Court Probation Officer and Certified Peer Support Worker Marisol Cano-Garcia discusses barriers, supports and pathways for community resources for folks with mental health conditions with Liz Liano. Here is a transcript of their conversation:
Liz Liano:
Hey, so you have some insights you want to share with us on recovery and rehabilitative measures for people with substance use issues. Can you talk about some of the biggest barriers or harms for people with substance use disorders that hurt them either in the beginning or their continued recovery?
Marisol Cano-Garcia:
Yes, so a lot of it is the unstable housing that we have for people that are struggling with substance abuse. We don't have a lot of homeless shelters that can take people in when they are unhoused and the qualifications for people to become housed are barriers within itself. They want a birth certificate, a social ID, and a lot of times our unhoused population that are struggling with substance use, they don't have any of those documents. And it takes a lot to gain those documents because you need documents for those documents. So if you don't have someone like a caseworker or a peer support or a team that is assisting you with gaining these documents, it's almost impossible to gain housing. And then along with that, when you have Sometimes going hand in hand substance use and the criminal justice side, they kind of get involved very easily because a lot of times if you're struggling with substance use, we have backgrounds. And not every housing place, even housing places that are specifically tailored to the substance use population, they're not really tailored to allow people to gain housing because sometimes their criminal record, which is a huge, huge barrier. Another huge barrier I would say is Medicaid. Medicaid has a lot of stipulations about when someone can receive treatment, what type of treatment they can receive, and what the parameters for that looks like. Medicaid has a10 day cut off. So if you've been clean and sober for 10 days, they essentially won't allow you to go to inpatient. They will put you in a lower level of care, which could be PHP or IOP. So that can be really difficult for a lot of people.10 days is a huge fee, but10 days isn't enough just to go to group every day. Sometimes we need to have people going to an inpatient facility where they are in groups all the time.They'remonitored24 7 and that kind of helps them get to a stable area. So Medicaid becomes a big parameter with that. And a lot of times it's difficult to gain. Medicaid if you don't know the right places to go. And the Medicaid system itself can be complex and making sure you're making those phone calls, making sure that you can get to the Income Support Division office and when they ask for documents, being able to provide them. So those are two of the largest barriers I would say for anyone in the substance abuse community that is struggling.
Liz Liano:
That seems like quite a list. You talked about housing and Medicaid and just the difficulty navigating all of these systems. So can you talk about some of the mitigating factors or big supports that kind of level out all of these barriers?
Marisol Cano-Garcia:
So I would say that, if you go to any type of drop-in center or anything that can help you get Medicaid pretty easily. So I know Community Hope has systems set up to do that. The Gospel Rescue Mission, there's No Pain, which is located off of Missouri. They're a drop-in center. They can essentially help you get set up with Medicaid, just assisting to figure out how to fill out the application, things of that nature. So if you go to places that are naturally inherent to community supports, like the Community of Hope, they're able to assist you with navigating the system. And if you get involved in any type of like outpatient programs, like there's ACT at La Clinica de Familia and there's ACT at the Peak. They can also help you kind of assist get into those systems as well. And they're a big support system because they come with a team of a psychiatrist, therapist, and they have a whole model set up to make sure that you're getting the needs that you. are missing. And also if you decide to go to detox, like you see like hospital or the peak, sometimes even if you don't have Medicaid, they'll let you come in sometimes and they'll assist you in getting the correct Medicaid. They want to make sure that people are getting the treatment that they need.
Liz Liano:
So you're talking about kind of important for people to have these warm handoffs and having people who can support them in navigating all of these kind of complex systems and help them figure out what paperwork and all of these little fine details. These are things that support people getting into recovery and getting into these systems. What isa good support for somebody to continue their recovery?
Marisol Cano-Garcia:
So I would say once you get Medicaid, you can get, they're called care coordinators and essentially they help you coordinate everything. You can, they'll help you set up doctor's appointments, eye appointments, transportation appointments. They can look to find you different places for inpatient services, detox, PHP, IOP, whatever level of care you need. And another cool thing with majority of the Medicaid is in New Mexico, they also have peer recovery specialists through your Medicaid. And that's something that they can also set up. I would say that that's one of the biggest support systems because when talking to another addict alcoholic, it's a lot more comfortable when you're talking to someone who's been in your shoes before. feels less stigmatizing and it can turn out to be a great benefit because they feel more comfortable and open. So sometimes things that maybe they're hiding because they feel shameful about it, they'll come out and talk about it and they can get better support for that. And a lot, like let's say if they're going to like MAT treatment for, and you should go to, so for Suboxone clinics or methadone clinics, they also typically have a certified peer support worker there as well. And that's also someone that can help them with the continuum of their care when they're seeking recovery and support. And they can essentially help them with the middle ground of what that looks like on a day-to-day basis of how am I going to get here or how do I apply for this voucher? And they're a good midway point for people to have assistance that typically don't.
Liz Liano:
So you mentioned Medicaid can offer a peer specialist and you mentioned some of the facets of being a peer specialist. Did you say one of your certifications is a peer support worker?
Marisol Cano-Garcia:
Yes, so I'ma certified peer support worker through the state of New Mexico and that's through the behavioral health state department through Opry. And I've done that. I've had that certification for roughly coming close to 9, 10 years now. So there's different ways to become a peer specialist. You can either, you can have one through because you have your college education or you can have a mixture of things. So because I have my own lived experience and I graduated with my high school diploma and I had letters of recommendation, I was able to apply for that and become a CPSW. Now there's different parameters, like if you have a college education, they don't typically ask for certain things, but your college education needs to be more focused towards something like social work or counseling, things that are more geared towards the substance use population. And for me, being a peer support worker. I've done a variety of jobs, like working in mental health institutions, working for community-based centers like La Clinica and Zia Recovery Center. And now in my new job working in the court system with treatment courts. So you can find peer support in a lot of facets. And for Medicaid, they usually cover like a region. And I think they will even come and do home visits with you. They'll make sure that they can, or they'll do like on the phone visits depending on like what your location is, like if you're in a rural area. So they do a lot of the ground work and it, it's very trying sometimes because if you look at our map of New Mexico. Southern New Mexico has a lot less resources than Northern New Mexico. So sometimes you're trying to shift and figure out who can go where and what's going to actually apply to the certain population. And it's a lot of navigating the system and it can be very complex. So if it's complex for me, it's complex for the people that I'm helping. And I want to make sure that they are able to gain all the knowledge that they can and get the right things that they can. So it's important to just be their biggest advocate, essentially.
Liz Liano:
So as a person with lived experience You're talking about navigating the system is difficult. This is like you've already navigated the system and traversed all of these entanglements.
Marisol Cano-Garcia:
Yes. You know, it's very difficult to, you know, I came from a family where like I really didn't think about what Medicaid was or, you know, I didn't worry about those things. And then I was in, when I was in my active addiction, I didn't necessarily know where to go. I didn't know the places to be at. All I knew that we had Missy Valley Hospital in Las Cruces. And my family did a lot of the legwork to get me into certain places because I was very incoherent. I couldn't possibly figure out what was going on. So I'm thankful for that. But as I gained sobriety and recovery and I started my journey of working in the treatment world, the behavioral health world, the mental health world, I learned how many barriers there are for people. And it is so, difficult to navigate those, especially if you're currently still using. And even when you're trying to stop using, it's just difficult. I don't understand insurance jargon still. You know, it's sometimes it's frustrating. So learning how to navigate that myself and then putting that in my professional career, I would love to say that a lot has changed in, you know, close to 10 years. But the reality is, that it just becomes more difficult. And we're seeing a wider spread of addiction with certain stuff substances. So that makes it a lot more difficult. But I try my best to educate myself on what is local for everybody and even going, throughout Dona Ana County. And I try my best to make, communication with them so that if I ever have someone in need, I can just call them. So I think that's a big part of it is like making sure you're talking to everybody you possibly canso that you have their information.
Liz Liano:
So you're talking about, reaching out to people and stuff. On a last note, what would you like to say to someone, maybe someone listening who is struggling with substance abuse or mental health conditions who may be hesitant to reach out for support?
Marisol Cano-Garcia:
What I would tell them is that Substance use looks different for everybody. You could be walking down the street and someone that looks like a normal mom or a normal dad, they could be struggling and not talk about it. And it's a lot of times it's based upon like what we're dealing with in our environment. But don't be afraid because there's so many people in the quote unquote real world who are people that are in recovery and that more than likely, if you were to reach your hand out, they would be more than willing to reach their hand out to you and help you. And I always tell people, you'll never know how far you can make it unless you give yourself that second chance. And you're very deserving of a second chance. You just need to put forth your effort to make it there. And before you know it, life will be so different and life doesn't have to be what it is. We don't have to be stuck in the box of addiction. We can go out there and exit that box and we can be whoever we wanna be and do exactly what we wanna do. So don't give up on your second chance and just go for it.
Liz Liano:
Beautiful. Well, thank you for sharing all your perspectives and insights with us today.
Marisol Cano-Garcia:
Yes, thank you, Liz.
Resources mentioned in this interview are listed here:
Drop-in Center:
Mesilla Valley Community of Hope
999 W Amador Ave · (575) 523-2219
Outpatient Programs:
ACT- La Clinica de Familia
ACT - PEAK
A peer support worker (may be found at La Clinica or other organizations mentioned, or be appointed through Medicaid) can aid in applying for resources, can educate or assist on other aspects of their care.
New Mexico Medicaid:
Medicaid can appoint you a Care Coordinator to assist you with resources.
People in New Mexico can go to YES NM to find and apply for resources.
If you or someone you know is in crisis, you can call 988 or the New Mexico Peer-to-Peer Warmline at 1-855-466-7100.
