An episode of “Changing the Conversation” podcast
Annette Diaz and Ana Florence discuss peer support and how people with lived experiences can support others during the COVID-19 pandemic with host Katie Volk. This episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).
November 9, 2020
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Katie Volk, Host: [00:05] Hello, and welcome to Changing the Conversation. I’m your host, Katie Volk. Today’s podcast is sponsored by the New England Mental Health Technology Transfer Center. Today, we are joined by two guests from a project called Sharing our Wisdom: Lived Experience and COVID-19, which focuses on mental health, social justice, equity, COVID-19, and a lot more. Our guests all have lived experience with mental health challenges and will share what they learned in their journey and what has helped them during these difficult times.
Katie: [00:36] Our topic today is how peer work is shifting, particularly from a Latina perspective amidst the COVID-19 pandemic. My guests are Annette Diaz and Ana Florence. Annette is a recovery support specialist. She coordinates Recovery Support Services at Community Health Resources, one of the largest behavioral health agencies in Eastern Connecticut. Annette, welcome.
Annette Diaz, Guest: [01:00] Thank you for having me.
Katie: [01:01] We’re also joined by Ana Florence. Ana is a clinical psychologist from Brazil and a postdoctoral associate at the Yale Program for Recovery and Community Health. She leads the Wisdom Project. Ana, it’s so good to have you here today.
Ana Florence, Guest: [01:16] Thanks, I’m happy to be here.
Katie: [01:18] So to get us started, Annette, tell us a little bit about your work.
Annette: [01:22] So the work I currently do here at Community Health Resources is Coordinator of Recovery Support Services throughout the whole agency. And what that looks like is making sure we work out of a recovery oriented systems of care. Another piece to that is the staff, the people with lived experience. Currently our agency has over 37 peer staff in different programs. And one of the things I do is negotiate with upper management in how to get creative in adding us to different teams to support clients.
Katie: [01:58] So interesting. One of the things I like about The Wisdom Project is that it’s a conversation between two people from the team. And so Ana is going to ask you a few questions and maybe I’ll chime in. And so I’m going to hand it over to her.
Ana: [02:13] Thank you, Katie. It’s so wonderful to have you, Annette. And I just wanted to start by saying what an amazing job you’ve been doing at advancing the work of peers within the system. That’s so important. And we actually started working early on in this pandemic together. I started doing research on this topic, and you joined one of our early listening sessions with folks with lived experience around COVID. And then we talked about how peer work has not been considered essential during this pandemic. I wonder what you think that peers can bring to this whole topic, specifically thinking that people with lived experience have lived experience with challenges, but they also have lived experience with recovery. And that can be incredibly value at this moment. So I was wondering, what is the role of peers in these challenging times?
Annette: [03:15] I know I can speak for my experience here at Community Health Resources is the way they work with individuals who are in distress is a lot more common than I think than maybe others expected, because we know how to manage through crisis. So when you get into an extreme state of distress, what works well and what are the possibilities? So because of the majority of us have been living that every day of our lives, we’re able to help others navigate through that. One of the things we did come across, too, is that some of our folks that have been with us for a very long time, and let’s say they’re in the maintenance stage in their recovery. And then the pandemic came, it was more of, okay, I need to make sure that my basic needs are okay, in their max. It wasn’t an acute level of stress. It wasn’t like, oh my goodness, I need to go to the hospital. I can’t do this. I can’t do that.
Annette: [04:08] I was really impressed by the recovery community itself. When this pandemic hit, everything went on to virtual quicker than some agencies. And the support that was offered to people was just, I was floored. And I remember sending off this information to my peer staff. And they were like, “Oh my God, this is great. I really appreciate it.” I will say that everybody has different experiences in the role. So some may not have an acute state of distress or substance abuse and things of that nature. So one of the things I did find is it also depended on that factor. I guess how bad was your bad or how that was your bottom? So it’s been a lot of supervision for me with staff lately. I used to do it once a month and now I’m doing it once a week, because a lot of people are in fear.
Annette: [05:07] Am I giving the right message? Am I doing the right thing? Or a lot of people may not have some of those challenges and it’s not just mental health and substance abuse. It’s also, I’m poor. I can’t afford this type of food. I haven’t been able to get to the grocery store for eight years before the pandemic. So it’s a catch-22. And I think one of the terms I like to use is transferable skills, because, so the people who have not had a vehicle to get to grocery stores who have known how to survive off of $118 in food stamps a month utilize their strengths and teach everybody else some of their support, so that we can all get through this together.
Ana: [05:48] That’s so interesting, Annette, and I think there’s so much value to what you just mentioned. It’s counter-intuitive to think that folks who have experienced mental health challenges would be doing well and maybe even better than some folks who have never been through anything like this before. And we found that when we did our first listening sessions as well, that some people had been very used to isolation, for instance, and even liked being alone. And so this was perfect for them. Some folks, as you mentioned, have been living on benefits for a long time. So they know very well how to manage that. And so I think it’s just very interesting, your take on the whole thing and thinking about transferable skills.
Ana: [06:35] You touched upon some changes that happened, increasing supervision, going virtual, and maybe even before other agencies were thinking about that. What are the other things that have shifted with the peer work with people?
Annette: [06:51] So one of the major shifts is the lens of looking at peer work. Again, it’s not just educating or being a role model of hope for people with substance abuse or mental health challenge. It’s just life. Parenting, everything, jobs. One of the things that I have found in this is the lack of guidance the state had provided in different languages. And access. So when everything went virtual, simple things like, well, it’s not simple, but it was things that were not thought of, well in my opinion, as far as we can have this tele-health service for this person, or the unemployment thing or the stimulus thing, all these things that were offered to people that were not offered to everybody. And I mean that as far as communication wise on how do I do this? I don’t know how to get on that. I don’t understand what this means.
Annette: [07:51] And so I found myself getting phone calls here from some of the clubhouses where my main office is, and people walking up to the door. I don’t know how to do this. I heard about this. Can you please help me? Shelters, I am part of a re-entry discussion table in Hartford for returning citizens and the homeless shelters that the people were living in coming out of the Department of Corrections had no idea how to navigate these systems. And I have even said, unemployment was extremely tricky when people got furloughed or however it may be, or you have to take care of the child or an elderly person. And I know I had touched on before, my mom had gotten into this big deal with her employer because my grandmother’s 95 years old, and she’s the main caregiver for her.
Annette: [08:42] So trying to explain to my mom how to apply for benefits and what does this mean? And all that. And I took that like, wow, my mom is an older generational woman who is not used to some of the navigating the systems that I have experience with. So again, so the peer work for me, I feel like the peer workers who are invested in this and they know how to navigate, but what about the ones that don’t or they’re maintaining their recovery, or they’re staying well for today and those things. How do I know that they’re going to be able to get to the things that they need or things that they’re qualified for? So everything was on a halt, and I just took things to the extreme. I used to get in the van and some of the clients I know, I’ve been here for almost 10 years.
Annette: [09:29] So some of the clients I know that didn’t have this or the women that were only on cash assistance and never had a job yet. Or for a couple of years. So I would go to their house and beep beep and come on. I put my laptop on the top of the company van. And let’s go, because you are entitled to the stimulus and you don’t know how to do the phones. And it’s just, again, it was things as simple as Android devices, clearing the cache for people, unloading some of their photos and putting them in a Google Drive. Where again, these steps, okay, well, here’s the solution. And I think that’s where some of the supervision came in handy with the rest of my peer staff, because it’s like, oh, so-and-so can’t access Starley for a tele-health, and I don’t know what to do.
Annette: [10:16] And so some of the basics came in. Okay, well go in their settings, here’s Google Chrome. So I’ve been able to create a lot of quick user guides in Spanish and in English. I actually have a girl who works with me who’s Polish. So she did the Polish one. So we gave the people what they need and just took leadership on it. It didn’t come from executive team as far as here’s this and here’s this translated. Even for the Department of Labor, it is very hard to understand to this day. So that has been the hugest support we’ve been providing for people right now is making sure that that stuff gets disseminated to people in the right language.
Ana: [10:55] That’s wonderful, and I can see the amount of work that you’ve been doing, you and your agency with just helping people or help maybe not a good word, but supporting people and navigating a lot of these new things that are coming up. And the fact that you work with a team and that you guys do supervisions to support each other, as well as seems so important.
Ana: [11:18] You also touch upon some things related to cultural competence, how things are not available in different languages and how folks may be struggling to even find information about things that they might need to access. As a Latina woman myself, and I know that you have involvement with cultural competency world, and I know that you’re also part of the Yale Latino Recovery Colectivo Group. I was wondering if you have any thoughts around that, whether you think… We know from research that this pandemic is affecting Latinx communities in a different way than it has been affecting White communities. So we already know that, but I was wondering from your experience whether you’ve been seeing that. And if so, how?
Annette: [12:11] I have, and I feel that… And I don’t know if it’s because everybody’s kind of reacting out of fear, their go-to is primarily English. I don’t know, maybe because I’m so invested in being Latino and having the resources and access that I need, it does get left at the door. I don’t know how it ever in the first place gets left at the door. I don’t know if it’s in some of the organizational components of any agency, they just don’t have that representation. But I know here, even from our methadone programs during this pandemic where people were bringing methadone to their homes, some Spanish people didn’t understand fully why. And I know it takes communication sometimes, and I feel that the recovery for special stuff I have in my MAT programs take that time out and are creative. One of them doesn’t speak Spanish, but he has Google translate. So he’ll Google translate, explain this to her.
Annette: [13:18] So I think maybe because we have been so creative in our own well-being, that we tend to just continue in our day to day work to be outside the box. But I feel really bad for Latino communities who are tired of watching the news. You know what I mean? If they see COVID, they’re like, “I’ll change the channel. Let’s put on Novella or something.” Because just knowing that the stress of the universe is going through, but not really paying attention to what it is that they can and cannot understand. I feel like I’ve always been a teacher my whole life. So I try my best to keep teaching people what it is they can and they cannot do or what’s available to them in Spanish. But I just feel that our cultural needs are not being understood, especially family right now.
Annette: [14:14] Spanish people have a tendency to be real close with their families. And in this pandemic, how do we do this safely? What do we understand that we don’t understand? I mean, my partner’s mom is in Puerto Rico, and she had called us and told us that we need to sleep in separate rooms. And all this stuff that assumptions out of fear, where it’s like, no, let me explain some of the stuff that’s really going on… so many information the CDC puts out universally, that’s not… When the news comes on, it’s in English, they have somebody in the back for sign language, but there’s never that Spanish interpreter. On the news channels for us, for Spanish, I feel like the information is not given out the same way it is in the United States.
Annette: [15:04] To me, I just feel like we have a huge disconnect, and I don’t know what the solution is for that.
Ana: [15:12] Thanks, Annette, for bringing our attention to that issue. Sometimes we talk about cultural competency, but then we can’t really imagine what that would look like in real life or what types of challenges, someone who doesn’t speak English might face, and what that might look like. And I’m so glad that your team has you as their point person. And you can be very sensitive to these issues and bring that to the floor. And the one thing this whole conversation made me think about is how peer work aligns so well with the recovery framework and how it really allows you to see the person more holistically. So those not being so interested, which symptoms you’re experiencing, or we should eliminate some symptoms, but rather just really seeing the needs of the person and that involves their cultural needs, their language needs, their need for getting food and for being able to be with their family safely to get information.
Ana: [16:16] So just so many different components, it feels like it’s an approach that really allows you to see the person as a whole, rather than seeing just parts and trying to treat some of the things that are part of life. So I’m really appreciative of that work and of that lens that you bring to mental health.
Katie: [16:38] One of the things I’m struck by, and Ana, listening to this conversation is, Annette, how many different ways you’re supporting your team and how creative it sounds like they’re being. And I was wondering how your team is staying resilient these days and how they’re nurturing themselves in supporting their communities.
Annette: [16:57] I have suggested them taking days off. I always tell them, after six months you always take a week off. So that’s the only thing they can do right now, whether it’s home or going for a hike or things of that nature. Our job offers meditation and yoga during work hours as part of self-care. And I think the majority of the staff know how to take care of themselves because they don’t want to not be available. They don’t want to go back to those dark days. And I will say that our agency’s culture here, I mean, it’s extremely supportive. So we go to lunch, we cook, we laugh, we joke. There’s time for, yes, we’re all our plates full. And I feel like I’ve never worked so hard at my life right now.
Annette: [17:51] I feel like I’m on every single project. But it’s okay, because I have support here. So coming to work for me, it doesn’t feel like I’m going to an aimless job. My management team, I feel I always say jokes here. I’m like, okay, well I have three or four bosses. But in the guidance, the leadership, and I don’t think I would have been able to make it this far or the rest of my staff without having that support. They’re very nonjudgmental. And I don’t think none of us have been able to get as far as we can with our ideas to help people if it wasn’t for the support.
Katie: [18:30] Yeah. It sounds like you’re both connected to the mission of what you’re doing, but you’re also connected to one another, which is just so critically important to our well-being.
Katie: [18:40] Annette, thank you so much for taking the time to talk with us today.
Annette: [18:43] No problem. I really appreciate it. Thanks for having me.
Katie: [18:47] And Ana, it’s been a pleasure as usual to have you as part of our conversation.
Ana: [18:51] Thank you so much, Katie and Annette, this was a wonderful conversation today.
Katie: [18:55] And to our listeners, join us next time on Changing the Conversation.
Erika Simon, Producer: [19:00] Visit c4innovates.com and follow us on Twitter, Facebook, and LinkedIn, for more resources to grow your impact. Thank you for joining us. This episode is sponsored by New England Mental Health Technology Transfer Center and was produced by Erika Simon and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Our host for this series is Katie Volk. Join us next time on Changing the Conversation.
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