Getting People Into Treatment And Following Through When They Are Out

This is the fifth article in a series called A Cape Addiction that explores drug abuse on Cape Cod. Timothy Lineaweaver from Woods Hole explains how the program, Cape Care for Depression, helps connect people to treatment, and William Dougherty of West Falmouth sees early success in his program, Recovery Without Walls.


It has long been the two-pronged conundrum for the recovery field: how to get people into treatment, and once they have undergone treatment, how to keep them on track.

Two Falmouth men are leading relatively new programs that tackle both issues in unique ways. Timothy H. Lineaweaver of Woods Hole, who is also co-chairman of the Falmouth Substance Abuse Commission, is project director of Community Care for Depression. This program that began in 2004 screens people on Cape Cod for depression and addiction. From there, they are referred to a social worker, a psychologist, and other services.

William A. Dougherty of West Falmouth started Recovery Without Walls 10 months ago to deal with the issue of how to help people when they come out of treatment programs. Having worked in the treatment field for 15 years, Mr. Dougherty said one big problem he saw is there is no money or “reimbursement potential” available to people who leave treatment centers. Often those people have no income, no driver’s license, and little support from friends and family. What Mr. Dougherty’s program does is to provide help with transportation, rent money, or mentoring. Mr. Lineaweaver’s program is supported by grants. Mr. Dougherty’s is staffed by volunteers and supported by donations. Both men had their own struggles with substance abuse decades ago and are motivated by helping others.

Community Care for Depression is an attempt to steer toward treatment people who may never have addressed their issues with addiction. The program is about identifying these people and “connecting them with care,” Mr. Lineaweaver said.

The program has placed questionnaires to screen adults and adolescents for depression, anxiety, and addiction in four primary care health centers on Cape Cod. For people who live on the Upper Cape, the nearest health center is the Cape Cod Free Clinic and Community Health Center in Mashpee.

In its third year, Mr. Lineaweaver’s program has performed 14,000 screenings of 9,500 patients. Some patients are screened more than once to see if there have been changes in their condition. The program has made more than 1,800 referrals for services and identified 1,500 individuals needing care. Many of them are uninsured.

What Mr. Lineaweaver has found from the screenings is that the substance abuse/addiction rate is 24.4 percent in the population that filled out the surveys.

That means, since the program began in late 2004, 2,323 people taking the survey have been identified as having some issue with addiction.

Mr. Lineaweaver said that in studying the survey results, his staff have found that often the more depressed people are, the more likely they are uninsured and the more likely they have a problem with addiction.

“A lot of people who really need services can be shut out because they don’t have insurance,” Mr. Lineaweaver said.

The primary funding source for Community Care for Depression is a three-year, $460,000 grant from the Robert Wood Johnson Foundation.

In a program like Community Care for Depression, success can be seen in small moments that show how its work has made a big difference in people’s lives. Mr. Lineaweaver wrote about one such moment when a staff social worker shared with him a drawing made by a patient, a Brazilian man who suffered from post-traumatic stress disorder, depression, and anxiety. In a corner of the picture, the man drew an image of the social worker with a halo around her head.

While Mr. Lineaweaver’s program is about getting people into treatment, Mr. Dougherty’s program is aimed at keeping people connected with treatment.

Mr. Lineaweaver pointed to the need for Mr. Dougherty’s program. “It is well-known among providers that one of the missing pieces is case management. It’s usually not a reimbursable service. Many nonprofits struggle with scarce resources.”That’s where Recovery Without Walls comes in.

When he started the program earlier this year, Mr. Dougherty, who serves as its executive director, said he thought he would have 10 to 15 clients. The program already has 54 clients ranging in age from 19 to their mid-50s, and who come from Cape towns from Bourne to Provincetown. Mr. Dougherty is expecting to have helped 160 clients by the end of next year.

The purpose of this program is to help people at a time when they may need it most: after they have left treatment and are trying to reenter the community.

“We’re not a counseling agency. Much of what we do is financial support,” Mr. Dougherty said. The program, which offers “structure, safety, support, and stability,” is registered as a charity in Massachusetts. Initial funding for the program came from the Church of the Messiah in Woods Hole, and other local churches have offered support. Two fundraisers last summer helped raise $20,000. Mr. Dougherty is married to Deborah C. Dougherty, who works in the development department at Cape Cod Health Care, the parent company of Falmouth Hospital and Cape Cod Hospital.

Mr. Dougherty is in the process of putting together a board of advisors for Recovery Without Walls. He hopes eventually to have at least two clients of the program become members of the board, in addition to being volunteers with the program.

Recovery Without Walls, Mr. Dougherty said, gives people an “infrastructure,” connecting them with services.

Mr. Dougherty said counseling sessions are often set up before the patient leaves treatment, “but if they can’t get there, sooner or later they will be back in isolation.” Many people who leave treatment programs have had their driver’s licenses taken away and need help with transportation to meetings and treatment sessions. Mr. Dougherty even helps people get jobs, talking to employers, for instance.

“We try to fix the broken shoelaces of their lives,” he said.

Mr. Dougherty said a common feeling among people struggling with addiction is the feeling that they are not a part of the community. Integrating clients into the community, through work and even volunteer jobs, “pulls them out of victimhood and into being a community member,” Mr. Dougherty said.

That has been the experience for one client of Recovery Without Walls, a 51-year-old woman who lives in East Falmouth. After being sober for nine years, she and her husband began drinking again. She ended up in treatment and, through treatment, was able to get her life back on track. But when she came out of treatment, she had nothing: no money and no income. A counselor referred her to Recovery Without Walls. “It made such a huge difference for me,” said the woman, who now has a full-time job because of transportation provided by Recovery Without Walls volunteers.

“I’m five months sober today,” she said yesterday. “It’s humbling, because I was sober for nine years before. Things happen in life, but if you don’t put your recovery first, you’re in big trouble.”Another woman, a 24-year-old living in Falmouth, said Mr. Dougherty helped her get a job and has also connected her with “strong women in the community.”She said she’s gotten the “re-ignition to live again.”She has been sober for six months.

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