On the grounds of the Austin Recovery Center in Buda, Texas, one can find many testimonials to the healing and restorative power of the work done there.
Prayer flags hang from deck railings, and wooden posts painted with phrases like, “Believe” and “Love Yourself” adorn the flower gardens. On one door, a sign reads, “You cannot discover new oceans until you have the courage to let go of the shore.” Inside a comfortable lounge space, big letters hang on the wall reminding residents simply to “B-R-E-A-T-H-E.”
Austin Recovery Center provides both residential and outpatient services to those in recovery at one of three locations in Austin. Residential services, though, are limited to the Buda campus, where the Center has 65 beds total for both men and women. Of these, 14 are in what’s known as the “Family House” – the space reserved for women with children. These beds are available to women who are in their third trimester of pregnancy or who have children up to 5 years old.
While a welcome resource for moms in need of recovery services, David Houke, the Director of Programs at Austin Recovery Center, points out it’s a rarity. In Texas, Austin Recovery is just one of three residential recovery centers who accept uninsured women and allow them to bring their children to treatment. The other two are located in Dallas and El Paso. “If we had more funding, we’d have more beds in the Family House,” said Houke.
September is National Recovery Month, and at TWHC we know that the issues of substance use disorders and addiction fall especially hard on women with children who lack access to the services that they need to get better. At our recent community engagement meetings in Austin and Houston, we heard from dozens of local healthcare providers who stated that access to substance use disorder treatment is one of the biggest areas of need among their patients.
Houke says that women in Texas face a huge gap in services when it comes to recovery. Over the years, Austin Recovery has seen funding for its programs decrease significantly. When the Center’s Family House opened in 1993, women could typically receive up to 9 months of care there. Now, Houke said, women are lucky to get 90 days. Currently, Austin Recovery relies on a combination of grant funding and public funding to provide services to uninsured women. He says he sees the expansion of Medicaid in Texas as being the first step to opening the treatment doors to more women. “While women can get Medicaid while they’re pregnant, they can only get services during that short period of time and then the coverage is up,” he said.
Nick Vache, the Facility Director at Cenikor Foundation, echoes Houke’s sentiments. Cenikor Foundation provides inpatient detox services, and Vache says about 60% of the population that it serves are uninsured. The rest have Medicaid or private insurance, and Cenikor also relies on a combination of public and private funding to operate. “The low-lying fruit here is the expansion of Medicaid,” he said.
Both Houke and Vache concur that recovery is typically a more complicated process for women, who often require treatment for additional issues, like trauma or depression, and who face more stigmas and barriers to accessing treatment than men. Both centers have medical staff on hand to treat the many needs their patients may have, but it’s often much harder to get women through the door.
“The biggest barrier that we see among women is the stigma of needing to leave their family for treatment,” said Vache. “While if they were suffering from diabetes or cancer, they’d probably jump at the chance to get treatment and have the support for it, with [substance use disorders] there’s a stigma, which is then compounded by the stigma of needing to leave their children to get help.”
Houke says he sees that, as well. “We often see that moms don’t want to leave their children for treatment and lack options for childcare if they do.”
Vache adds that the lack of available options and waitlists at places that do accept women in need are big deterrents. “Waitlists are a huge barrier.”
While both Houke and Vache say expansion of access to health insurance and health services would be a huge win for women experiencing addiction, they also say that there needs to be more connection and resource sharing among healthcare providers and organizations providing services for those in recovery. They’d encourage any healthcare provider in need of recovery services for a patient to call them.
“Part of my job is to make sure that we’re aware of what’s available and that others are aware that we’re available,” said Houke.
Vache also says that greater integration is needed to both connect women to services and to make sure all parties are educated about the issues, particularly when it comes to medical interventions on pregnant women working toward recovery.