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Pathways To Spirit is hosted by Dr. Troy Melendez and Dr. Nate Velez of Journey to Recovery, offering an inside look at the people, practices, and purpose behind a culturally grounded approach to healing from addiction. Through conversations with the Journey to Recovery team, the podcast explores the program’s history, its new facility, and the clinical and cultural principles that guide their work. Pathways To Spirit provides a welcoming space to learn how Community, culture, and connection support the recovery journey, and how this program is shaping a path toward wellness and a deeper sense of spirit.
Welcome to Pathways to Spirit. Our journey today seeks to honor the sacred land, revered teachings, and ancestral wisdom that guide us through the path of mental health wellness and holistic recovery. Together we'll explore the stories of strength, healing and hope, embracing the clinical techniques and cultural foundations that remind us we are never alone on this sacred journey toward wellness and a strong personal connection to spirit. Welcome back. I'm Doctor.
Troy:Troy Melendez, and I'm here with Doctor. Nate Velez and Joe Remitera. And we've got a special episode for you all today. We're gonna talk more about Journey to Recovery and all of our efforts in behavioral health and impact that it's having on the community.
Nate:Oh, it's good to be back. Good to see you Troy and welcome Joe to the studio. We're so excited to have you today.
Joe:Thank you. Great to be here.
Troy:Why don't you tell us a little bit about your position here and how you're seeing the growth of Journey to Recovery? We got the new facility. We're staffing ourselves up, and we're getting ready to, you know, implement some new programs and some new components to what we're doing with JTR. But from your position, where do you see that fitting into the community and what are the opportunities for us going forward?
Joe:Wow. Well, thank you, Troy. Appreciate that. So, with the community, I think that behavioral health in general is a huge piece. It really is.
Joe:You are the sum of your thoughts and behaviors. And for health and wellness, behavioral health is a key component. At Health and Human Services and at Salt River, what we like to do is we like to focus on the five determinants of health. And we like to take a look at the health and overall wellness in each one of those areas and make sure that people are doing well or have access to care in those areas. Behavioral health is one of the largest ones.
Joe:And when we take a look at the opportunity for health and wellness, behavioral health is certainly a big one. We did a study a few years ago on the average age of mortality within the community. And we found out that the average age was only 52 years old. And we said, we need to do a different approach here. We can't continue to do the same thing and expect different results.
Joe:So what we decided to do is focus on a community of caring model based on the five determinants of health. And like I said before, behavioral health is such a big piece. One of our biggest challenges are the folks that lose their life between the ages of 18 and 40, which is about thirty three percent. So a lot of those individuals, it is related to substance use. And the journey to recovery really is a big piece to address that.
Nate:Yeah. We've come a long way, you know. I think about some of our earlier you know, Joe I have you and I have been involved in a lot of conversations over the years. Joe talks a lot about this community of care model and how collaborative it is, and so I think about Joe where we've just come full circle on developing some of your vision, you know? And one of the things that really hit me when I started is I remember being in an orientation and you gave PowerPoint presentation on our North Star.
Nate:You know, like, what is our why? What is our North Star? And so Joe talks a lot about that, and that really inspires me as, you know, being on part of this team and Joe's team. And, know, Joe, tell us more about, you know, how you feel we're living into that vision and our North Star and how it ties into some of the work we're doing around substance use. And I'm really interested in hearing more five years later, right, how you see that kind of playing out.
Joe:All right. Yeah. Thanks. So I was in the Navy. And one of the things that they taught you when you're in boot camp is always know where the North Star is.
Joe:Because if you know where the North Star is, you're never lost. And I think our North Star here within the community is really to make a positive impact of the next seven generations. Right? And one way of, you know, looking at that is whatever decisions we make, do we have that in mind? Are we making the best efforts to achieve, you know, ultimately the health and wellness within the community?
Joe:It really does govern all of our decisions. And when we look at the the model of caring that we've created, it's really to to make sure that you know, the man in the maze? You know, when somebody goes through life and they take twists and turns, there's times when, you know, they may need help, assistance. Maybe someone in their family needs help. Maybe a child died.
Joe:And what we like to say is we're ready when you're ready. And we want to create all the services and support for those individuals when they need that care so that we can get them through life until at the end of life, they've lived a good life and they meet their great creator. So really knowing that that true north and what we do isn't just for that patient today but also for seven generations.
Nate:Well, is a model of, you know, it's a contagious model too, right? Right. And you help lead that in our system of care at JTR in particular, right? So you talk about our family values, our traditional values, the benefits of how families are healing and that comes from our top. And so what really inspires me is that, you know, at Joe, at your level and then, you know, it's reiterated at our ACM level and then we look at our council level.
Nate:And so do you find, Joe, that this thread of inspiration and ideals and North Star and it's kinda like in tune, it's one heartbeat and I feel like you don't get that very many places, right?
Joe:No, not at all. And really, when you think about, you know, what we're doing, not just Health and Human Services, but all the departments within, you know, Salt River, this really is the vision of this community and the leadership. It took forty years to build the River People's Health Center, you know, which is a place for health and healing, not just allopathic medicine, you know, but also traditional medicine as well. We're bringing, you know, services that resonate, you know, with those that we serve. So, when you think about this vision, it really is I feel like we're standing on the shoulders of giants.
Joe:All the past community leaders and elders, I feel like it's been their vision. And to bring it to fruition and to focus on that individual and their journey through life and creating all the services that's needed for them to to experience a fulfilling and and well, you know, life is is really great. It really is a different model because you can't really find this anywhere else other than in Indian country.
Nate:Yeah, it unique and, you know, I think about that quite often, you know. Joe and I have a lot of discussions almost daily about our momentum and where we're going and how all these things tie into one another across the spectrum. Not only in our Journey to Recovery line or substance abuse line or behavioral health line but as a community and inside River People Health Centers how our integrated efforts are joining each other. And then Joe mentioned something that maybe we could stick on a little bit because and it's in our introduction of our podcast, is the spirit and the traditional element of what we do. So, you know, Doctor.
Nate:Melendez, I'm really I'm curious as to when you hear Joe talk, like, what are some of the traditional and spiritual elements that we're starting to bring into our healing process around recovery and closing the gaps for, you know, the mortality rate and improving lifespan? I think initially,
Troy:it's our connection with Wellbriety and White Bison. White Bison certified, people are getting trained in mending broken hearts and talking circles, and so we've had that component as a part of what we've been doing pretty much from the beginning. As we get deeper into this, we've just recently added a cultural counselor, Bowie Leonard, and joins Jared Lewis from outpatient, and they're starting to get more involved with the different programs and looking at where are those opportunities to bring some more traditional approaches. And we were just I just went to lunch with Bui and we were talking about some of those opportunities with regards to our hiring and hiring other native counselors and helping the folks that are from the community working with us that have an interest in being counselors to go through that process and become counselors so that, you know, we've got people from the community that are counselors and are starting to fill some of these roles. But I'm very excited about opportunities for us to bring in more of the traditional aspects and using the culture in positive ways, to help people heal themselves and then thereby, you know, the individual heals and then the family heals and then the community heals.
Troy:And so we're, you know, in part of that vision as well. We're at least in the initial stages of building sweat lodges in the back of the units.
Nate:It's starting this week.
Troy:It starts this week. Yeah. There we go.
Nate:We're planning to get it going.
Troy:Space was being cleared for it but I wasn't sure, you know, what that is what what the timeline on that was. I'm also working with Frank to bring in some folks that do breath work and from a native perspective. It's something that's just kind of been lost as we, you know, get more civilized or, you know, progressive in our communities. We forget some of the basics and one of the primary basics is our breath. It's our connection to spirit, it's a way for us to heal ourselves, it's to focus more on that and block out some of the nonsense and drama that we've got in our lives.
Troy:And so bringing these components in, very encouraging to see that. Know, we've got the evidence based procedures, we've got the clinical elements to it, and how can we now merge, these more traditional approaches to healing, that bring in spirit. And I think that that's a crucial component of what we're trying to do with folks.
Nate:Yeah, it really is. And Joe, you've been front and center on being our lead on, you know, instilling cultural values. And so, you know, maybe you can talk to us about your work with our cultural community group and how you're weaving that into our vision of healing throughout the community.
Joe:Yeah. So thank you for mentioning that because I think that's really core, you know, to what makes us special here, right, is instilling the culture and values of this community. What a rich community we have. And I think that when you resonate with those that you serve, they'll come back and they'll come back. What's really interesting is that, you know, we've been doing this for, you know, a few years now at Salt River and also Health and Human Services, which is doing that cultural training piece.
Joe:We've really seen that patient satisfactions has gone up quite a bit. It's actually through, you know, off the charts at River Peoples Health Center. And I think that because we've done that, we've instilled the culture and values of this community with how we treat each other and how we treat our patients, that our patient satisfaction has gone high and word-of-mouth is out there so much so that we don't do a lick of advertising and we average around 200 to 300 new patients per month. It's made a big impact focusing on culture and the values of this community. It really has.
Nate:Yeah, and you know what's really exciting now is, you know, as Joe's leading kind of the charge with our instilling cultural values and we have our ACM, Miss Jackson initiating our five and five committee and elders from the community that are being invited to help move us in that direction to teach us and tell us how we should be doing this. Your point, we're really good at Western medicine.
Joe:Right.
Nate:And so as start to be really what should be the foundation, the foundation should be culture and should be tradition, especially where we practice the healing we practice. And so it's so cool. It's so cool to be a part of this. And to Joe's point, like, where do you get to do stuff like this?
Troy:Right.
Nate:You know, where do you get to experience this and and learn and be innovative? Joe calls this being above the line, right, being in a space where we can be innovative and learn from one another and bring that almost this contagious effort that kinda radiates through staff. And I think we have some of that going. Would you think so? Or how would you describe that?
Nate:You can kinda feel the buzz kinda thing?
Troy:Yeah. Yeah. It's into the new space and as you know, employees start to grow in number, they start to come together more and they're more cohesive unit and they're getting a better idea of what it is that we're doing and where their input comes into this. Because, you know, we've got folks, from all walks of life that are coming together here. Some of our former clients are now employees with us and they're bringing their perspective into it.
Troy:And yeah, it is, it's a contagious feeling of, hey, we're doing something special here. And you mentioned the word-of-mouth that, you know, yeah, we don't have to advertise. People are going out and telling people, you need to go check out JTR. You need to get over to river people. You need to get a counselor over here.
Troy:You need to start because the resources are there, and are you talking about the problem or are you doing something about the problem? And so it gives those folks an opportunity to actually take that action. And as the healing continues to grow, I think it becomes more and more contagious in the community. Know, it's kind of more popular to be healthy, you know, it's more popular to be, you know, kind of getting your emotions under control and, you know, being a better father, being a better mother, being a better son, daughter, you know, it's just self improvement is the new contagious.
Joe:Right, right. I couldn't agree with you more, Doctor. Melendez. And, you know, and I think, you know, the culture that we've created at Salt River and Health and Human Services, you know, it's beyond just the patients. I mean, it's the employees as well.
Joe:There was a time when we first opened about three years ago, it was really hard to recruit. Now we've got a lot of people coming to us, including behavioral health specialists, medical professionals, doctors, dentists. I feel that, you know, the word is out there that we really take care of our patients through taking care of our employees. I've never seen employee satisfaction go down and employee or inpatient satisfaction go up or quality or productivity for that matter. I think we're in the business of hiring, training, and retaining great talent.
Joe:And when you do that and you support them and you give them the tools and resources to be successful and you reinforce that positive results, success begets success. And to your point, you know, doctor Velez, I I think it's a movement is what we're we're creating here.
Nate:I agree.
Joe:Really, it is a movement. And, you know, we're healing ourselves. We're healing together. And we're leaning into, you know, that vision, you know, of seven generational improving the health and wellness of the communities, you know, community members and seven generations.
Nate:Yeah, I agree. It's a movement and it's to your point, Doc, it's kinda cool to be in recovery in this community It's a community concept that is contagious And then, you know, when I keep thinking about it, I keep looking over at Joe and I know that one of the things that is really important to us, and you made mention to this, is we want community members to be a part of this because they're the foundation of it. And so one of our philosophies, Joe, at Journey to Recovery and in behavioral health is that who better than the members of the community to heal the community? And so we have an obligation, we kind of we talk about this a lot in behavioral health, is we have an obligation to heal the community and then use the community as a foundation to heal its own people. And so, you know, as you kinda hear that as our commander in chief, right?
Nate:When you hear stuff like that and you see that happening, what resonates inside you?
Joe:Well, you know, I like to go back to the determinants of health and the social determinants of health. The social part is the biggest. Do people feel part of the community that they live in? Do they feel accepted? Right?
Joe:Do they have education opportunities? Do they have job opportunities? Do they have career ladders? Right? And I think that, you know, like the program that you've built, know, A Journey to Recovery and peer, you know, support, what, you know, a shining example of improving the health and well-being through that social determinant and giving people opportunity and hope.
Joe:So, when I think about, you know, the overall health and wellness, I often tell our HR department, they're doing as much as our primary care providers and the health and wellness of this community by giving people jobs, by giving people training. Right? It's so important. I am proud to say that we have a very robust program here. We work with Crystal Benuelos and Mr.
Joe:Steve Haydukovich, the director over at HR, to help place our community members. We have a very robust training program. And since we've opened the new River Peoples Health Center, I think we've placed over two fifty community members and given them full time, you know, employment.
Troy:That's great.
Joe:I think it's just wonderful. And what you've done, you know, with behavioral health and, you know, you promoted, you know, one of the cultural counselors just very recently. Bowie. A community member, Bowie, who's doing a fantastic job. That really does do a lot for the social fabric.
Joe:You know, it really helps the overall health and wellness by giving people opportunity. Yeah.
Troy:Yeah, you mentioned Crystal. She's been a great partner, her and her staff, in the peer support training. We're in our are we really in our fourth year?
Nate:We are. Wow. Okay. And how many total have we pushed graduated through our program?
Troy:Oh, we're gosh, I just did the math on it the other day. It's three, we're close to 90.
Nate:90. It's about 30 a year. 90 credential peers. Yeah,
Troy:average around 10 per session.
Joe:That's amazing. Great.
Troy:And yeah, we're seeing a lot of these folks that are moving. I'm no couple offhand that I can think of that started as a peer support and have moved into BHT positions and are now interested in taking classes to become counselors. Wow. And they talked about that in their peer training. This is my ultimate goal, and as we give them those opportunities to work in behavioral health and work with the populations that they want to work with, then it opens more doors for them.
Troy:They can see beyond the peer support position, a BHT position, what's my next step, do I want to get involved more in this community? And so we're seeing a lot of benefits. And her team has played a strong role, not only in just A huge role. Yeah, not in just contributing, they do two of the weeks. They do training for a day on two separate weeks of the training, but then following up, like you mentioned, giving jobs and helping people to get prepared for jobs and, you know, really helping them to develop as professionals and being able to serve the communities that have helped them to heal themselves.
Troy:So, yeah, it's a lot of great partners. It's a collaborative effort in a lot of different areas and I'm just really excited and looking forward to more of that collaboration and looking at how can we expand this, how can we connect it to other areas in the community that are also serving the same population, and really just take as much out of this in terms of the benefits that we can.
Joe:Yeah, absolutely. And I think, you know, when you talk about community, I think the integrated delivery model that this man here to my left, Doctor. Velez, is such a crusader about, is really, you know, making sure that we're integrated with these opportunities, that people know that there is help. There is, you know, not only opportunities for employment, that sort of thing, but also behavioral health as well. Think what you've done, Doctor.
Joe:Velez, in having behavioral health in the schools, also in primary care, we like to say, like I mentioned before, we're ready when you're ready.
Nate:And the answer is yes.
Joe:The answer is always What's your question? Yeah. What's your question? Exactly. Well done, Grasshopper.
Troy:You're right. Very well done. That's right. I love it.
Joe:But but, to your point earlier, it really is a community approach. Yes. There's no wrong door. Right? And we're all connected.
Joe:We're all connected as people. We're all connected as departments within Salt River. And, if that person comes through the door, you know, in in the schools, we're gonna get them to the right person that they need over at River Peoples. Right?
Nate:Yep.
Joe:So it's an amazing model. It really is.
Nate:Yeah. And this whole concept of no wrong door. Right. Yeah. Weave you through where you need to be and we'll receive you where you're at with what you have.
Nate:And so training everybody to be ready to receive that be of service to that provide the empathy needed for immediate connection is a philosophy that we call stickiness.
Troy:Stickiness.
Nate:Right. So it started off in behavioral health, but we're starting to it's a community term almost now, like we're starting to use this term to really drive the philosophy of connection among all of us. So, you know, one of the things I keep thinking about too is, you know, we started off building this model and we garnered some attention from the local tribes. Many of the 22 tribes in Arizona have been like, Hey, what are you guys doing over there, Joe? What are you guys doing over there, Nate and Troy and Frank?
Nate:And then we come give tours and stuff. And so recently, and Joe can speak to this, but this model has started to garner national attention. And so maybe you could speak to that, Joe, because I think this is a proud moment for you and us that that has really landed on the map. Right. Yeah.
Nate:Well, it's a
Joe:proud moment for Result River, I think. It really is because, like I said, I feel like we're standing on the shoulder of giants. All these buildings and programs, they were all set in play years and years and years ago. Right? It was, you know, it took forty years to build the River People's Health Center.
Joe:But talking about, you know, recognition, when I first came here and I was introduced to our, council, they found out that I had worked at Gila River. Right? And and and there was a running joke. Joe, what what what does really Gila River do? Right?
Joe:Because Gila River, that's a sister tribe to the south and they have a very mature program. They have a critical access hospital. They have three big ambulatory centers. They have a skilled nursing facility. Really is kind of a benchmark for for for Indian country, and I happened to work there for seven years.
Joe:My wife's still there. She's been there twenty six years. She works in the pharmacy. But so for years, it was always, what does Gila River do, Joe? But I'm happy to say that Gila River, their health and social services committee, they came here to to Journey to Recovery to see what Salt River's doing.
Troy:Right.
Joe:Which I think is really amazing. And they were very impressed. They came to visit us maybe about three weeks ago about the program, not just the beds, but the crisis unit and the peer support. They were just really gobsmacked with what we're doing. So, congratulations with your program, Doctor.
Joe:Velez, with Journey to Recovery and all the great work that's happening there. Only that, I should say
Nate:Thank you.
Joe:Yeah. You deserve that. Absolutely. Another visitor we had recently was the Health and Human Services Director Kennedy or Secretary Kennedy. He came out and he said that, this is a model, not just for native, you know, communities, but all of The United States.
Joe:So, like I said, this doesn't happen, overnight. Right. This takes a lot of careful planning and execution and really a vision. And we've been given that vision by this community and by council. Yeah.
Joe:And it's just amazing to walk through those hallways and journey to recovery and river peoples and live and breathe, you know, the dream that was created many, many, many years ago.
Nate:I totally agree. Totally agree. And one thing I think about a lot is, you know, the process of evolution and persistence and grit and perseverance and blessings and all the things that have to line up for these things to happen, from our community support, to our council support, to our president and council support is amazing. So to continue to maintain that and think about the future and how we continue to evolve.
Joe:Right.
Nate:Right? How can we continue to evolve, Joe, and improve the services that we have because you arrive, quote unquote, right? But you still have to stay fresh and you still have to evolve and you still have to maintain. And so how do we meet the changing needs of the community and continue to evolve? Is that a mindset?
Nate:What is that?
Joe:Well, I think what we'd like to say is we always wanna be the best at getting better, right? You know? I think that when it comes to making the impact that we want to make, you gotta start with, you know, what's our why, right? And I think it's really important to hear the voice of your community, your members, and what their needs are. I think that one of the great things, you know, working in this community is how, hey, if we need something, we're gonna do it.
Joe:Case in point is a public health authority, right? We knew that we needed to, you know, take a real close look at how we can prevent injury and maintain wellness. And we started our own public health authority. I think the first one of the first ones here in Arizona by a tribe. Another thing is the journey to recovery.
Joe:You know, that started out as a center called the Lark and then it became Journey to Recovery and, you know, it was a, you know, a program we had over here at the main campus. And then we designed we said, hey, there's such a great need based on the data to make a difference between particularly, you know, the age group between 18 and 40. We need to build this. And guess what we did? And not only did we build a residential treatment center, but we also put in a partial hospitalization, a crisis unit.
Joe:You know, we did, you know, the hiring. So, I think that we want to be the best at getting better. And what's really amazing with this this community is how we're able to figure out what's needed and then put the resources and the manpower to to get things done. We've got an amazing community manager and our assistant community managers are fantastic. Lena Jackson's ours.
Joe:They support, you know, as well as counsel on, you know, addressing all the needs that are needed. And I could go on too. I mean, there's transportation, there's case management that we stood up, the vending machines that, you know, that give out COVID and, you know, testing and other, you know, prevention things. What's the goal? Think is continue to be dialed in and really understanding where those gaps are and then filling them for our community.
Nate:I agree. I agree and appreciate you, Joe, for everything you provide to us as as our leader.
Troy:Definitely.
Nate:And the inspiration you give us daily to keep being the best at getting better.
Troy:I like that. Thank you for joining us on Pathways to Spirit. Remember, within our traditions and our spirit lies connection, support, love, and hope. Let us walk forward together, honoring our paths and supporting one another on the journey toward physical, emotional, spiritual health and wholeness. Until next time, may the spirits of the ancestors guide you and may you find peace, healing, and renewal in every step along your journey.