Mona White is currently a peer support specialist at Action for Mental Health in Buffalo, New York. For the past year and a half, she has been the peer support specialist for the jail in Erie County. Her position is made possible through a grant from the Erie County Department of Mental Health. Her unique position is the only one that exists in New York State. She works with consumers who have mental health and substance abuse issues and are incarcerated in the jail (Erie County holding center). In an interview, Mona discussed her work in this area.

"I obtain clients from referrals from the Erie County Department of Forensics and Crisis Services. In order for individuals to be referred to me, they must have a mental health diagnosis and be chemically dependant. The whole point of my job is to build a relationship with the person in jail so that I can assist him with putting services into place for when he comes back into the community. I start the process by going to visit the person in the jail and building a rapport. I tell the person what I do and offer my services. I explain that this is not mandatory and that I am there as a peer. I try to share a bit of my own personal story so that I connect with them. In that way, we both become comfortable and get on an even playing field. I explain the services which I help provide which are housing, benefits, counseling, support groups, self-help groups, rehab placement and placement in a detox unit. All of the services that Action for Mental Health provides are offered to them.

"The consumer will let me know if he wants my services. If he does, I will do an independent living plan with him. What I do next for the person depends upon what he wants and needs. Housing is usually the biggest concern that people have. Most of the people that I work with have fallen through the cracks and have been through the system a number of times. They have criminal records involving such things as petty larceny or trespassing. None have been involved with serious crimes. The people I work with have been through the jail system many times.

"The program that I work on is designed to find out why these folks fall through the cracks. The program puts a peer at the jail to give support to these consumers as they make their way back into the community. It is designed to stop some of the re-arrests. Living on the streets and committing petty crimes is a way of life for a lot of folks. Many of them like living that way or so they say.

"The demand for my services varies. Sometimes I can get two or three referrals in one day from a counselor and other days I get none. I have a case load of eighteen. That is a large amount given the population that I am working with. Therefore, it would be impossible to have 30 or 40 consumers since I would not be able to do anyone any good. I could not give enough time to an individual that he would need if I had any more than 18 clients.

"Sometimes consumers think that I am a way out of jail so they express an interest in my services. Even after I explain otherwise, they still think that I am a way out. If a consumer is really serious, he or she will stay with me. If they think that I am their key out of jail, and then they figure out I am not, they will say, ‘I do not want your services.’

"Whether someone is going to accept services from me can sometimes be determined in the first visit. If someone wants my services, I follow him all the way through the process of his release. I go to court with him. I visit him in jail as often as I can in order to keep the connection, build support and build up the trust in our relationship.

"My ability to engage people has a lot to do with the way I come across to them. The way that I am helps them to make a decision about whether they want services from me. I obtain their trust. That is a big issue for these consumers. I share where I came from with these folks. When they hear that, they are able to say, ‘Wow, you’ve been here where I am.’ The peer element really works well in connecting with people.

"The peer model is one of the things that helped me in my recovery. I could connect and identify with a peer. It was someone who had suffered through some of the same issues that I have. I felt as if a peer knew what I was experiencing. I find that people are more accepting of me than they would be of someone who is not a peer. I am not knocking those who have just a book education but many consumers shy away from those counselors.

"It’s hard to obtain all of the needed services for my consumers. I do not give up. I keep at providers as all good advocates will do. I break down the barriers. I knock on the doors and keep showing up. Many providers get tired of looking at me. I do a lot of old time case management. I take an interest in the consumer and I will fight to the bitter end to get them services. I don’t usually accept no for an answer. Obtaining benefits for consumers is not too difficult. It is the housing piece that is the real problem.

"Early on, I noticed that the problem of obtaining housing for my consumers kept coming up. I went and talked to my supervisor. She arranged for me to meet with the leaders of various mental health housing agencies. These leaders in mental health housing agreed to consider my consumers for services if I could show they had some type of stability. This was a big accomplishment since these organizations will no longer say no, right off the bat, to assisting my consumers.

"The consumers that I work with are difficult because they are seriously and persistently mentally ill. They do not stay on their medications. They also have significant criminal histories. One of the reasons that people fall through the cracks is that when they get out of jail, they do not have a place to go and live. There is a trail of paperwork that is necessary in order to obtain most housing. By the time you do all of this work, a lot of time has passed and you have lost these people again. They have fallen through the cracks because they get out of jail and they are not able to connect with housing or services right away.

"I have had to be creative in my approach to getting housing for my consumers. One hundred percent of the people that I work with are drug and alcohol dependant. So the route I take is to get them into a detox unit and then into a rehab for chemically dependancy. Then, if the consumers stay in these programs, I have a much better chance of getting them into housing. I can show the housing providers some stability and show them that the consumers are doing what they need to do. I can then ask the housing provider to take them on and provide services. I can’t take a consumer right from jail into housing because that does not work.

"I enjoy my job. I like the fact that I am not sitting in an office. Instead, I am out in the field and in the community running all over for my consumers. This does not make me tired. I am energized. I like trying to get services for people and investigating what types of services are out there.

"We could definitely use another peer advocate like me. I have heard Dr. Liebergall (the head of Forensics for Erie County) tell people that I am doing a fine job and that they wish they could clone me. I think peer advocates would be helpful in all the local jails, correctional facilities or prisons. They could work with the staff to help with the transition of people going back into the community.

"When people are in jail, there are no counseling services available to them. They do not have AA or NA meetings at the jail. They do not have Medicaid in jail. They do not have a case worker who comes and helps people sign up for benefits. It would be extremely helpful to make sure that someone has Medicaid in place when they are released from the jail since a person can’t obtain all of the needed services without it and some rehabs and detox centers will not take a person without Medicaid.

"The hardest part of the job is when you do all that you can do for a person and he just doesn’t choose to accept your help. This is usually when you think that the person has finally discovered the benefits of recovery and then you see that he has gone out and got drunk again. Sometimes I will see the names of some of my consumers back on the list of inmates at the jail.

"I consider it a success when one person accepts my services and does not commit another crime. I actually have three consumers that are doing really well. That is three consumers in the year and a half that I have been a peer specialist. These three consumers have been with me from the beginning. All three have housing which they obtained from some sort of transitional services or through rehab or detox. They are all in counseling or going to 12 step groups or MICA (Mentally Ill Chemical Abuser) groups. One young woman has had her three children returned to her and she is moving into a bigger apartment. I am very proud of her. The population that I am working with does not have a high success rate so it is great that I have three consumers who are doing well.

"My personal recovery is what I use to help someone else. I usually share with other people that I am a recovering alcoholic and that I have suffered with depression. This seems to put a lot of people at ease. I have also been in jail. I have been in the holding center. It is really interesting to go back to the jail. I have been on the other side and now I am on this side.

"My experience is what has enabled me to go back and to do this job effectively. I share these things with people. They don’t believe that it is possible to change their lives around so I am a good example for them to see. I have been in recovery for ten years. When my consumers hear that, they can’t believe it. I use my story to make other people comfortable. My life experience has made it possible for me to help someone else today."