Community Health Workers

****We are not using Michelle's last name in order to protect her privacy. 

When Michelle unexpectedly got pregnant with her now 10-month-old son, she was using heroin every day. Scared and wanting to protect her baby, the 26-year-old knew she needed help. 

Enter LaTasha Timberlake, a community health worker who not only helped Michelle through her pregnancy, but continues to help the young woman create a healthy and safe environment for both herself and her baby.

"LaTasha gave me plenty of time and space," Michelle said. "Of all the girls she works with, she always remembered me and what I am going through. It made me think she cared for real. I'm not just a number to her. I’m a real person. And I know I wasn’t the easiest to work with."

Community Care

Timberlake is part of the CARE Plus program, which connects community health workers with mothers who are struggling with substance use issues. Managed by Debra Litzelman, a senior research scientist at Regenstrief Institute and D. Craig Brater Professor of Global Health Education at the IU School of Medicine, the program is part of IU’s Responding to the Addictions Crisis Grand Challenge and builds off the existing WeCARE Indiana program.

The overall goal of the program, in addition to providing resources, is to reduce infant mortality. The health workers meet the women at their homes or in the community, staying in touch via phone.

There currently are 15 highly trained addiction recovery coaches and community health workers who, so far, have enrolled 145 women in the program.

"I believe it is the very personal touch and connection that the community health worker has with the CARE plus participants that can make the difference," Litzelman said. "Community resources and organizations exist to meet many of the individualized needs that our community health workers uncover, but it's going the extra mile (for example arranging a three-way call between the participant, agency, and the worker) that helps model for the participant ways to negotiate the system. This helps empowers participants to take similar steps going forward."

Prior to the pandemic, the coaches were stationed at Eskenazi Health community health centers, HealthNet clinics, and the Raphael Health Center. While COVID-19 has eliminated meeting face-to-face, Litzelman said the coaches have remained busy, pivoting their work to continue to provide services — "meeting" over the phone and conducting safe supply drop-offs — while maintaining social-distancing measures.

A long journey

Michelle's journey began in Indianapolis, where she was one of four children. Raised by her mother, a teenage Michelle found herself on her own after her mother moved to Arkansas to care for Michelle’s grandfather, leaving her daughter the house and a car.

On her own, Michelle began to backslide, staying out late and eventually dropping out of high school. After a few rough years, Michelle went back to school, eventually enrolling and graduating from the Aviation Institute of Maintenance career school while also working.

But she was struggling. Having previous experience with pain pills, she eventually moved on to heroin, which her boyfriend at the time was selling. After a few years, she and her boyfriend broke up. A new boyfriend helped her get clean, but she said his infidelity led her to relapse.

She then found herself pregnant and not sure what to do. She confided in her doctor about her situation and confessed to her boyfriend that she was using again. Because her boyfriend didn’t want Michelle taking medication during her pregnancy, and quitting cold turkey was too tough, she turned to getting suboxone off the street. But she knew that wasn’t sustainable. That is when she met Timberlake, who helped her find the resources she needed.

Michelle entered an inpatient rehab, obtained a prescription for suboxone and eventually delivered her baby boy. Although Michelle's own life has been full of heartache and pain, it isn't until she starts talking about her baby, and his journey into this world, that she loses her composure.

"My baby started withdrawing when we were about to go home. He was so irritated and rubbing his face, sweating," said a tearful Michelle as she described her baby's time in the neonatal intensive care unit. "I was an addict; I know how it feels, and I know it is all my fault."

Michelle eventually was able to return home with her baby, who is now healthy and thriving. She has maintained her recovery, exclusively breastfed her baby, and is now working a fulltime job.

"I was breastfeeding, so I'm really proud of that," Michelle said. "I'm thinking about my baby and his future. I’m trying so hard to be different, and I’m taking it one day at a time."

"Yes, we all have made mistakes but it’s all about what you do from now on," LaTasha added. "Whatever I put in front of her, Michelle would grab hold of it. I wouldn’t harass her or nag her because I wouldn’t want someone to do me that way. I just wanted her to know I’m thinking about you, and I want to make sure you are doing what you need to do. It is important to know that someone is thinking of you."

Someone in her corner

Walking into the Indianapolis Library branch, Michelle smiled as she saw Timberlake, giving her a hug and showing her the latest pictures of her little boy.

"Oh, he has gotten so big," Timberlake said as she gushed over the photos.

In a meeting room in the back of the library, the two caught up on what is happening in Michelle’s life.

"I can’t quit thinking about what you told me on the phone," Michelle said. "About building credit and getting a home. That's what I want."

"It’s totally up to you. You can plan your future and what you want," Timberlake said. "You have to do what is best for yourself and that baby boy. You've got to realize your worth."

As she listened to Michelle talk about relationship troubles and wanting to get her own home, Timberlake was straightforward, giving the encouragement needed without becoming preachy or pushy. She even shared some of her own stories about her past relationships and being a mother to two sons, one born when she was just 20 years old. And Timberlake understands not only being a young mom trying to do what is best for your children, she also understands addiction.

Growing up, Timberlake's mother abused crack cocaine, and her father was abusive. She became a ward of the state at the age of 14 after running away. She managed to graduate high school and started college, but she quit after becoming pregnant.

Eventually, Timberlake went back to college and became a social worker. Throughout her career, she has been inspiring women to be strong and independent and to know that there is nothing they can't do if they put forth the effort.

"Being able to support these young women is so gratifying for me," Timberlake said. "Working with the population we work with, especially those who have their barriers, you don't always get to see that flower bloom. I get to see Michelle bloom and see her healthy and raising a happy baby. Now I'm just waiting on her to be a more independent woman and to see her worth."

Throughout her journey, Michelle has taken advantage of many of the support programs available to young mothers, especially those struggling with substance use. But it is her relationship with Timberlake, she said, that has really made a difference.

"She stayed on me the whole time I was pregnant. She reminded me of my auntie," Michelle said. "She is really blunt; she tells it how it is. I need that. I’m stubborn. I need to be told how it is. Once I had the baby, I didn’t see why we still needed to talk. But when she kept sending me things I needed to do, I realized I still need her."

As she moves into the next phase of her life, Michelle is looking forward to what the future might hold. Although she still struggles with relationship issues and to maintain her recovery, she continues to take the steps needed to provide a healthy environment for herself and her baby.

"I'm really proud," Michelle said. "I'm getting to know more about myself. I’m growing, I’m learning. I’ve got a good job; my baby is healthy. I’ve completed a lot of the goals that I set for myself. I'm just proud of the person I'm becoming, and I’m proud of the person I will become eventually. I just feel blessed."

Responding to the Addictions Crisis

The Responding to the Addictions Crisis Grand Challenge initiative engages a broad array of IU's world-class faculty, as well as IU's business, nonprofit and government partners. Working together, the groups are contributing to an initiative to implement a comprehensive plan to reduce deaths from addiction, ease the burden of drug addiction on Hoosier communities and improve health and economic outcomes. This initiative is one of the nation's largest and most comprehensive state-based responses to the opioid addiction crisis -- and the largest led by a university.