Transcript
Andrew Nelson: Welcome to Exploring
Rural Health, a podcast from the Rural Health Information
Hub. My name is Andrew Nelson. In this podcast, we’ll be
talking with a variety of experts about providing rural
healthcare, problems they’ve encountered, and ways in
which those problems can be solved.
Joining me is Kelsea O’Leary, Behavioral Health Program
Manager for the Choctaw Nation of Oklahoma. The Choctaw
Nation service area encompasses almost 11,000 square
miles across southeastern Oklahoma, making it the third
largest tribal land area in the contiguous United States.
Funded by an RCORP behavioral health care support grant,
the Recovery is Possible project delivers comprehensive
case management services directly within contracted jails
across the Choctaw Nation area. To get started, Kelsea,
can you tell us about this project and what kinds of
needs it helps to address?
Kelsea O’Leary: The Recovery is Possible
Project really focuses on the full continuum of recovery,
not just treatment, but prevention, family healing,
reentry support, and long-term recovery stabilization. We
serve justice-involved individuals in rural communities,
and they’re often navigating substance use disorders,
mental health challenges, trauma, poverty, and overall
limited access to services. Our team provides jail-based
services before release, and that includes
psychoeducational groups, case management, recovery
planning, and linkage to community resources, so
individuals have support already in place when they
reenter the community that they’re going back to. We also
work closely with behavioral health providers, peer
recovery organizations, corrections, probation, parole,
and several community partners to help reduce gaps in
care and improve this continuity of services that we
provide them.
And then another really important piece of our project is
the family recovery. We host Celebrating Families, which
is nationally recognized. It’s an evidence-based program
designed specifically for families impacted by substance
use and incarceration. It creates a safe environment for
families to rebuild trust, strengthen communication, and
learn healthy coping and parenting skills together as a
family. In rural communities, there really aren’t many
programs like this available, so it’s been really
incredible to watch families reconnect and support one
another in recovery.
We also put a huge emphasis on prevention and community
education. So that includes Narcan distribution events,
overdose prevention education, stigma reduction efforts,
and conversations around substance misuse that help
normalize seeking support and treatment. A lot of people
still struggle in silence because of the shame or
misinformation that is in our society today, especially
in the smaller rural communities. So even something as
simple as educating someone on how to recognize an
overdose, carry Narcan, or talk openly about addiction
can truly save lives, and that is one of our major goals.
At the end of the day, our goal is to help people see
that recovery is possible, hence the name of the program,
not just for the individual, but for the families and our
community as a tribal nation as a whole.
Andrew Nelson: What led you to identify
jail-based case management as a priority for behavioral
health in your community, and how did you determine this
was the right entry point for the RCORP grant?
Kelsea O’Leary: One of the biggest
reasons we chose to create a program specifically for the
jail-based population was because we recognized a major
gap in services that became even more apparent after a
2020 Supreme Court ruling, McGirt vs. Oklahoma.
And when the Supreme Court affirmed tribal jurisdiction
in much of eastern Oklahoma, tribal nations suddenly
assumed responsibility for a significant increase in
criminal cases involving tribal citizens. So that shift
impacted every part of the justice system. It impacted
courts, corrections, probation, parole, behavioral health
systems, and then it required tribes to rapidly build
infrastructure and services that in many cases just did
not exist before. For Choctaw Nation specifically, we
realized that there was no formalized system in place to
provide meaningful substance use treatment, recovery
support, or even reentry planning of that sort for
individuals who were already incarcerated. And many of
these individuals were cycling through the justice system
with untreated substance use disorders, unresolved
trauma, co-occurring mental health conditions, and
overall, very limited support once they were released.
The reality was that incarceration alone was not
addressing the root causes of why people were returning
to jail, right? So, we knew if we truly wanted to reduce
recidivism and improve outcomes for our tribal citizens,
we had to intervene while individuals were still
incarcerated: before release, not after a crisis
occurred. It’s a pretty unique opportunity because for
many participants, it may be the first time they’ve had
consistent access to behavioral health support or that
recovery education, and it offers them that space to
begin thinking about their long-term change. So that’s
really how the Recovery is Possible project was born. We
wanted to create a culturally responsive
recovery-oriented system that could begin inside the jail
and continue into the community that they return to. Our
goal was never just to help someone complete a sentence.
It’s to help them successfully return to their families
and their communities with the support they need, the
resources, coping skills, and a solid recovery plan
that’s already in place and ready to go. We also
recognize that justice-involved individuals in rural
communities face significant barriers that are often
compounded after release, like transportation, housing
instability, unemployment, stigma, and lack of treatment
access. So, the project was intentionally designed to
bridge those gaps through peer recovery support, case
management, behavioral health referrals, family
programming, and strong collaboration with courts,
corrections, and community partners. All of that is tied
together in a neat little package with what we call an
aftercare plan. And it is a document that they have in
hand the day that they are released back into society.
Andrew Nelson: When you’re embedding
services in jail facilities, I’m sure there are some
unique logistical and security challenges. What were some
of the biggest obstacles that you faced when getting this
partnership set up with correctional facilities? And how
did you overcome them?
Kelsea O’Leary: One of the most unique
challenges of developing the Recovery is Possible project
was that we weren’t stepping into an already established
framework. We were building the program from the ground
up while simultaneously implementing it. So, I think
that’s true for a lot of grant-funded work. It’s like
trying to take off in an airplane while you’re still
building the runway. You have the vision, the goals, and
the urgency to begin serving the people immediately, but
at the same time, you’re actively creating the policies,
procedures, partnerships, workflows, and all of those
things, safety protocols, in real time. And because this
is a jail-based program, there are also logistical and
security considerations, of course, that we had to learn
and adapt to very quickly. Our staff had to be trained on
facility-specific safety protocols, including
understanding what items could and could not be brought
into the jail environment, for example.
We also implemented internal safety standards for staff
while conducting groups and individual sessions. For
example, staff are trained to sit closest to the exit
door during sessions and to ensure the door remains
accessible at all times, because jail doors lock
automatically once they shut, as their own safety
precautions. And that’s one of the ongoing logistical
challenges that we still navigate today, on occasion.
With turnover in detention staff and all the facilities
that we go into, there are times when new officers may
unintentionally shut the door behind them while escorting
clients into group. And when that happens, our staff have
to wave them down, immediately advocate like, “Hey, we
need to keep this door unlocked, please,” get their
attention. And then just let them know that we do prefer
that the door stays cracked open, or if they have the
ability to have access to the key, to keep it unlocked
for our safety; that is ideal. It’s not always
situationally ideal that a corrections officer is
available at the door at all times, especially with
limited staff in these more rural areas. So, we do
advocate on our own behalf on “Keep that door unlocked.”
And then another major lesson we learned early on was the
importance of structure and accountability and just
maintaining the fidelity of the program that we’re trying
to build. So, we established a zero-tolerance expectation
for disruptive or unsafe behavior during group sessions
by clients. At the beginning of each cohort, clients and
the group leaders help create ground rules, and every
participant is expected to uphold them. So, if someone
violates those expectations through negative or
disruptive behavior, they’re removed from the remainder
of the cohort. Similarly, if a participant is placed on
lockdown within the facility outside of group sessions,
they’re excused from the group. And if someone chooses
not to attend the group [without] a legitimate reason, like
they were submitted to court, or they had a medical
appointment, then they’re also removed from
participation.
Of course, you know, if there’s active behavioral issues,
we need to address those and limit exposure to those as
much as possible. But they weren’t created to be
punitive. They were developed to protect the therapeutic
environment that we’re trying to create and reinforce
accountability. We realized very quickly that if we
wanted clients to take the opportunity seriously, we had
to establish consistency, boundaries, and what our
expectations are, that mirrored the responsibility
required for long-term recovery outside of incarceration.
And a lot of these lessons just came through trial,
error, adaptation, and collaboration with correctional
staff and the participants themselves, just figuring out
what is going to work and what is not going to work.
Andrew Nelson: Now, is this an ongoing
service that’s provided to incarcerated individuals, or
is there a set schedule? How does that work?
Kelsea O’Leary: They have to be
sentenced through the Choctaw Nation criminal courts. And
once they reach about the 18-month mark, they will be
incorporated into our psychoeducational group continuum.
Each group is 12 weeks long as an evidence-based
curriculum, and we have four of them, and they’re just on
a running schedule, and they keep going. So, everyone
will get an opportunity to experience these four groups,
and with each completion of a group, the 12 weeks, the
court recognizes that for them, and they give them 30
days’ time served for that time. So that’s another reason
why we kind of start as far out as 18 months, because
once all of that adds up, it times to where they get
about a year, and then they’re released. We had to really
formulate and figure out what that timeframe’s going to
look like, because they also get time served with being a
trustee or doing classes outside of our program as well.
So, try to make the best of the situation with the little
knowledge that we have.
Andrew Nelson: You mentioned aftercare.
One of the innovations in this project is providing
services before release so there is continuity of care
after people are released. What does your experience with
this program tell you about how early intervention with
folks who are in custody can affect post-release
engagement with behavioral health services?
Kelsea O’Leary: So, what we’ve found is
that beginning services while individuals are still in
custody creates the trust, consistency, connection,
before they ever walk out of the facility. And by the
time someone is released, they already know their case
manager or their peer recovery support specialist we
connect them with. They’ve already participated in
psychoeducational groups, they’ve already started
identifying triggers and recovery goals, and they’ve
already had a plan in place for treatment, housing,
recovery meetings, or other community services that we’ve
identified in their needs assessment and met those needs
on their aftercare plan. And that relationship-building
piece is huge, because many justice-involved individuals
have had negative experiences with systems in the past
and may intentionally be hesitant to engage in behavioral
health services. There is that stigma there. And we’ve
also seen that incarceration can provide a rare moment of
stability and reflection for some participants.
So, while they’re in custody, individuals are more likely
to be receptive to conversations about recovery, or
trauma, parenting, coping skills, and create those
long-term goals because they’re removed from some of the
chaos and environmental triggers that we’re facing in the
community. It creates an opportunity to introduce
recovery concepts and begin building motivation for that
change before release even happens.
And then another major takeaway has been the importance
of continuity. Recovery doesn’t happen in a single group
session, or at the jail door on release day. Individuals
do better when there’s a warm handoff, which is our goal,
is to have a warm handoff into community-based services,
rather than expecting them to independently navigate
fragmented systems on their own. And because our
participants already have well-established relationships
with our program staff prior to release, they’re much
more likely to answer the phone, attend appointments we
make for them, engage with peer support, and just simply
remain connected once they’re back into society.
We’ve also learned that accountability paired with
support is a major key to their success. The structure
participants experience in the jail-based setting, like
the attendance expectations, group participation,
accountability, and consistent support, it helps create a
foundation that can transition into community recovery.
And when people feel supported, respected, they are
well-prepared before release, they’re far more likely to
engage in the behavioral health services afterwards.
Early intervention gives individuals the opportunity to
build those skills, those relationships, and establish
those recovery supports before they ever return to the
same stressors and environments that may have contributed
to incarceration in the first place.
Andrew Nelson: I see your grant period
started on September 1st, 2022, and goes through August
31st of this year, 2026. Obviously reducing recidivism is
one of the goals of the program. At this point, do you
have any data on whether participants show lower
recidivism rates compared with other justice-involved
individuals who didn’t get these services?
Kelsea O’Leary: Yes. We’re beginning to
see very encouraging preliminary outcomes related to
recidivism. And honestly, it’s reinforcing why this type
of early intervention and continuity of care model is so
important for the justice-involved populations. And when
we first launched the Recovery Is Possible project… 2022
was implementation, but it was the very end. I’m going to
reference 2023. That year was really our implementation
phase. We were building the infrastructure while actively
operating the program. We were still figuring out
processes within jail systems, identifying what would
best serve both clients and our court system. We were
still developing partnerships with corrections and
refining how services would even be delivered in the jail
setting. And even during that phase, we were still
completing needs assessments, aftercare planning, and
facilitating psychoeducational groups for the qualifying
participants. But by 2024, the program really began
gaining that momentum that we’re seeing today.
According to our Choctaw Nation’s Corrections Manager,
the court system saw a 200% increase in individual
sentences through the Choctaw Nation criminal courts
after McGirt-related jurisdictional changes further
highlighted the urgent need for structured rehabilitation
and reentry services. In that year, we served 32 clients
and saw a recidivism rate of approximately 34%, with 11
of those participants returning through the system. So,
while that still showed room for growth, of course, it
allowed us valuable insight into where we needed to
strengthen engagement or change some structure and
further continue our care. Then in 2025, we saw a major
shift in both our processes and outcomes. We served 96
clients that year through the program, and only five
individuals returned to incarceration. This gave us a
6.25% recidivism rate compared to the national average,
which is often cited around 45%. What’s also important is
that the few individuals who did return were within that
six-months-to-one-year post-release period, which we know
is often the highest-risk timeframe for relapse and
recidivism.
A huge part of that success comes from the structured
psychoeducational continuum we built alongside
corrections, which I mentioned before: they start at 18
months and continue until the day that they’re released.
Those curriculums include anger management, Fatherhood
and Motherhood is Sacred for our parenting education,
life skills, and We Shall Remain, which is a
Choctaw-specific relapse prevention curriculum developed
with principals rooted in White Bison Wellbriety. We also
utilize interactive journals through Change Companies to
strengthen engagement and reflection throughout the
process. What makes the partnership especially impactful
is that corrections fully supports this rehabilitative
model. Every 12 weeks, like I mentioned, they get 30 days
time served off their sentence as long as they get a
certificate of completion from our program for that
curriculum. And that incentive structure not only
increases engagement and accountability, but it also
generated more than $200,000 in cost savings for the
Choctaw Nation criminal system, just for 2025.
Andrew Nelson: Another service that
Recovery Is Possible delivers is administration of
Celebrating Families!, an evidence-based,
trauma-informed, family-centered curriculum designed to
strengthen family relationships impacted by substance use
and incarceration. How do you go about integrating tribal
cultural values and practices into the Celebrating
Families curriculum and case management services to
ensure that they resonate with Choctaw Nation families?
Kelsea O’Leary: That’s something that’s
actually very important to our program. Recovery looks
different for everyone, and for many families in our
community, spirituality and faith and family connection
culture all play a huge role in healing. So, we try to
naturally incorporate those values into work we do
instead of just treating recovery like it’s a completely
clinical process, right? So, Choctaw Nation is actually a
publicly recognized Christian tribe, and spirituality is
something that’s deeply woven into all our communities.
And because of that, we’re encouraged to incorporate our
higher power into our teachings and recovery
conversations. In Celebrating Families, for example, we
begin each session with a prayer before sharing a family
meal together, and we typically end each group session
with the Serenity Prayer. Those moments may seem pretty
simple, but they create a sense of comfort and connection
and community for those families participating.
And it just opens up that door to be comfortable to talk
about their faith and how they can grow in their faith to
sponsor their recovery and what-have-you. And honestly,
the family meal itself becomes really powerful. A lot of
the families we serve have experienced trauma, addiction,
incarceration, long periods of disconnection from one
another, and sitting down together, sharing a meal,
talking, laughing, and learning together creates a safe
environment, and it becomes a part of that healing
process. We also try to approach case management and
recovery support in a way that reflects Native values,
things like respect, accountability, community, and
healing the family as a whole, instead of focusing on
just one individual. In Choctaw Nation, in particular,
our values are faith, family, and culture. And we try to
embody that every day in everything that we do with our
clients.
Another really important piece is that all of our staff
are trained in Native-American-specific motivational
interviewing. That training helps staff understand how to
engage with participants in a culturally responsive and
trauma-informed way that honors the communication styles,
historical experiences, and relationship building with
the Native community. It helps us approach conversations
with empathy and respect and collaboration rather than
judgment or confrontation. And it just opens that door to
having those conversations. We learn so much from the
clients that we serve. “We probably learn more from them
than they do us,” is what I like to say, because I can
tell you, every single contact I have with a client, I’m
learning something new. And it’s really a beautiful
process. I’m not only learning about their recovery world
or stigma itself, but I’m learning about culture and how
to be most effective in that manner for them. We also
incorporate culturally grounded programming, like I
mentioned before, the We Shall Remain curriculum, which
is Choctaw-specific to us. And it’s a relapse prevention
curriculum built around the Wellbriety principles. So,
programs like that help participants reconnect and
establish recovery with their identity and resilience and
incorporate culture in that community support.
We do have a strong stream of referral sources. I think
that’s important to highlight too, because we’ve worked a
long time to build those relationships with these
referral sources. And that’s really something that we
struggled with in the beginning, was just educating on
Celebrating Families, what it is, just to get people
involved. It took us the first year to even really get
what it is out there to get some type of buy-in. Our
first buy-in was the drug court program in LeFlore County
here in Oklahoma. And from there it’s trickled down. Now
we have buy-in from Indian Child Welfare, CASA [Court
Appointed Special Advocates], multiple sober living
programs in our community, as well as our behavioral
health therapists within Choctaw Nation. They now are
able to recognize what Celebrating Families is, and pair
that with specific families that they’re working in. And
that referral network has been incredibly important,
because these families are often already navigating
multiple systems at once. So having trusted partners who
understand the value of the program helps families feel
even more comfortable engaging with it. And a lot more of
our referrals come from professionals who’ve seen
firsthand that families need more than just individual
treatment. They need support rebuilding relationships,
communication, parenting skills, and then just stability
within their, I like to say, “new family unit” because we
are all new people now. We have two embedded jail-based
case managers, and they are both trained and facilitators
for the Celebrating Families program, and they
participate in every cohort.
Andrew Nelson: What process do you go
through to recruit and retain personnel in the rural
areas that you serve?
Kelsea O’Leary: For the Celebrating
Families training specifically, as of January this year,
we are now trained to internally train. So that is really
going to give us that leg to stand on to expand our
efforts incredibly, and working in both jail-based
settings and community-based family programming requires
staff to have a really unique and diverse skillset. Our
team has to be able to navigate correctional
environments, provide behavioral health recovery support,
build trust with those families, understand trauma, yet
still remain very flexible enough to meet people where
they are in very different settings. And we are all very
well-trained in navigating that.
One thing we prioritize heavily is training and
professional development. All our staff are certified
through the state of Oklahoma’s case managers, which
gives them that really strong foundation in care
coordination, ethics, documentation, and just the
behavioral health support services realm. In addition to
that, all our staff are trained in the Native American
specific motivational interviewing, like I mentioned
earlier. And that’s incredibly important for the
population we serve. And because we work in correctional
settings, obviously staff have also had to understand
jail procedures, safety protocols, professional
boundaries, crisis response, and how to maintain those
therapeutic environments within a structured facility
setting. Then on the community side, they also need
skills in family engagement, group facilitation,
parenting, education, recovery support, and case
management as well. So, it really takes a balance of
clinical knowledge, I’d say adaptability, cultural
responsiveness of course, and really positive
relationship-building skills.
Andrew Nelson: Policymakers often want
to know if successful models can be replicated elsewhere
in other parts of the country or in other contexts. Are
there any elements of this program that you believe would
translate especially well to other rural or tribal
communities?
Kelsea O’Leary: Absolutely. I believe
this program can absolutely be replicated in other rural
or tribal communities, I’d say even urban. One of the
biggest strengths of the Recovery Is Possible project is
that the framework itself is built on evidence-based
practices and structured systems that are transferable
far beyond our specific service area. Everything from the
psychoeducational curriculums we facilitate in the jail
setting to our needs assessments, aftercare planning,
case management services, and even the Celebrating
Families curriculum, they’re all grounded in
evidence-based models. So, we intentionally built the
program around approaches that have already been shown to
have effectiveness in behavioral health, substance use
recovery, family reunification, and specifically
recidivism reduction. Our psychoeducational continuum
inside the jails includes evidence-based curriculums,
like I mentioned earlier; all areas that directly impact
successful reentry in that long-term recovery. And
honestly, while our system was developed to meet the
needs and expectations of the Choctaw Nation Court
system, of course, the larger goal isn’t unique to us.
Most justice systems want the same outcomes, right? They
want reduced recidivism, healthier families, safer
communities, and just individuals who can successfully
reintegrate and become a contributing member of society.
So, our framework is designed to support exactly that.
And I think what makes the model especially valuable for
replication and the continuity of care piece is starting
services before release, building relationships while
individuals are incarcerated, and then continuing support
into a community through case management, recovery
support, and then offering family programming as well.
And that’s something many rural communities are still
missing. And it’s been one of the most impactful parts of
our program. Now, there are definitely aspects that are
specific to Choctaw Nation context. Of course, you know,
for example, our relapse prevention curriculum, We Shall
Remain, very Choctaw-specific. We also incorporate
cultural practices, spirituality, Native-centered
approaches into the way we interact with our clients and
our families. Those pieces are tailored to our population
and our community values. But the overall structure
collaboration with courts and corrections, evidence-based
education, accountability, case management, family
engagement, peer support, continuity of care, those are
all things that could absolutely be adapted to fit other
tribal nations, rural communities, and even urban
systems. The cultural lens may change depending on the
population being served, but the foundation of the model
remains strong because it’s rooted in all these
evidence-based practices, and they’re all
relationship-centered.
Andrew Nelson: For the people that you
work with, and the communities in which they live,
substance use and incarceration can carry significant
stigma. How have you worked to reduce barriers to
participation and help create a welcoming environment for
justice-involved individuals and their families?
Kelsea O’Leary: One of the biggest
things we’ve learned is that stigma is in fact one of the
largest barriers preventing people from seeking help.
Substance use, incarceration, even just behavioral health
treatment can carry so much shame, especially in those
small rural communities where everyone knows each other.
And because of that, we have tried to approach this work
in a way that feels welcoming, community-centered, and
ultimately just judgment-free. A big part of what we’ve
done is meeting people where they are without creating
additional barriers. For example, our community Narcan
drives are intentionally designed to allow individuals to
receive free Narcan anonymously without providing any
type of personal information. We don’t ask invasive
questions. We don’t collect identifying information or
make people feel scrutinized for wanting overdose
prevention resources. Sometimes people are just getting
Narcan for themselves or a loved one, or simply because
they want to be prepared to save a life in their
community.
That low-barrier approach has really helped normalize
overdose prevention conversations and reduce some of the
fear and stigma around asking for that help. We’ve also
focused heavily on making prevention and recovery
education feel engaging and community-oriented rather
than clinical or punitive. And one of the best examples
of that was our recovery month event last September. We
had an ’80s themed glow-in-the-dark 5K that brought
together more than 200 community members, and we had
speakers with lived experience [that] shared their
recovery stories. We provided behavioral health and
recovery resources and just created an event that
celebrated recovery openly and positively. And what made
that event so impactful was that it shifted the
conversation around substance use into something hopeful
and community-driven. And people weren’t showing up to be
lectured or judged. They were just showing up to support
recovery, connect with resources, and hear real stories
from individuals who’ve lived through addiction and
recovery themselves. And it was such a positive response
that the event is now an ongoing Choctaw Nation event
moving forward.
Andrew Nelson: I think it’s great that
things like that are growing out of the original
structure that you set up.
Kelsea O’Leary: Yes. We also offer a lot
of education. Education’s been a huge part of stigma
reduction for us. Our team provides trainings throughout
the entire reservation on topics like current drug
trends, opioid misuse, fentanyl awareness, and Narcan
administration. But we’ve also tried to make those
trainings interactive and approachable, so people
actually engage with that information. So, for example,
we utilize drunk goggle simulations to help participants
understand impairment in a hands-on way. And we
facilitate a mock bedroom activity where participants
search a staged teenager or college kids’ room for hidden
drug concealment items. And that activity really opens
people’s eyes, because many parents and caregivers and
community members as a whole simply don’t know what to
look for or what current substance use trends look like
among youth, or even how easy it is to get their hands on
these drug concealment items that look like everyday
household items.
Andrew Nelson: In rural areas, when
people have access to the Internet, and broadband
specifically, telehealth and digital tool tools like that
can really expand reach of care. Is that something that
you folks have used much, or does Celebrating Families
tend to rely more on face-to-face interaction with
providers?
Kelsea O’Leary: We do a lot of
face-to-face. Up until recently, our program really has
not incorporated telehealth services in a major way. And
a lot of that comes down to the unique challenges of
working within both healthcare systems and the
correctional settings at the same time. Because our
program operates under healthcare, there are strict
requirements around the digital platforms, the technology
that we’re even allowed to use, to make sure we adhere to
the privacy and security of our policies. So
unfortunately, those approved systems don’t always align
with what’s available or accessible inside jail
facilities.
On the Celebrating Families side specifically, we’ve also
intentionally remained primarily in-person because we
feel that it’s a way to stay more true to the fidelity of
the curriculum. A huge component of Celebrating Families
is the shared family meal and the relational connection
that happens face-to-face. The curriculum is really built
around rebuilding that trust and effective communication
and having healthy family interaction in a physical
shared space. So, we felt it was important to preserve
that in-person experience rather than trying to
transition into a virtual format. Because of that, our
approach has really focused on meeting people where they
are in person, whether that’s inside the jail setting
within the community, or through family programming, like
Celebrating Families. With that being said, we are now
entering a season where technology is becoming a little
more necessary. Our corrections department recently
entered into a contract with a larger jail facility, and
they have the capacity to help house sentenced
individuals due to the increasing demands on the
correctional system. The challenge is that this facility
is located about three hours away from our service area.
So consistently being able to provide in-person services
becomes a lot more difficult for us.
Because of that, we’re working currently to establish
systems that would allow us to provide that virtual
psychoeducational group opportunity, conduct those needs
assessments and aftercare plan services for individuals
housed there, since it’s three hours away. And we’re
navigating what it looks like from both the security and
technology side, while still trying to maintain the
quality and engagement of the program. And I think one
thing rural communities have taught us is that
flexibility and innovation are just so important. While
we still strongly value in-person relationship building,
especially in family-centered recovery work, we also
recognize that technology may become a critical tool in
helping us maintain continuity of care and reach
individuals who would otherwise have very limited access
to services due to geography, like this new contracted
jail, to help out with the housing. There’s no feasible
way we could give them in-person services because of the
distance between us.
Andrew Nelson: I’m glad you’ve been able
to find your way to integrating the ongoing services you
provide, to maintain that connection with people. What
responses have you seen from folks in your community or
family members of individuals you’re providing services
to? Are there any stories you can share that illustrate
the program’s impact on participants’ lives?
Kelsea O’Leary: Yeah, absolutely. The
response from the community participants’ families with
Celebrating Families has honestly been incredibly
encouraging, and especially considering Recovery Is
Possible is still such a young program, I really think
our data tells the story of what our communities were
needing all along. And I gave a little bit of that data
earlier, obviously, with regard to our jail-based
services. And we will look at our recidivism outcomes,
and the engagement we’re seeing from participants and
families. It really reinforces that these services are
making a real difference. And even though the program is
only about four years old, we’ve already seen a
significant reduction in recidivism among participants
receiving services. And that tells us the model is
working. More importantly, it tells us there’s potential
for even greater impact as the program continues to grow
and strengthen. But beyond the numbers, some of the most
meaningful feedback comes directly from the participants
themselves, of course, at the end of each
psychoeducational group inside the jail setting.
And then during the second-to-last session of Celebrating
Families, we facilitate discussions and surveys with the
participants, and we talk openly about what’s helped
them, what changes they’ve already started making in
their lives, and how they plan to apply those skills
moving forward after release or throughout their recovery
journey. And honestly, there are so many success stories
we could share. We’ve had participants completely
transform the direction of their lives. It’s amazing. One
client who participated in Celebrating Families obtained
permanent housing, bought herself a vehicle, maintained
full-time employment, graduated drug court, completed
Celebrating Families, which is a 16-week program, very
long, and is now actively using her story to advocate for
recovery within the community she lives in. And watching
someone move from just surviving to truly thriving and
becoming a voice of hope for others is just so powerful.
And then another participant was involved in our
jail-based services while he was incarcerated. And after
release, he independently chose to enter a recovery
program on his own. He maintained active communication
with his peer recovery support specialist we connected
him with. He has secured full-time employment, and he’s
been spoken very highly of by the recovery program
director. And that kind of self-motivation and continued
engagement after incarceration is exactly what we hope to
foster through early intervention and the continuity of
care that we’re trying to establish.
Andrew Nelson: It’s got to be really
fulfilling to see those results as you’re helping people
back into recovery. Looking beyond the grant period, are
there any new initiatives or ways in which you want to be
able to expand services going forward?
Kelsea O’Leary: One thing we’ve learned
is that the need is much greater than we originally
anticipated. And because of that, we’re always looking at
ways to expand and strengthen the services we provide
beyond when the grant ends, right? And one of the biggest
areas of expansion we’re currently working toward is
implementing telehealth capabilities, like I mentioned a
second ago. And it’s definitely a huge undertaking for us
operationally, but it also opens the door to serving
justice-involved individuals in ways we haven’t
previously been able to. So it’s another win, is how we
look at it. We’re also looking at expanding the reach of
our Celebrating Families program. Now that we’ve
successfully completed several cohorts in our first four
years, we have a much clearer understanding of our team’s
capacity, what works well, and how to structure these
groups effectively. And because of that experience, we
feel confident moving forward that we can target larger
cohorts that allow us to serve more families while still
maintaining the quality engagement that we’ve established
and fostering those meaningful relationship-building
opportunities within that program.
Another area we’re really excited about is strengthening
behavioral health continuity after incarceration. We’re
currently exploring the development of a referral pathway
specifically for participants interested in individual
therapy services after release. And the goal would be to
connect clients directly with a therapist who specializes
in working with justice-involved individuals and re-entry
populations, because we know the transition back into the
community can come with significant emotional, behavior,
and obviously environmental changes. And then I’d say on
the prevention and community outreach side, we definitely
plan to continue growing our annual recovery month 5K
event which is hosted every September. The response from
the community was just far beyond what we expected, and
it created such a positive and engaging space to talk
openly about recovery and substance misuse and behavioral
health while reducing that stigma. We’re also exploring
more innovative stigma reduction initiatives, including
developing a stigma simulation experience that would
allow participants to walk through scenarios reflecting
the barriers and disparities individuals face when living
with stigma tied to substance use, incarceration, mental
health conditions, or even just a family association with
any of those.
And the goal is to help community members and
professionals better understand the emotional and
systemic challenges many individuals encounter when
seeking help or reentering society with those stigmas
attached to them. And we’re also planning to implement
ongoing training opportunities focused on adult Mental
Health First Aid for both professionals and community
members through the Choctaw Nation service area. We
really believe that education is one of the strongest
tools we have for strengthening communities and
increasing early intervention. So overall, I really think
that what we’ve learned most through this project and
working with celebrating families is that recovery
support has to be holistic, right? It has to be
community-centered, and it has to be ongoing. Recovery
does not stop. We work for it every single day. So, the
more we continue building systems of support, education,
and just continue with that connection within our
communities, the greater impact that we’re going to see
long term.
Andrew Nelson: You’ve been listening to
Exploring Rural Health, a podcast from RHIhub. In this
episode, we spoke with Kelsea O’Leary, Behavioral Health
Program Manager for the Choctaw Nation of Oklahoma. Look
in our show notes for more information about their work
and visit ruralhealthinfo.org for all things pertaining
to rural health.
