Sam knew she needed help, but she didn’t know when she hit that “send” button, what was
about to happen.
The email arrived October 23, 2023. Like many emails that come through the Greater Cincinnati Behavioral Health Services website, this person needed help.
“I’m currently struggling on my own. I was homeless and now I’m on the verge of being homeless again. My car was just impounded so transportation is hard, and I have to get to classes because I’m fighting to get my daughter back.” Samantha was hurting. She knew she needed help. What she didn’t know was how much things were about to change because she faced her fear and found the courage to hit “send.”
Samantha (Sam) was born to parents who had substance use and mental health concerns. She started smoking marijuana at 13. By age 20, she had moved onto heavier narcotics. She was arrested in 2015 and sent to an in-patient lock down facility. Once released, she went back to using, got into trouble again and was sent back into rehab. The cycle continued over and over.
In early 2019, Sam was sent to prison for the first time for not finishing her rehabilitation program. She was released in 2020 and spent three months in a 6-month half-way house program before bolting, again. Sam ended up in Troy, Ohio where the drug use continued. She was eventually arrested and sent back to prison for violating her parole.
She served three more months then tried to find a job but had difficulty because of her criminal record. She eventually found a job and began a relationship with a man who would move in with her and father her child. The situation soon turned toxic. Her boyfriend had major anger issues in addition to his drug use. Sam ended up homeless and was forced to give up custody once her baby was born in the spring of 2023. She admits it was then that she really hit rock bottom. “I didn’t have anyone to turn to. I was in a bad relationship, homeless off and on, I was tired of using, and my baby was taken away. I was really looking for someone to help.”
Fast forward to that email last October. What happened after Sam hit “send”? Her information was sent to Jamie Ayer, a former peer support worker who is now a Care Manager for people in Hamilton County who are enrolled in GCBHS Substance use Disorder (SUD) programs. Jamie left a message for Sam, who called her back. “That’s half the battle,” says Jamie. “You want to catch them in that moment of seeking help because if you miss it, more than likely you might never hear back. In this case, she did call back. It’s a great feeling when you can help someone who is ready.”
Jamie took Sam to Open Access (OA) – a process GCBHS uses to assess and connect people to needed services the same day they come in. OA cuts down on staff time from missed appointments and gets clients into treatment quicker. (You can learn more about Open Access and how a grant from the Blue Cross Blue Shield Foundation helped us expand SUD treatment in the “news” section of our website: www.gcbhs.com.)
According to Jamie, Sam’s boyfriend was “problematic.” He was physically and mentally abusive and helped get Sam evicted because of his destructive behavior. They were also both actively using. “She was living in her car when I met her", says Jamie. “We had to meet secretively because he didn’t want her to escape the living hell they were surrounded by.” Sam agrees, “He was like an anchor, weighing me down. He didn’t want to let me get anywhere.”
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Sam meets with Jamie at her apartment.
SUD Treatment Expansion: An Integrated Model to Provide Holistic Care to our Clients
Greater Cincinnati Behavioral Health Services (GCBHS) opened Office-Based Medication Assisted Treatment (MAT) services in Hamilton County at our Glenway location in 2019. The program provided a helping hand to individuals with opioid or alcohol addiction. The aim of these services was to offer evidence-based treatment and support for individuals with intensive substance use disorder (SUD) needs.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines MAT as “The use of medications, in combination with counseling and behavioral therapies, to provide a ‘whole-patient’ approach to the treatment of substance use disorders. Medications used are approved by the Food and Drug Administration (FDA) and are clinically driven and tailored to meet each patient’s needs.” Learn more about MAT services on page 3.
By 2021, the leadership at GCBHS began discussions to implement an Opioid Treatment Program (OTP) as part of its MAT services. It had become increasingly evident that to assist clients who presented with more intensive challenges, additional options needed to be available. The organization submitted a grant request to SAMHSA and received funding in the fall of that year.
The Clermont Recovery Center, a division of GCBHS, would serve as the program’s primary model. The facility, located in Batavia, has been offering OTP services since 2013. The experience of their team was instrumental in laying the foundation for establishing the OTP Medication Unit in Cincinnati.
One of the grant’s goals was to find a centrally located and convenient facility to assist the population that the Hamilton County SUD teams were working with – people with co-occurring substance use and mental health disorders, including those experiencing homelessness. Shelterhouse had built a dispensary within their building, but it was not yet operational. The location was ideal, as it was located amongst the team’s target population. It also had a primary care clinic on-site for close collaboration in meeting not only the clients’ behavioral health needs but their primary care needs as well. GCBHS reached out to Arlene Nolan, the Executive Director at Shelterhouse and Kathleen Bennett, the former CEO of Neighborhub Health (formerly
Cincinnati Health Network – an organization providing healthcare for the homeless and HIV populations) to establish the partnerships needed to launch a successful OTP Medication Unit within the shelter.
The Opioid Treatment Program (OTP) at Shelterhouse opened its doors in July of 2023 and became the first OTP in Ohio to operate in a shelter setting. The program offers psycho-social services such as counseling, case management, and peer recovery support in addition to medication prescribing and dispensing. When provided together, these services allow individuals with opioid use disorder (OUD) to stabilize, by assisting them in managing their withdrawal symptoms and cravings with medication, while also exploring their substance use and related needs through recovery-oriented supportive services, using a harm-reduction approach.
The current Opioid Treatment Program Team includes a medical director, a prescriber, a nurse supervisor, MAT nurses, peer recovery coaches, a case manager, a counselor, and a team manager. In addition to the OTP team, the GCBHS PATH (Projects for Assistance in Transition from Homelessness) Team is also located at Shelterhouse. They work with Hamilton County residents who need housing, as well as mental health treatment and support. These two teams work closely with one another since many of the clients they serve have cooccurring diagnoses.
Thus far, the key indicators seem promising. The program has a 66% retention rate within the first 30 days of treatment in comparison to a study for individuals experiencing homelessness that identified a 55% dropout rate within the first month. Additionally, between baseline and reassessment, clients have shown improvements in housing stability, social connectedness, abstinence, a reduction in criminal justice involvement, and reduction in health consequences related to substance use.
Julie Kubin, Director of Addiction Services in Hamilton County (center) and some of the OTP team at Shelterhouse.
Dr. Amy Seese sees at patient at Shelterhouse.
Dr. Katie Schmidt is promoted to Chief Medical Officer
Greater Cincinnati Behavioral Health Services (GCBHS) is pleased to announce that Dr. Katie Schmidt has been promoted to Chief Medical Officer.
Dr. Schmidt has been a cornerstone of our medical team in her previous role as Medical Director and throughout her 12 years at GCBHS.
To read more about Dr. Schmidt and her recent promotion, go to www.gcbhs.com and check out our online blog post, dated 7/24.
Learn More About MAT Services
Medication Assisted Treatment (MAT) services can be an integral part of a person’s treatment plan and recovery process. Individualizing the treatment plan to fit a person’s specific needs is best practice, and offering medication is just one of many tools in the toolkit to assist a person’s recovery journey. GCBHS offers two types of MAT services:
• Office-Based Services (OBOT) are offered one day a week at our Madison location. OBOT treats alcohol and opioid use disorders and requires the client fill a prescription at a pharmacy (which is available on-site at Madison) or receive an injection depending on which medication is right for the individual served.
• The Opioid Treatment Program (OTP) treats opioid use disorders and is offered 6 days a week. Medication and supportive services are provided on-site at the location in Shelterhouse on Gest Street.
While the ultimate goal is full recovery, we recognize everyone’s journey is different. It is important that we create attainable goals and outcomes for our clients, and always remember to meet them where they are. Learn more at: https://www.samhsa.gov/medications-substance-use-disorders
Who the Opioid Treatment Program is Helping
Prior to his jail sentence, Matt had been drug free for five years with the help of Medication Assisted Treatment (MAT). When he was released, the real problems started. “I had lost everything,” he shares. “I was homeless. I lost hope. I started to have cravings and felt as though I wanted to start to use again. I was pretty down and out about the whole situation.”
With no place to go, Matt ended up at Shelterhouse, where he connected with a GCBHS peer recovery coach. This relationship was crucial to Matt because it gave him encouragement and guidance. Says Matt, “It was good to have someone to talk to. My recovery coach helped me find a job and she gave me rides to interviews.” Their relationship became a cornerstone of his recovery journey, offering him the support he needed to get through a difficult time.
Matt was one of the first clients to enter the Opioid Treatment Program (OTP) program at Shelterhouse. According to Matt, the location was another important factor in his recovery.
“Having it at Shelterhouse is convenient. I could walk next door and not have to worry about transportation. If I didn't have the program and the help that I did, I don't think I would be where I am at right now.”
“You have to put in effort for the program to work,” he explained, noting the importance of making positive changes in his life. “You have to change people, places, and things. Make the right choices and find the right people to hang out with. I had to work for what I had.” His commitment to change and resilience eventually led him to a stable job as a welder.
Matt continues with his OTP appointments at Shelterhouse. When on-site, he sees the doctor, a counselor, and he receives medication from the dispensary. He appreciates the consistency of care the staff provides, especially the nurses and Dr. Amy Seese, who is the doctor he sees on his visits. “She’s really nice. I like her,” he says, emphasizing the supportive environment created by the team.
Reflecting on his progress, Matt expressed, “It really helped me get back on my feet and strive to get my life together. If I can do it, anyone can do it. I've had to put my nose down and make the best choices for myself.” Read more about the MAT OTP services available at Shelterhouse on page 2.
Brian Folton (center) is one of the Peer Recovery Coaches on the OTP team.
www.gcbhs.com
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Once Sam removed herself from her volatile relationship, things started to fall into place. She felt relaxed and comfortable and was able to share things with Jamie, not only about her traumatic past but also her aspirations to get custody of her daughter back.
Jamie helped Sam start the process of building her life back. Since that email in October, Sam has an apartment, a car, she’s enrolled in college, and she started her own business. She is grateful for the support she’s received from GCBHS. “I’m so glad I got connected. I just don’t know where I would be today if it weren’t for my GCBHS team. I was almost to the point…I don’t know what I would have done. They can’t always fix it – but they are there for me and that’s what’s important.”
And that goal of getting her daughter back? It’s getting closer to reality. Sam was recently approved to have overnight visits with her now 18-month-old.
“My baby drives my desire to get better” Sam shares. “She’s the reason I sent that email… and I’m so glad I did.”
Welcome Cassidy Lekan
Greater Cincinnati Behavioral Health Services (GCBHS) welcomes Cassidy Lekan LISW-S, LCSW, LICDC as our new Vice President of Recovery Services. She was most recently the President and CEO of First Step Home. Prior to that Cassidy was the VP and Chief Clinical Officer of Transitions Inc., in Kentucky.
Cassidy is a graduate of the University of Dayton, and she obtained her Master of Social Work at the University of South Carolina. She serves on the Hamilton County Addiction Response Coalition Steering Committee. Says Cassidy, “I grew up doing a lot of service which is why social work is very important to me. I like being a part of someone’s journey to recovery.”
And what brought her to GCBHS? “The philosophy of the organization…the quality of those who work here. As an organization, GCBHS is always looking to fill gaps in needed services. Being a part of that growth is very exciting!”
Cassidy will be overseeing our Hamiton County Substance Use Disorder and Outreach Services, including our programs at Shelterhouse, St. Anthony Center and Jimmy Heath House.
