Dr. Nickolas Zaller, Dr. Femina Varghese
Zaller, an associate professor at the University of Arkansas for Medical Sciences’ Fay W. Boozman College of Public Health, said the project came to fruition after discussions with Varghese and Udochi, the assistant director of substance use treatment with Arkansas Community Correction, about the capacity of telehealth medicine to reach people in isolated areas.
“We hear all the time that we live in a rural state, [that] we have all these access issues in terms of health care in general,” Zaller said. “I feel that we underutilize the potential with things we have, like telehealth and telemedicine, to reach more people in rural areas.”
According to Zaller, the pilot study will take place at the local office of Arkansas Community Correction, which oversees parolees and probationers, who are required to report there. If they fail to show up for a meeting with their probation or parole officer, a warrant is issued for their arrest.
“The idea was that is an opportunity,” Zaller said. “They’re already in the office. We’ve identified individuals who are struggling. Can we then provide some additional services while they’re there?”
According to an analysis by the Pew Research Center and the Laura and John Arnold Foundation of data from a 2016 federal Bureau of Justice Statistics survey, one in 44 Arkansans is under some form of correctional supervision, one of the highest rates in the nation. Zaller said this high rate could in part be attributed to the fact that Arkansas lacks adequate treatment capacity for folks with mental health or substance use issues.
“We haven’t invested, it’s just plain and simple,” Zaller said. “We have not invested in that capacity. We haven’t prioritized it, we haven’t invested, and this is the consequence.”
Zaller and Udochi said the team decided on West Memphis for the pilot study because of its proximity to more rural areas of the state, as the RWJF fellowship focuses specifically on health care in rural America. Udochi said individuals on parole or probation living in rural areas face unique challenges to accessing necessary services.
“Some of the rural areas, they don’t have the necessary services rightly available in their location,” Udochi said. “Second to that is the transportation issue. So they have to travel a long distance to get the services they need. The hope is that with telehealth services, we can see how beneficial those services can be in alleviating some of those problems in those areas.”
Varghese, an associate professor of counseling psychology at the University of Central Arkansas in Conway, will supervise her Ph.D. students who will provide the telehealth counseling. Zaller said he, Varghese and Udochi intentionally designed the pilot study to involve students in hopes of generating future interest in the criminal justice field.
“We wanted to do something where we could help these parolees in critical areas and provide our students with some wonderful training, as they’re interested in this area, and when they graduate they could continue the work in this area, whether it’s part of their practice or pro bono,” Varghese said. “It would be sustainable to two different roles.”
According to the research team, the pilot study will compare two different groups. Each group will receive a six-session intervention. One group will receive only the treatment that the Community Correction department assigns to it based on its assessment and no telehealth counseling. The other group will also get the Community Correction treatment assigned to it, but that will be augmented by the telehealth counseling conducted by Varghese and her students.
“A lot of it is a cultural shift,” Zaller said. “What do we see as the big picture? What sort of society do we want to live in? Right now, we’ve chosen a society totally dominated by fear. … And unless we change that narrative, and unless people understand that there are a lot of structural factors that relate to crime, including violent crime, we have to understand that it’s not all the same. We have to really start thinking carefully about what it is that we’re punishing people for.”