KOKOMO – A longtime addict, Tiffany Eagle has participated in many treatment programs. But until November 2015, there was always something missing.
The programs, while sometimes helpful, focused on the addiction itself - how to stop taking drugs and abusing alcohol. What Eagle needed was different.
Eagle needed a distinct kind of help, something that answered a more important question: why? Why the reliance on substance abuse? Why did her mind work that way? Or, the same questions many in Howard County are hoping to answer.
Eagle, now 33, has struggled with drug and alcohol addiction for roughly 15 years and during much of that time participated in court-ordered treatment programs.
Like many addicts, Eagle’s addiction began as self-medication for her myriad mental health struggles. And like so many before her, drug and alcohol abuse quickly morphed into something more, a downward spiral threatening to ruin her life.
On top of that, the help Eagle received was falling short in a major way. That shortcoming, Eagle believes, was the product of a misplaced focus.
“Various things have happened, whether some of them were my own doing or of other people’s doing, things happened that obviously landed me in this addiction,” said Eagle in an interview Thursday.
“And in the last 10 years, I have been incarcerated, I’ve been to prison, I’ve been through probation, [an intensive outpatient program], all these programs that the criminal system puts you in, which I do think are good programs, but nobody had ever really addressed, I think, the underlying issues.”
That was the case, at least, until Eagle entered in late 2015 the then-new mental-health diversion program offered by Howard County Superior Court II.
The program, commonly referred to as a mental-health court or problem-solving court, got up and running in August 2015, and Eagle was one of the first to begin participating in it.
On Monday, Eagle graduated from the program, one of four to graduate from mental-health court since it started. There are 12 people currently enrolled in the program.
The program allows offenders suffering from a mental illness to get treatment rather than go to or stay in jail. Once they complete mental-health court, their charges, usually low-level felonies or misdemeanors, are permanently erased.
“If they’ve been charged with a crime, and the root cause was a result of a mental-health problem, we want to help them get treatment rather than be incarcerated,” said Superior Court II Judge Brant Parry in a previous interview.
It was a chance for Eagle, incarcerated on alcohol-related charges for 11 months, to be released into the program and effectively start life anew.
In fact, she was motivated enough to pull out of a plea bargain already agreed upon with Howard County officials. It was, said Eagle, the “light at the end of the tunnel.”
“When I finally was able to address what made me think the way I think, what drove me to do the things that I do, it was life-changing,” she said.
Eagle said that through IOPs and other programs she received treatment centered on her mental health, but such therapy was always provided in the context of her drug addiction.
“In substance abuse treatment, the problem is you’re drinking and you’re using,” said Eagle. “In the mental health treatment, that was an effect of the problem, the drinking and the using was basically a symptom.”
Through group and one-on-one sessions, including many with Community Howard Regional Health officials who teamed up with the court to provide forensic-diversion care, Eagle saw progressive improvement.
The forensic-diversion program was specifically created with funding from a state grant to get mental-health treatment to people in the criminal justice system in Howard, Tipton and Clinton counties.
Now, the hospital’s program is offering wrap-around mental health services that are tailor-made for all the participants in the mental-health court.
The addiction, Eagle learned, wasn’t the cause of her struggles; instead it was a byproduct of something much more serious.
That knowledge has allowed Eagle to stay clean for nearly two-and-a-half years and continue receiving treatment from Community Howard.
“I had deeper conversations with them about the traumatic things that have happened in my life, and they helped me to understand why those things affected me the way that they did, and how I could change that,” said Eagle.
“I’ve been through a lot in my life, and a lot of those things affected the way that I thought about myself and the way that I thought about other people, and eve so much as my performance at work, the way I handle my relationships with other people, and they helped me to basically view it from a healthy standpoint instead of allowing that trauma to control my life.”
Eagle’s success is something officials throughout Howard County are hoping to replicate on a broader scale, specifically in its criminal justice system.
Reaching out
Howard County Jail officials estimated last year that around 40 percent of inmates are taking medication to help treat a mental illness, and the percentage of people in the criminal justice system dealing with mental illness is likely higher.
To confront that issue, community stakeholders began a mental health coalition, consisting of law enforcement personnel, Community Howard doctors and treatment specialists, elected officials, including judges, and more.
Since October, the group, which meets once a month, has grown to include nearly 40 invitees.
In an interview, Richard Cotterell, Community Howard Behavioral Health Services program manager, and Meggan Planck, director of operations for behavioral health at Community Howard, both said the coalition has become a collaboration among varying agencies, and has avoided the stigma often associated with mental health.
“In bringing all those different entities together, everyone has their own sort of connect that we may not have as an agency but they do, so you’re pulling a lot more resources and knowledge together to combat whatever problems or barriers you have,” said Cotterell.
Moving forward, the group hopes to accomplish a number of things, including drop-in services at Community Howard and an after-school program for the local teen population, a group Planck said is hardest-hit by street drugs.
A potential teen group program would focus on both mental health and substance abuse, she noted.
But most recently, the coalition’s agenda was focused on figuring out ways to help the jail, both its mental health and population concerns.
In March, the jail had an average population of 473, including inmates held out of county. In March 2016, that number was at 342.
The jail, which often serves at the first stop for those handling serious mental illness, is a familiar place for Community Howard officials.
Currently, Community Howard offers a weekly “skills group” for both males and females, and offers one-on-one services to inmates in their program who are not able to attend group settings.
The focus is, say officials, on the co-occurring disorders of mental health and substance abuse and taking steps to ensure future success.
The treatment specialists are also available for unscheduled visits, sometimes necessitated by a jail officials’ call asking for a risk assessment or a simple conversation with an inmate.
Those visits, said Cotterell and Planck, significantly help both the inmates and mental health officials.
Not only do jail visits allow treatment specialists to assist inmates while incarcerated, they also increase the inmates’ awareness to what is available in their own community.
That fact was noted by Eagle, who said the treatment was “a breath of fresh air” during her incarceration and motivated her to seek out more services.
Eagle acknowledged, however, the need for even more services in the jail, especially one-on-one treatment, saying that without therapeutic opportunities “a lot of people walk back into what they came from because they don’t know any different.”
But with 175 people referred in the last six months by Howard County Probation to Community Howard for treatment, the impact has been noticeable.
“[Going into the jail] makes it easier for us to provide those services,” said Cotterell. “And a lot of times they are seeking that while they’re incarcerated. And that’s where our forensic-diversion grant specifically has allowed us to go into the jail and provide those services that we traditionally wouldn’t be able to provide.”
Cotterell noted that the medical diagnosis and personal repertoire developed during in-jail visits helps Community Howard significantly in its efforts to get inmates reestablished in the community and in a plan for treatment once they are released.
Additionally, Planck acknowledged the ironic role the jail sometimes plays in mental health treatment, opening up a door to a brighter future than would have otherwise been discovered.
“It has allowed us the opportunity to reach out to more individuals than we normally would be able to, because unfortunately there still is stigma with mental health and co-occurring disorders, so people do not want to reach out," she said.
“Without the jail intervening in a way, we could not be able to reach as many people as we do.”
Community Howard has also begun to work with jail officials to provide outgoing inmates with information about the treatment options provided at Community Howard.
“The inmates do want more information,” said Planck, describing such an effort as a going-away packet or brochure-type information.
The idea of getting people from the jail to mental health treatment is one that has openly been embraced by law enforcement officials in Howard County.
“They need to go over here and as soon as the court can figure out how to get them to a mental health services group, that’s where they need to be. They don’t need to be in jail,” said Sheriff Steve Rogers, who has petitioned state legislators to create programs to keep mentally-ill people out of jail.
Vivitrol
In addition to jail visits, Community Howard officials have also worked closely with those in the criminal justice system to administer Vivitrol to drug addicts.
In fact, the county’s new Vivitrol program was the first thing identified by the mental health coalition in October.
Effectively, Vivitrol “blocks opioid receptors in the brain for one month at a time, helping patients to prevent relapse to opioid dependence, following detox, while they focus on counseling,” according to the medication’s website.
Specifically, it helps heroin addicts get off the drug once they have detoxed.
The current program, which starts for many at the jail and ends at Community Howard, has become a way for, especially pre-trial detainees, to end an addiction and get involved in treatment.
So far, “since rolling the jail Vivitrol program out in February, 12 individuals have been referred for our services from the Howard County Jail,” said Cotterell in an email. Vivitrol is also available at Community Howard to anyone looking to end an addiction.
“The process here is developed, designed if you will, to help identify those folks in the jail system. These 12 people were able to be released…from the jail that typically would have just been held,” he noted. “So they’re under close scrutiny, observation of the courts, probation, they’re getting the medication, but we’re wrapping these services around them. It’s a whole kind of package deal.
“Folks can still walk off the street and come in and get Vivitrol. This is just the process we have to help facilitate getting treatment to those folks in jail who have been identified.”
And while the Vivitrol program is still building, local officials are confident about what it can do for the community, possibly making a dent in both addiction and recidivism rates in Howard County.
“It’s in its infancy but it’s growing, so we’re pretty proud of that,” said Planck.
Education and awareness
More than anything, though, the most important thing, say health officials, is providing two things: education and awareness.
And with that, the elimination of self-medication and a stigma that only harms the community’s most vulnerable.
“Research has shown that one in three people have a mental health disorder, either diagnosed or undiagnosed. And just like cancer, those individuals are not cancer. They have a disorder that they’re trying to work through,” said Planck.
“So we try to keep that in perspective – they’re not their disorder; they are just individuals who are seeking help.”
Planck noted research has also shown that “most individuals” who develop addictions can trace back to some kind of trauma, an event that has led to self-medicating.
It’s important, added Eagle, for addicts to accept their condition and to seek help, something she did and now credits for giving her a vastly improved life.
“It’s 2017, and we all have freaking issues. We do. A lot of people have been through a lot of things, and the things that we go through in our life do affect us in the long-term basis, like the way we think, the way we feel about other people and the way we feel about ourselves,” she said.
“And until we can really address that issue, there’s nothing wrong with those people, it’s just a part of life. If you don’t ever try to fix it, then it doesn’t get any better.”