 Good day and welcome to Issues and Answers, a production of the Government Information Service. I am your host, Jacques Hingson Compton. Now today we're going to be talking about the operations of the Turning Point Rehabilitation Centre. And we're talking about this because mental health is something that's very important in our society. And to speak with us here today is our, the lead counsellor at Turning Point, Mr. Robert Huggins. Side note, we also went to St. Mary's together. I'm pretty sure you gave me a call-out when we were in school, but we'll leave that for another discussion. I hope you don't hold any grudges. I still do, but we're being professional right now, so that's aside from the point. But thank you for having me. No problem. Thank you for coming. So why don't you first of all tell us about what your function is as lead counsellor at Turning Point? Well, I think I have one of the best jobs in the world, right? Not only do I help people directly in terms of helping them deal with their substance abuse issues, but I work with the staff of people who are very experienced, very involved, and very enthusiastic about the work that they do. So primarily for those who may not know, at Turning Point we provide support to persons with a substance use disorder, meaning anybody whose substance use has reached a level of causing problems within their life, concerns in relationships, social life, etc. So if you feel you've reached a point where you cannot control within your setting your drug use, then you come to us, we provide a safe space within which we give you the support, the education, the medical treatment, the counselling, the social work, everything that you needed to help you reach that sobriety and reach that level of comfort for the rest of your life. You just focus on drug rehabilitation? That is correct. Nothing else like mental illness or anything like that? We have a lot of clients who are comorbid, as they say, so they have co-occurring disorders, but our primary focus is on the substance use disorders. So some clients may come with these, like I said, co-occurring mental health issues, but we do manage them within the care as well, but like I said, primary focus being the substance use issues. So if a client comes in, that works for both the physical or mental health issues. If that primary issue is such that it may be a distraction to their treatment or the treatment of others, we ask that they deal with that issue first, stabilize that concern, and then once that is managed, then they come to us so that we can focus on the other aspects. Because they could be a hindrance to the development? Not only themselves, but others. I see. Now I also understand that you are no longer at your traditional spot in La Tocque. You all have moved. I mean, I know it's been a few years, but you all have since moved. We do miss the sea view, yes. But yeah, for a lot of practical reasons, it makes more sense to be on the Millennium Heights complex and that compound itself, which is on the highway, because we have greater access to the other support systems that we need in order to be able to help our clients. So we're close to dental services, the hospital, we have medical care access, we have mental wellness. So we have all the other tools, resources, everything that we need within one compound. It makes it just much easier for everybody. And what are your operating times at the moment? Administrative, Monday to Friday, 8 to 4.30, but we're a 24-hour facility. So clients in residence will have care provided by nurses, attendants, etc., throughout the 24-hour period. So if for some reason I have an episode or something after hours, I could still be submitted? No. If you need to come in for an assessment, anybody who seeks an admission must first be assessed. So we would do that assessment during the administrative hours, Monday through Friday. Basically, what assessment does is it's sort of a screening practice where we meet with the client, we discover what their needs are, we find out if they are fit for the program. So if there are any concerns, like I mentioned earlier, if they have any medical needs that are beyond what we can manage and we would recommend they go and manage it at the hospital or with their private practitioner. If there are any psychiatric concerns and we may refer them for an evaluation by the psychiatrist, you might get that they get medicated and stabilized first and then once they reach a stage and we say, okay, this is your date for admission. So that's essentially what we cover in that screening process. Once that is done, you come in for your set date for admission, you go through the admission process, you enter in, you're oriented and then after that process you start participating in the program itself. Typically up to 40 days, 42 days, that is what the program length is. You have psychiatrists on staff that conduct the evaluations? We have the psychiatrists from Wellness, so we access them through Wellness, which is one of the reasons being on that compound is so advantageous to us because we have those resources that happen to them. Remember now, it's one complex. It's not a matter of turning point versus Wellness versus it's one millionaire might complex. So we're all one body, just different departments. So we have access to all the resources within that complex. I see. I want to talk about, there's a lot of things I want to talk about. I want to talk about right now the difference between, is it terminated inpatients and outpatients? I don't know if you could talk about that a little bit. All right, so the outpatient program in itself is many of the clients come in and because in this stage in their life, they may not necessarily be able to dedicate 24 hours stay within the service, but they still require some help. So whether it is they have family to care for or they have a job they can't get away from or something so, but they still want to be able to access help. So that's what the outpatient program allows. It allows more flexibility. Maybe they might come in five days a week or they might come in two days a week or whatever. Based on assessment, we would make a recommendation to them. Sometimes they might come into an inpatient program and transition into outpatient over time. In this case, outpatient clients come in for specified time during the day and they participate in the program, whether it is that they sit with the other clients and participate in the community meetings or one of the group lessons or lectures or they go directly to their counselor and have a session or they work with the social worker. They can do any of those things. And that may change day by day. It may be consistent through each day that they come in. But the difference here is that when they come in let's say nine o'clock, they may leave by midday or three o'clock depending on what their program is because we try to cater the program individually. The residential program, however, these clients stay with us. So they have a bed, they stay on the compound, they sleep, they get their meals, they participate in the program and they are part of the community for the period of their stay. Now what I also want to know about is what does counseling look like inside Turning Point while you were there? So this is the beauty of it. I think for me, maybe I'm a little biased as a therapist myself, but one thing with therapy is that you try to remain flexible to the needs of the client. But we do favor certain therapy styles. We love solution-focused therapy, which is a very straightforward type of therapy. We love cognitive behavioral therapy, which is a proven therapy for these types of concerns. It does a lot to speak to the thoughts that people have and how these thoughts affect behavior and emotion, etc. We use a lot of what's called motivational enhancement or motivational interviewing. These types of therapies try to draw what are the factors that motivate the client to one change. We often say we have to do it for ourselves. We can be, as it says, influenced or motivated by others to some extent, but if we don't do it for ourselves, and most times it doesn't last, right? We have to find that intrinsic sort of motivation to help any change last longer, basically. But that doesn't mean that if you motivate the change for the sake of your children to be available for them or to be a better husband or wife or partner or whatever the case is, these are things that can help as well in terms of serving as motivation. That's what motivational enhancement works to do, basically developing that and seeing the discrepancies between what you want and what your actions are currently gaining for you. Okay, we're actually due for our first break, but I really want to continue this conversation with you. You're watching Issues and Answers, a production of the Government Information Service. Please stay tuned. We'll be back in a moment. Everyone says counselling, counselling, counselling. I don't have a chance. In my opinion, PS won't be able to do counselling. But, Glacia, just yesterday you asked me advice about your husband, and we spent over an hour on the cell. That's counselling. I don't want to do it for myself. Just think about it, Glacia. When you have been difficult to do someone, you ask your friends for advice to help you to deal with your problems. But wouldn't you prefer getting advice from a professional counsellor? I hope we're not one of those who think counselling is for crazy people. Hmm. When your situation keeps going, I don't need professional counselling, but I don't need people who don't know the doctor's visit. Don't you know the Ministry of the Public Service has an employee assistance programme, they call it EAP, which is offering six free counselling sessions for government employees? Glacia, why don't you take advantage of it? Really? It's free? Let me call the EAP unit ASAP, because I want professional, did you say free? Free counselling. But Glacia, where are you? I'm with the counsellor. Call the EAP unit at 468-2269. EAP Works, let it work for you. Welcome back to Issues & Answers. I'm your host, Jacques Hingson Compton. And if you recall, I'm here with the lead counsellor at the Turning Point Rehabilitation Centre, Mr Robert Huggins. We were talking about the operations of the Turning Point Centre just before we left, and you were talking, well, we were finishing our discussion on what counselling looks like within the Rehabilitation Centre. So, yeah, as much as I said, I'm a little biased in the counselling aspect. We really bring forward the fact that recently we brought on a social worker onto our team, and that has been, I think, one of the best moves we've made because now that has strengthened our follow-up, right? And what that means is that oftentimes when clients join us, after they've concluded their stint with us, they go out into the real world. But our staff limitation was so low, and we concentrated more on who we had in-house. So, while we didn't encourage the clients to continue to return for the AA meetings and to do check-ins and what not, our follow-up wasn't the best. But now that we have a social worker, our social worker has really strengthened that area. So even after they have left us, we continue to have that follow-up. And even before they have left, he does things like help them find better housing, find job opportunities, and just help them with any concerns or issues that they may have that might be a source of stress or difficulty for them that might be contributing to their drug-using habits. Now that you're making more use of social workers, do you find that your clients who have left, are they very receptive to the efforts of the social worker? Yeah, I've had nothing but praise for our social worker. We have a new council, we have a new social worker. Both of them are exceptional. They know what they're doing. They're very enthusiastic about the work that they do as well. I'm very pleased to have them. I mean, I don't want to sing praise for them alone because our tendons are RCAs, RCAs being the rehabilitative care assistants who are essentially the people who lead the AA meetings or that aspect of the program. Down to our domestic, our clerk, all of these people contribute such things within the program because this is a very holistic program. So even the domestic would assist the clients, the residential clients in terms of how they do their laundry or take care of their other needs in terms of cleaning or caring for the space and whatnot. Our nurses help them with the hygiene needs and other medical concerns and whatnot. So when they participate in the program with us, it was a lot of people who get involved in that drug use. They tend to let go of everything else including self-care, care for others and whatnot. And it's about helping them find themselves, relearn some of these basic skills that we have and become a person again, basically. So helping them understand that they have power and control over things. It's not that they are labeled as, and this is one thing that's very important. We used to have language that labeled people, so we call them addicts. You know, you would say an alcoholic and whatnot. Now, this is a person with a drug use disorder, you know, a person who uses drugs. You're distancing the person from the problem, allowing them to understand that I am a person who has a problem and I can manage this problem, but this problem does not define me, right? So yes, in short, it has worked excellent for us and we continue to grow and become better over time. So it's treated more like a disease or an illness as opposed to kind of giving him a negative label. Yeah, and that's one of the difficulties we're having right now because especially in our society, especially when we speak to the use of alcohol, it's one of those things where people have what we call a moral view in that they believe that you can kind of choose not to use and they believe it's a marker of low willpower or mental strength if you cannot control your use. But that's not the case. We have proven scientific information that shows that the use of drugs affects our brains and in turn causes difficulties, which in turn, you know, progresses and becomes worse and it's not a matter of choice. They have two difficulties in making those decisions and being able to control their use, right? So getting people to recognize that this is a problem that they have, that they can change and it's not a matter of them being weak per se, but it's a matter of genetics, circumstances, experiences, all of these things coming to play. If you experience trauma and most drug users have experienced trauma. In fact, drug use in itself can be traumatic, right? So trauma-centered care that helps as well, but helping them understand that and feel empowered to be able to make a change and grow, that's very important for progress. Do you have a lot of persons who relapse and have to come back to? Yeah, it happens very often, but relapses not mean failure, right? I tend to use analogies maybe a little bit too much. So forgive me. No, that's fine. Let's put it in this way. If you have a vehicle and you're troubleshooting, you have one problem, you put it back on the road, it fails again, you bring it back and you troubleshoot again because there's obviously a problem you missed, right? It doesn't mean that the car itself is damaged or not good. It's just that you miss whatever, you need a second opportunity to look back. And that's what happens with oral clients. They have a problem, we deal with it in therapy, social work, whatever the case may be, and they go out and maybe in a month, a month and a half or whatever time period, they relapse. It doesn't mean they fail. It means there was something that we have missed or addressed again to help them with. So they can come back to the full. They don't necessarily have to come back for the full sting, but they come back, they do a couple sessions, we talk about what happened, what the issues were, and we figure out how to deal with whatever the new issue is. I want to talk about, there's a few more things, but I want to talk about specifically the challenges that you would have normally and the challenges that you did have under COVID. So, yeah. Yeah, so COVID did a lot for, I think, everybody understands how impactful in a negative way it was on a lot of our services. In one way in particular, I think that the biggest way it impacted was that because there was such a, we had so many illnesses and there was such a demand for nursing services, they pulled the nurses from telling point to go and assist in other areas where they were, I wouldn't say needed more, but maybe a little bit more urgent in their need. So that caused us to have to pull back our services and only provide outpatient services because without our nurses, we did not have sufficient staff to be able to operate at 24 hours. Thankfully, in the last month and a half there, about maybe two months, we received our nurses back and we were able to resume our residential services, but there was that period where, we were limited in what we were able to offer to the people. We only had the outpatient service and you can imagine that even then in that period of high stress, people were turning to drug use a lot more. So there was a high demand, but we didn't quite have the capacity to be able to meet the demand and there were limitations. So there was that challenge. That was a difficult time for us. We were struggling to figure out an option for them and whatnot. But thankfully, we are at a point now where we can provide that service, we can provide support to people. We want people to reach out to us. They can give us a call or email us to do an assessment. The number is 458-6500. You'll get that telephone from direct nutrition point or they can email turning.point.govt.lc. Even if it's just to ask questions, they can do it in that way. But we are here and able to help them right now and we're looking forward to doing so. Okay, we're due for our second and final break. So when we come back, we'll discuss a little bit more and maybe you can talk about anything else if you want to discuss regarding the Turning Point Rehabilitation Center. No problem. You're watching Issues and Answers. I'm your host, Jacques Kingston Compton. Please stay tuned. We'll be back in a moment. I'm so fed up with my 13-year-old child. She's driving me crazy. I just don't know what to do. All that I need is some good licks to wake up. Alice, ignore the counseling pension given. Government employees have free access to professional counseling services under the Employee Assistance Program known as EAP. EAP? EAP? What's that? Not me that telling people my business. Listen to me, Alice. I was struggling with my child. I made an appointment to see an EAP counselor and I was very satisfied with the service that I received. And you know what? Up to a day like today, my information remains confidential. Cox, how come nobody in the office knew anything about your counseling? Ah, that's because EAP counselors, they work under strict clauses of confidentiality. I know you know what confidential means. EAP providing professional counseling services? How much is it? Girl, the counseling is free. Free for you, free for your child. And you know what? Your information remains confidential. Call the EAP unit at the ministry of the public service. Telephone number 4682269 for more information. EAP Works, let it work for you. Welcome back to Issues and Answers. I'm your host, Jacques Kingston Compton and we're here with Mr. Robert Huggins, the lead counselor at the Turning Points Rehabilitation Centre. So thank you for staying with us. We're at the home stretch, we're almost at the end. So tell us a little bit about your challenges outside of COVID that you would have at the Rehabilitation Centre. So we're always looking to improve our services. That's one thing. In terms of defining what the program itself means, what we can offer, space and so forth, there are limitations to what we can offer right now. So we're working on ideas and things to be able to develop, creating more space for physical activity because we know that sport and activity, these types of things, they go hand in hand with recovery, creating more safe spaces and spaces to be able to relax, reflect on these types of things. So some of our challenges may lie really in accessing training or resources to be able to put some of these things together, but it's not a barrier that I would say is going to keep us down forever. We will get there, we have plans in place, we are looking into things to do. But I think our major concern right now is the fact that we're not getting the type of referrals or calls that we would expect to have, especially in a period like now. Typically there were a few quiet periods we would have. Carnival is always a quiet period and Christmas is a quiet period because people want to be out there on the road. I see. Or they want to be with their family, whatever. But after carnival you would see their eyes, after Christmas you'd see their eyes, whatever. But this is a period where we typically see more clients coming in that we do have now. So the challenge we have is I think people either through confusion of seeing the empty space at our old location or because we had pullback services for a period I don't think a lot of people recognize that we are still there and available to them as a resource. Not just a resource to yourself, you think you have a concern and I'll speak a little bit about what that concern might be. But if you think family members, workers, co-workers, whoever it is that have a concern as well be able to access and seek out help for them as well. Mind you, Turning Point is a voluntary program. So you don't send somebody to Turning Point as a punishment or for any other reason. They have to want to be a participant in the program. That doesn't mean a company might let them know like, listen, you need to get treatment or we can't keep you on something with that effect. I'm not advocating for ultimatums, but that can serve as a source of motivation as well. But once people recognize that they have a problem or they have somebody they can speak with them, do an intervention and invite them to at least call and seek that service out. How do you recognize if yourself or somebody has an issue? That's a good question. So in the same way not everybody with sugar in their blood have diabetes, not everybody who consumes a drug has a substance use disorder. What we mark it by really and truly is it boils down to two things in my opinion. There's a list, but in my opinion it boils down to two things. One, having an obsession with it, meaning that when you're not using it, you're sort of thinking about it. You're planning or you're always recovering from it. And two is where it is having a negative impact on parts of your life, but you continue to use. For example, you have indirect health consequences from your use, but you continue to use despite that. Or you're in financial trouble, but you still spend all your money on it. Or your family, everybody you have in relationship issues but you're still ignoring that to continue to use. So that's the two primary things as far as I'm concerned. So if you find that these concerns for yourself or others affecting you, then you might want to consider let's have a conversation. Now there are stages as well. We have what we call mild, moderate and severe disorders. So somebody in the mild spectrum, they might only have the obsession part, not necessarily the problem part yet, whatever it is. And then as you go up, you go up the scale of moderate to severe where they have all the issues. So even at a mild stage, it's still good to seek help because just like any disease progresses, this can progress from that mild stage to moderate and severe. So these are the things you want to look for. How is your drug use impacting on the things around your life? So is it hindering your life in any way? Yes, in particular. Because you have people literally, our social worker and our counselor, they have problems in the hospital with the doctors. They speak to people there. Doctors call us from the arm, the hospital, A&E and whatnot. And you have people literally in there with severe chronic disease directly caused by their drug use. And you speak to them and they do not want to stop. Despite the obvious consequences on their health, they cannot stop. They will not stop. These are the people who need our help. But again, even when we talk to them, we advise them and everything, we advise them into treatment. It's a voluntary program. So we do our best. Social worker counselors speak to them, advises. We try and get them to come in, but ultimately they have to make that decision. In your experience locally, is there a particular drug of choice? Is it just alcohol? Is it mainly alcohol? The three main ones that we see are alcohol, marijuana and crack cocaine. Crack is, we see the least. But alcohol is by far the most prominent. Thankfully we don't really see a lot of other drugs like LSDs or heroin or these things. I would say thankfully that the solution population are afraid of needles. So we generally don't really worry about that and it's not very accessible here. So even when we do have people who travel, come down, we use these drugs because of the lack of access, they tend to switch to the more accessible alternatives. That's interesting because a lot of people, as you mentioned, marijuana, a lot of people would say you can't get addicted to marijuana. I guess that's not the case for you. That's not the case. We see it all the time when people we have with a marijuana use disorder. So yeah, marijuana can cause problems. You have to remember that a substance use issue is not always about the physical effects as well as psychological as well. So if you're using a substance and yeah, there might be physical withdrawals and whatnot, but if it is that you find, you can't fall asleep without it. You can't start your day without it or something. So these are psychological effects which we speak to a disorder as well. So you can get addicted to food. You can get addicted to chocolate. Why can't you get addicted to marijuana? And I suppose in a case where you might stop taking any of these substances, you feel a sense of withdrawal. That's how you know that. That's how you know that. Draw out cravings or some other discomfort or signs or whatnot. Usually, yeah, typically you would see these things. There's actually something that I have been wondering. Do you find that, let's say under COVID, you had a lot of maybe a rise in maybe alcohol abuse because people have lost their jobs. Some people maybe they're just home for extended periods. Have you had anything like that? So I'm hesitant to speak on that because I'm a person I believe in data. I don't have data. So I can only speak from what I see. And the problem is I work in that field. So what I see is I'm on the front line of it. So what I see is sort of bias because I have that view. So if I make that comment, it may not be a true reflection. I do believe that research is needed. And it's something I've been calling for in terms of not just finding out what the changes in use and has been. We have had secondary school surveys. The last one has been several years back. We definitely need a new one. But it's not sufficient. A secondary school survey doesn't speak to youth out of school. It doesn't speak to adult populations. Male, female, all of these things have to come into account. We need to engender more of a culture of research within here and base our decisions on our program decisions or on the data that we derive from that. And I'm hoping right now I'm having some discussion. I'm hoping that we can reach a point where we can do some sort of research because simple things like asking people what are your expectations of treatment? When you think about treatment, what do you expect to get there? What are you hoping to achieve? It's a bright and the only goal that you want to get. Are there other drugs of interest? Just getting general information from the people. So we know when we're developing Turning Point, we're not developing based on what I think is best. I'm not saying that I don't have a feel or whatever, but I don't want it to be, in my opinion, driving the organization forward. I want data to drive where we go. Learning from the experiences of also our Caribbean partners, the world, et cetera, all of that. Very much so, understood. Well, Mr. Huggins, I want to thank you very much for coming on our program. It's a pleasure having you here. I consider him my arch nemesis for reasons that you will have to go back to the beginning of this program to understand. I'm Jacques Kingston Compton. You're watching Issues and Answers. Thank you. And please stay tuned to other programming from the Government Information Service and the National Television Network.