I had a great day at the Evergreen Recovery Centre offices based in Everett, north of Seattle. The team were very welcoming and were keen to hear about my Fellowship and what my objectives were.
I met with Natalie Fryer who is the Director of Clinical Operations. Natalie gave me an overview of the organisation which has several residential treatment facilities and outpatient services across King, Pierce and Snohomish Counties.
Natalie explained that their Seattle program offering residential treatment for Pregnant and Parenting Women (PPW) had closed last month. The residential building was in much need of structural repairs and their funders could not afford the cost involved. The organisation took the difficult decision to close the program as they felt, strongly that the building would not survive the winter. The managers worked hard to ensure all of the women in treatment at the Seattle facility were moved to appropriate sites. Many of the women moved to the PPW site in Everett where I also visited. Natalie introduced me to some of the Management Team and Linda Grant, the CEO.
Next up I attended a budgeting meeting in order to understand some of the costings involved in a residential facility like the PPW program. The site offers a 14 bed unit and a 9 bed unit next door including day care facilities. The mothers involved can bring their children up to the age of 5 years old before they start school. During their stay women receive parenting support, mental health counselling, family counselling, relapse prevention planning and basic life skills. The day care facility offers play therapy, nurtures social skills, developmental assessments and observed interactive parenting. The program is funded mainly through medicaid dollars making this program unique and accessible for those on a low income. This is only one facility across three Counties however so the demand is high.
The program began in 1999, and about 100 women go through every year. Comparing it to the 1,524 pregnant women reporting Opiate use across Washington State in 2014, it becomes clear why the program is in such high demand! The number of newborns diagnosed with Neonatal Abstinence Syndrome has increased from 114 cases reported in 2000 and 881 cases in 2014. I have learned that Opiate use is a real issue in Washington State with many professionals describing it as an epidemic taking hold over the last decade which crosses all classes. The use of prescription pain killers is a big problem across America with many individuals beginning with Opiate based pain killers, building a resilience and leading to Heroin use. The Evergreen Recovery Centre runs a detox facility near the PPW program and more than 70 percent of admissions are for Opioids.
I was lucky enough to be taken out for lunch by the lovely PPW Management team and had engaging discussions comparing Washington State’s Heroin and Opiate use to Scotland’s. Heroin has been an issue in Scotland for many years and of approximately 12,500 individuals who presented for treatment in 2015, 85% reported their primary problem substance to be Heroin. Approximately 12.8 per 1,000 women who presented with pregnancies in 2014/15 reported drug use, with 50 percent of those reported Opioid misuse in Scotland.
Studies of Evergreen Recovery Centers’ PPW program have found that babies born to residents have better prenatal care and 66 percent better birth weight. Mothers are less stressed about parenting and there are 35 percent fewer reports of inadequate parenting among women who took part in treatment. The risk of premature delivery, low birth weight and infant death was lower for women in treatment, compared with women who were actively using. The picture below celebrates that 15 children were reunited with their Mothers in 2017 so far and 8 healthy babies were born.
After lunch I was able to sit in on the weekly ‘Staffing Meeting’ where the residential team meet to discuss individual women within the program and their progress. Each building provides the residents with a nurse and a counsellor, and the women are expected to meet with their workers and participate in group therapy. The women are also connected with a ‘peer sister’ when they arrive in order to support them to settle into the program. A ‘Recovery Support Leader’ is also identified in each building by the manager to run in-house recovery meetings. The program takes approximately 180 days if women have completed their individualised treatment plan although this timescale can be flexible if women complete their goals earlier than expected or cannot find suitable housing in time for their graduation. All of the women have to complete their ‘Prep Project’ before they leave which involves a written history of their drug use and its consequences, a personal piece to their recovery and a relapse prevention piece. For example, for her personal piece, one resident chose to write about Down Syndrome as her child had been recently diagnosed. The second half of the meeting the childcare workers attend to update on the children within the child care facilities and how the women are engaging with their children and the workers.
I am then shown around the facility by Jennifer Walter, one of the very knowledgeable managers of the PPW program. I am shown the bedrooms, bathrooms and common areas. Each building has a monitor on duty at all times. These monitors can dispense medication (excluding opiate replacement medication) if needed, provide low level emotional support to the residents and are as highly trained in order to be as understanding to the needs of the residents as possible. Jennifer explained how important it was for every member of staff, from the Cooks to the Directors to be considerate and empathetic to the situations the residents have found themselves in. All staff are trained in Motivational Interviewing.
I found that the day was drawing to a close and I was sad to be leaving. The staff in the PPW program are so welcoming, supportive and passionate about making the program work that it makes for a great atmosphere. My husband came to pick me up and introduced himself to Linda (CEO) and Natalie (Clinical Operations Director) who took much amusement in his Scottish accent. Whilst they couldn’t understand much of what he said they were charming and respectful and agreed one day we might all meet up in Edinburgh! I assured the team I would be back in Seattle too so would come back and visit when I do.
Keeping Families Together Safely 