trying to build a greater life. We're not saying there's not, we're not immigrants, but there's a lot of people that are, there's a lot of people that never leave Santa Cruz County because they can't cross that checkpoint about, what, 15 miles up.
They can't access different healthcare, they're stuck with that. So that's what we know, that's the culture. We can cross over to Mexico and go to the dentist for 20, 30 bucks. We can get a script from a doctor, it's legit for 20, 30 bucks.
If you don't have the state care, it's really expensive to get the treatment that we need, right? Rehabs and everything costs a lot of money. So that's our assumption slide. And it gets into my story.
So a year ago I wouldn't have known how to share my story. There's a lot of key components that lead to my substance use and trauma. So we joke about it 'cause we're in the field, right? But I have a ACES score of eight, and when we were talking, I'm like, my score is the highest guys.
There's a lot of emotional abandonment. I came from a strict Catholic background, and a lot of anxiety. So all of that stirring up was just like a bomb waiting to explode. In my teen years, I lived in Chandler so I was too loud and fat for the white kids.
Like, no, you're so annoying, shut up. And I was too whitewashed for the Mexican kids. So I was always looking for acceptance. And I started heavily drinking and smoking pot at a early age.
And my 13 years of age, I also lived through a sexual assault, which I didn't know was sexual assault until I was in recovery. I thought because I went out and I snuck out that night that I had consensually had sex with a 19 year old male. When I was in recovery, I found out no. So I lived my years moving forward, being objectified.
I objectified myself, I thought that was my value. Like, oh, this is what I'm gonna do with my life, right? Little did I know I was carrying a heavy blanket of shame and guilt throughout all of that time. It would take me a really, it would take me hours to explain all of my story, so I'm gonna kind of miss jump through.
I became a teen mom at 17. At 21 I had my second daughter. But at 21, instead of falling in love with my daughter, I fell in love with methamphetamines, because for the seven years after my first contact with substances, I was trying to fill a void that methamphetamine filled. I was energized, I was happy, the depression was gone.
I was just living my best life, right? A year later I tried heroin and I was so sick for three days after that. That should have been the thing to say, no, that's on the stop. Like this is making you sick, and I was like, this is great.
Like I feel nothing, I felt nothing for the first time in my life. So I kept on moving forward, destruction, a mess, I was catching misdemeanor charges. But that still was to me, I'm only getting 24 hours in jail. I got off with a really good deal.
I was paying fines. So that wasn't serious consequences, until I remember calling my grandma and I was like, grandma, I'm not gonna make it at this rehab. I was like, I need your help. Can you please get me?
Maybe in Tucson, Sierra Vista. So they call me and they're like, your grandma and your daughter have been in an accident, I believed it. I'm on my way to Mexico and all of a sudden I'm in a rehab, involuntary. In Mexico your family can sign you into rehab and leave you in there for however long they want.
And I was like, I don't eat Mexican cheese, you guys, like, I can't stay here. I'm gonna get sold into sex trafficking, like you can't leave me here. And they did. They did.
That was my first try at real recovery. I had counseling therapy, I got out, I made a mess. I kept on using, I kept on manipulating, using my grandparents as an excuse, using the trauma, I hate my mom, she's really mean to me, she's not helping me. And I wasn't ready to take responsibility for my actions.
I ended up crossing the border with a large amount of heroin, and I went to jail for the first time on a felony charge. Once I got out, again, kept on using, wasn't enough, that wasn't rock bottom for me. And it wasn't until, so I hold the world record in Santa Cruz, not World, Santa Cruz County record in the fastest revocation for probation. I was sentenced on a 5th of March, and by the 21st there was already a felony warrant arrest for me, and they were sending out patrols, I was making a mess.
What I didn't mention is that I was seven months pregnant at this time and I was still using, in and out of lapses of not using, I relapsed at about five months. And I went to court that day, Martin took me and I was supposed to be sentenced to IPS. When the judge spoke, he said, your child doesn't have a voice, so I'm gonna be the voice for that child. You're going to the Arizona Department of Corrections for a year and a half.
And that was the day that my life changed. I feel like I actually surrendered and I started being able to hold myself accountable for my actions. And that was in March, about a year later, the father of my son died by overdose, when I was sitting in county for more felony charges that got, I got a page two for my charges and I was awaiting that sentencing. That's when I had to make a decision to change.
And that's when I started exploring the options of maybe I could be a peer support, and maybe I can have a different life and maybe I can be a mom. I never believed I could be a mom and I never thought my kids would need me in their life. I thought they would be better off if they weren't there, right? And that's when my life changed.
I got out, I got my peer support certification, I got a job at Wellness Connections where I received services. I started just investing all of my time in that, and I found purpose. I started building a relationship with my kids. Even though my daughter still says, mom, why weren't you there?
And mom, she asks me all these questions, but now I feel able to address them because I'm in a different place in my life. I then started working for Hope, where I started being able to develop my own sense of style and being able to speak about these things, right? I can ask a mother in recovery like, are you sure you're ready to take this responsibility? 'Cause it's okay if you tell me that you don't love your kids right now and you haven't felt that connection and that bond 'cause I've been there.
I have a five month old baby and I could share my love for her is this unconditional closeness. My love for my other children isn't the same, I've had to work for that, right? Because of the traumas that I've experienced. But now I can speak about that and I can be honest and I could share these raw experiences.
I've gone through psychosis, I've gone through relapse and recovery and relapse and recovery and healing the resentment and pinpointing every single part and the chain and connecting it and going back and saying, this is where it started. Like I said, I could speak for a long, long time, but I wanted to share those key points with you guys, and that's why I know that pure support can be the change in somebody's life because it was what gave me hope. And then Martin can share you guys his story, 'cause that will also represent how strong peer support has an impact in our lives. So thank you so much.
(audience applauding) - So they told me that I have to hurry up because she stole some of my time. (laughing) I'm just kidding. I'm proud of this woman. I'm very proud of the woman she's been becoming.
I always saw something in her, and I'm very happy to hear her story share with all of you today. And I could share my story very quick anyways, it was just like many years I started doing drugs at a very young age. I started receiving services at a very, very young age. I was a rebel at a very, very young age.
So I started at a young age. It all happened very young. I became part of the system at a very young age as well too. And I was part of the system for many, many years.
In and out of hospitals, jail I've been arrested 19 times. I've been to prison three times. I've been to residential treatment seven times. Detox, I think I lost count, it's been more than 10 times.
I've been on medications, I have numerous of diagnosis as well too. But that never determined who I am now as a person. But yeah, I lived addiction many times. Suicidal thoughts.
In 2015, something happened. It was August 13 or 15, sorry. I woke up in a hospital bed full of tubes, machine is tied to my body. Sorry, sorry, sorry.
Sometimes it touches me, sometimes it doesn't. But right now it did. Yeah, so I woke up in that bed full of machines, tubes in my body, August 13th, 2015. They told me they found me dead from an overdose, which I'm sure I did it intentionally, that I've been in a coma for four days, that they don't know how I was alive.
But I remember waking up and feeling like things were gonna be better. Like that day I knew it was time. I woke up feeling different, I woke up feeling a peace that I never felt in my life. I knew I was done.
I knew I was done. I just didn't know what's gonna follow next. And that's the day I guess my life started changing. I went again to another detox, I went to another rehab facility, the same one I've been there three times.
And just things started falling into place. By then, I had burned every bridge. I remember I was on the run for my parole officer and they caught my parole officer and told her like, can you- I wanna turn myself in. She saw me, she said, you're not in a good shape, you need medical attention.
I was weighing 120 pounds, I was using a walker to walk. I was just skinny, I was just in a bad shape. She's all like, they will not accept you in jail. I'm like, I need to go to jail because I needed the shelter, I needed a bed, I need food, I need the things so I could feel better.
She said, Martin, you don't know how to survive outside. That probation officer touched me too, she believed in me. So yeah, I went to that rehab, completed, things just started falling into place, my family saw me. When I first talked to my mom, she was all like, I'm having a conversation with you.
My mom had put a restraining order against me, my wife, I had lost my wife, my kids. They slowly started accepting me, and it took a long process. When I was speaking groups at the rehab, they kept saying like, you have something Martin, you have something. They believed in me when I didn't believe in myself.
And so, yeah, like I said, I wanna become a peer support this time. I do this, this time I wanna help others with my story. Just things started falling into place. I don't know, what am I doing here in New York when I should be dead, you know.
In New York, sharing my story, something blessed for me and working at the jail, at the jail, I've been housed many times. The judge is my friend. (laughing) The sheriff is my friend, the probation officers are the ones I go to eat lunch with. And it's just weird, they ask me, they call me, Martin I have this individual, I'm all like, you want my input, you know?
And it's pretty cool where I'm at now today, I try to keep my feet in the ground and be Martin, when I try to get my ego big and be like, oh, I do this, like, remember, you should be dead, Martin is just a blessing that, so put your feedback in the ground, you know, I have someone that will bust that bubble on me. And I'm just at service, you know, trying to help others, maybe help changing the system, especially in the community where we're so behind. And for me to be the first few days that I just started this new rule at the jail, in March 7, I think it was, it's been like two months. And
the scent, like, I didn't know how much it had triggered me, how those trauma, the scent going inside the jail. I was hearing the keys and there's been some times where I just get locked, I'm like, I got keys, I could go out right, and come back. So I tried that a few times till I felt sure that I could go in and out of the jail, you know? But for me, it played a big role.
I'm helping develop a specialty court side by side, with Judge Velasquez. He's a champion judge, he helped me a lot. He's the one that reached out to me and built this position for me. They had to change the hiring process just to hire me because I'm a felon.
That was a big thing, County attorneys had to sign for it, they had to vote for it. And they had to had a meeting with me and explain to me the reason, because they're still kind of, is this person really gonna stay well? Can we trust them inside our jail? You know, inside.
But I'm glad that, and I'm sure they will not regret them hiring me. I'm helping develop a specialty court, which is a drug court, helping them develop a mental health court as well too. I'm helping to do groups inside the jail. So I get all excited, I wanna do so many things, and then I'm all like, I don't have have a team, it's just me and Martin calm down, like.
So I'm trying to get a team now. I just got hired two months ago and I need five people to help me, and I could get this, give me five people and we could do big things here, right? So yeah, I'm completely blessed. I have a great relationship with my mother and father, with my wife and kids.
I had a four year old, you know how Kassandra's the same movie different character. I could relate to everyone that's gone through some kind of lived experiences all the same movie. But in different levels, I was just never pregnant like Kassandra, but I look pregnant now, (laughing) but I'm not, okay? So yeah, again, that was my story.
You know, it's just been years of sufferment today I continue maintaining my recovery. I know that my job is not my recovery. And I try to tell everyone peer support that's working on that, don't make your job a recovery, if I did, I would be stressful, you know? So I continue maintaining my recovery and trying to learn, you know, trying to learn, continue growing and learning and be open minded and helping people.
I like seeing people grow, like Kassandra, I saw her hearing her talk right now and all that she's done. It just gives me like, something that heroin never gave me. You know, something that methamphetamines never gave me. Something that spies crack, all the drugs that I ever tried never gave me.
Seeing people grow, like, you got an ID? Yeah, gimme five, I didn't have IDs for years. Like a bank account? Oh yeah.
You know, little things, little, little things for us, it's something big. Just the ID part, and I would mention that, like, they want us to go get a job, but we don't have an ID, we need an ID to apply, right? And I can't sit at the MBD for hours and waiting my anxiety while I will get dope sick, you know, so I couldn't get ID. So these little things and sharing that with people, they were like, oh, okay.
So just get yourself, go find yourself a champion in your community, tell 'em that peer support is the special sauce for treatment and include 'em in people's treatment plan. That's what I hope you guys take from, whatever I'm saying. Peer support is the special sauce for treatment. Go find yourself a champion in your community and give him the opportunity.
Thank you very much. (audience applauding) - Thank you both to Martin and Kassandra for sharing their experience. I know that it's not easy. I can only imagine.
And for them it's huge, and I'm really, really proud of them. And for me it's an honor to work with them and learn so much of them, with them together. So with that peer support is fairly new to our community. I talked earlier about having to gain, there was a level of mistrust and having to regain that trust.
And as you probably figured out by now, Martin is a champion in our community, and everybody knows who Martin. And we've been on the radio and he's been here and there, invited to speak at different events and he keeps growing and that's awesome. And Kassandra as well on her way to that too. So that is kind of what's helped us build that trust and that voice, and that consistency, and that power, and that energy that they bringing to the table leads us to really be able to make the movement of integrating peer support into prevention, treatment, and recovery efforts locally.
Them and their all other peers and their agencies and now all of us that have regained that trust in the peer support service have incorporated them into the different aspects that were set out to do. So with prevention, they're involved, like I said, in public speaking events and different community awareness events and family and youth education. So whenever we do like a NARCAN training or whatever happens, we try to have a peer support person there for support, for info, for that one on one. And it helps reduce that stigma, right?
We keep talking about reducing stigma in everything that we do, and as part of prevention and our big overarching goal. So let's talk about these stories. Let's tell the truth. Let's really say what's happening.
So we use that in our prevention efforts. In treatment, of course, peer support is key side by side in ART meetings, as part of the outreach, as part of coordination of care. We have a lot of individuals with chronic diseases that don't go to the doctor, that aren't regular on their diabetes medication, right? That whole aspect of it, that medical side of it.
And coming from an FQHC, that's important for us to get people established with care and have that consistency in care. So now our care coordination team, our medical providers, we're working alongside our peer support agency and peer support from other behavioral health agencies to really hold their hands and say, hey dude, you gotta get your diabetes meds, or we don't want you back in the hospital. I got a call from our saying, you were at the ER, what happened this weekend? So that coordination of care is huge because part of healing, part of recovery encompasses this overall wellbeing, right?
Mental, emotional, physical, spiritual. So part of treatment is trying to incorporate it into all those pieces. Court accompany means supporting treatment, education, and of course the recovery piece that speaks for itself, right? Meeting all the basic needs and helping with that.
And we've also incorporating them into the workforce. With our local AHEC, we developed a peer support curriculum training. So it's basically for youth, and they're not certified and they're not a billable service or anything like that, but it's to train our youth in the community on the issue, behavioral health, substance and- For two purposes, one, to empower youth, to make them knowledgeable of what's going on, but at the same time, to provide 'em with not only those skills and resources, but for them to maybe inspire them to go into the field and to whatever part of the field they want.
And we have the peer support part of it too, and of course Martin has spoken in one of the sessions and we wanna make it a thing so it continues to grow, and really move that workforce forward. Job placement and training, we're in conversations with our local workforce office and trying to incorporate these and what else can we get to get people placed into jobs. And I know getting them an idea and all of those pieces is where peer support comes, but also those system changes and those leadership roles that peer support can have to really help make those changes. Just like what's happening in the jail and in the court system right now, which is another big piece of how we've integrated peer support into all of the areas.
And the key was rebuilding that trust, right? And we understand that- we talk about how the drug use is the supply and demand issue, right? And the supply is gonna be there until the demand is there, and what are we doing to address the demand, The supply, I know we've got our CBB partners and all that stuff, right, tackling the drug war. But what are we doing to address the demand and why is there a demand, right?
Finding those root causes. And that's why it was so important for me to come and have Martin and Kassandra share their stories. And we really dig into- I love hearing their recovery story. But sometimes what's behind that recovery story, right, and that's harder to talk about.
Just like yesterday, I think Tony was saying just within three years he kind of started thinking about deeper what's going on and really talking about that. But that's where the demand comes from. It's those root causes, that social determinants of health, right? That living in poverty, having multi generational families in the same home/housing, right?
That's huge when it's getting worse by the second. But housing, access to care, whatever that looks like. Educational opportunities, recreational opportunities, right? Getting busy, getting that hyperactivity busy.
Martin used to love baseball. He never really got to play baseball. Baseball is huge in our town and our team, right? He's like, I always wanted to play baseball.
What would've happened if he would've gotten all that energy out in the field? Kind of him, some nice cleats and something as simple as that can really change those outcomes, right? Yes, housing and food and shelter, those are basic needs that we all have, that we need to survive. But as humans, we need a little bit more, we need to find that purpose, that energy, and recreational opportunities is part of that.
And we sometimes fail because we're so stuck on food insecurity and housing, which are very important. But it's important to offer our children, our families, those opportunities to connect, those opportunities to build community. Sometimes you might not find that community within your own family, and that's okay, but we need those opportunities to connect and build community with others with similar interests and purpose and love. So what I'm- that just goes us to finish up and saying, let's keep in mind.
We've all seen this at one point or another, right? We all know somebody, maybe it's us, including myself, and just we're all peers. We're all peers in a sense. We know somebody not only because of work, but in a personal level.
And we need to use that as we move forward and make changes, make system changes. And like we were talking yesterday, it's a not one size fits all, it's a huge issue. And it's not a one size fits all solution because we're all different, we're all diverse. And we need to look within that, within our communities, within our cultures, and kind of customize that to each individual, because this is us and we're all peers.
Thank you guys. (audience applauding) - Okay. Thank you all so much. That was absolutely amazing.
And I think we don't have a ton of time for questions, but I am gonna open it up. First, is there anyone in the in person audience that wants to get up and ask a question? Right away- all right. Green shirt, go to that microphone right over there and ask your question, and then we'll take one question from our online audience.
- [Audience member]
Okay, this might be a loaded question, so just answer what you can. I feel like I keep hearing over and over again how the criminal justice system has played a role in individuals starting on the road to recovery. Why do you think that is? In what ways can we prevent incarceration as a segue to treatment and recovery?
And how has the criminal justice system impacted you?
- [Audience member]
Yes. (audience laughing) - So yeah. I can't really blame the criminal justice system. I think it just got a grab of me and- for their reasons, I probably did a crime or something.
Just the services wasn't there to avoid me to divert me from jail or from prison into treatment. There was no other option. There was no other option for me. So it played out that way.
I ended up in my own lived- I could share my lived experience. I had got my first felony, then from there it was just hard to get a job. And then it just played off from there, and now what we're trying to do some kind of diversion, right? And hopefully there's other communities that been doing it for a long time, others that haven't.
So when I started hearing them, maybe if they would've put me in that program, write a specialty court, if you complete do well for one year, we'll knocked off your felony, would've made a difference probably, I don't know, to be honest. But let's talk about it, let's give it a try, right? And something, so we're moving forward I think, to the right direction, and hopefully other communities do have those opportunities for specialty courts. Again, I cannot blame the system, I cannot blame the courts or jails or anything like that.
But I end up being part of it for many, many years and I just couldn't get out of that. Thank you.
- All right, we'll take one last question from our online audience. So what advice would you give to clinicians who are working with clients with SUD? How can they, as clinicians, advise them and connect them in with peer support and peer support specialists?
- So the advice that I would give is, to have somebody with the lived experience or to have somebody on your team and staff, because the the clinical part is gonna always be there. There's like a structure and that's how we know. But we talked about it yesterday, we need to be able to show up and we need to be able to be there with that enthusiasm and that hope and that free of judgment space to say, hey, all right, you did it, or even you relapsed again. But not to put that pressure on them to be there side by side.
A clinician has a certain, I don't know, structure that they have to follow. A therapist has a certain structure that they have to follow and they have to even deem if they're able for court. So definitely just having somebody with the lived experience on the staff. Thank you.
- All right. Thank you so much. So that is going to conclude this session. Thank you so much to our presenters.
This was absolutely phenomenal. We have tons and tons of additional questions, I'm sure for you guys. So if we have any unanswered questions that you didn't get a chance to ask, go ahead and email them to the Rochester email that is sprinkled throughout all of your conference packets and on the website. So I would like to say thank you again and we can give another round of applause to our awesome presenters.
(audience applauding) Thank you.
Yara M. Castro, BS
Health & Social Services Manager, Mariposa Community Health Center
Jail Liaison, Santa Cruz County Justice Court
Peer Navigator, HOPE, Inc.