This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

Jessica Horton has been a part of a Sacred Heart Rehabilitation Center recovery community for five years – first as a client and now, four years clean, as a peer support coach in one of its residential facilities. In its 11 locations across the state, Sacred Heart has established recovery communities, where a broad continuum of evidence-based services helps people with substance use disorders achieve recovery and stay sober.

Horton says she was "timid and guarded" when she entered Sacred Heart's recovery community, but her experience there helped her "open up and work on relationships" with herself and others. The recovery community provided her transportation, gave her work as a house monitor, and allowed her the opportunity to save money and work on repairing her finances.

"I got to reconnect with my children, have a relationship with them again, and have them in my life," Horton says. "I learned how to establish boundaries. Now I know when I need to be alone, when I need to be around other people, and when to reach out for help."
Jessica Horton.
Recovery communities across Michigan support a continuum of care by providing a range of resources from detox services, residential treatment, and outpatient services to case management, recovery supports, housing, and prevention programming. For Horton and many others, the approach is more effective than the more limited scope of traditional rehab.

"The first time I went to treatment, 12 years ago, it was pretty bad back then. There were a lot of us coming straight from rehab and [going] right back [to using]," Horton says. "When I came back to this program five years ago, it was like a stepping stone process. ... All of us mothers [who entered the program five years ago] have a year-plus in recovery."

Wrapping around Michiganders with substance use disorders

Clients in recovery communities benefit from health care assistance, medication-assisted treatment, counseling, peer recovery coaching, and aftercare services that continue to nurture them into sober living. In the Upper Peninsula, Great Lakes Recovery Centers use the recovery community model to serve residents living in all of the UP’s 15 counties.

"The more services you can wrap around someone, the better chance they're going to have for long-term success," says Greg Toutant, CEO of Great Lakes Recovery Centers. 

Toutant says recovery requires a "total ecosystem approach for whole person care."

"For someone to have sustained recovery, they are rebuilding, potentially, their entire life, which means supportive and stable housing, successful employment, continued counseling, and aftercare services," he says. "This entire ecosystem gives multiple options and opportunities because the disease of addiction is certainly plagued by relapse with triggers and stressors in life."

For Sacred Heart, this holistic approach includes specialized services that wrap around women who have children or enter the program while pregnant. Short- and long-term residential inpatient options, outpatient services, independent living apartments, supportive housing, parenting support, and child care are among the list of services that the women can access. 

"Our staff really works to make children feel safe and loved," says Paula Nelson, Sacred Heart president and CEO. "Often, they are coming from an environment that none of us want to see children in."
Paula Nelson.
More treatment, easier access are crucial

For people relying on public dollars to provide treatment services, accessing help is no easy task. According to a recent WalletHub report, Michigan has the nation's eighth highest share of adults who couldn’t get treatment for illicit drug use in the past year, and the sixth lowest number of substance abuse treatment facilities per 100,000 people (age 12 and up) using illicit drugs.

"It's not easy. There are hurdles," Nelson says. "In my opinion, we've overcomplicated the system. We forgot to put the consumer first. When an individual needs public funding, what they have to go through — it’s ridiculous. We need to streamline the process. This has to be dealt with at the legislative level, at the policy level at the Michigan Department of Health and Human Services. Also, the Michigan Department of Licensing and Regulatory Affairs plays a role in this."

Before people seeking recovery can even schedule an intake assessment, they must adhere to the procedures laid out by their region’s Prepaid Inpatient Health Plan (PHP). PHPs are organizations responsible for managing Medicaid services related to behavioral health and development disabilities. Each of Michigan’s 10 PHPs has its own protocols.

"Even if we still have multiple regional entities, they all should function the same way. A person that lives in Oakland County and another that lives in Macomb County should have an opportunity to receive the same services," Nelson says. 

Nelson notes that all but one of Michigan's PHPs require clients to contact the PHP to initiate treatment, and the client may then have to wait for a callback from the PHP. 

"It’s unfortunate because when people are ready for services, you want to get them in," she says.

Nelson notes that, to make matters worse, mental health workforce shortages are taking a toll on the limited treatment facilities that do exist.

"We're not doing enough to entice people, new people, to come into the field," she says. "So, to me, the crisis that we are dealing with right now is workforce development, recruitment, and retention. That’s something that needs to be dealt with at the legislative level."

Recovery communities as a long-term strategy

Considering that Michigan faces a burgeoning substance use disorder epidemic and rising opioid overdose rates, the recovery community model could be a more effective use of the limited public dollars spent on this disease.

"We see a lot of success stories," Toutant says. "We’ve seen women who were able to not only become sober, but took steps towards long-term recovery and worked to get their children back. There is the success that people have in terms of gaining employment again, rebuilding their lives, and the success of people who can stay in recovery-focused housing. We see success on an individual basis. But we also see it in the form of families that are healing."

Toutant notes that these successes ultimately impact whole communities, as fewer people with substance use disorder crowd hospital emergency rooms and court systems, and those who have surmounted their addictions again contribute to their families and local economies.

"It takes strong advocacy for anyone seeking care in the state to try to navigate through some of the complexities on eligibility for funding and utilizing the public system and private [insurance] systems that are out there," Toutant says. "To get that family member and loved one into treatment is so vital. Don't settle for that first denial."
Jessica Horton and Paula Nelson at Sacred Heart's Adult Residential and Clearview Campus.
Horton wishes people would not be ashamed of being in treatment or having family members in recovery.

"If they're comfortable with being in recovery, that will help remove the stigma and educate others," she says. "If we share our stories that we can get help, we can support each other and lift each other up. Some of us are going to stumble. When we are ready to accept each other with love, that's beautiful."

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at Estelle.Slootmaker@gmail.com or www.constellations.biz.

Photos by Nick Hagen.