Project 573 Covers Mental Illness in Mid-Missouri

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Project 573 joined Sarah Hill on KOMU 8 News at Noon Thursday to talk about covering mental illness in mid-Missouri. 

BOONE COUNTY — Boone County Sher­iff's De­part­ment Sgt. Mike Krohn eases his 6-foot-4-inch stocky frame in­to his squad car. He buckles his seat belt and turns on the beep­ing elec­tron­ic devices that make up his satel­lite of­fice.

It's from this vant­age point in 2005 that Krohn first saw in­ef­fi­cien­cies in the way the Sher­iff's De­part­ment ad­dressed situ­ations in­volving people with men­tal ill­ness. Dwayne Carey had just be­come sher­iff in Boone County, and pro­moted Krohn to his cur­rent rank of ser­geant.

Krohn began to no­tice an in­creas­ing num­ber of crisis situ­ations dur­ing his af­ter­noon and even­ing shifts. Depu­ties wer­en't trained to re­spond to people who were men­tally ill and get them the help they needed. In­stead, these people were of­ten locked up - the cause of their prob­lems un­ad­dressed.

"Since it happened on my shift and I was the guy re­cog­niz­ing it, it fell to me," Krohn said.

So Krohn did what he says law en­force­ment work­ers are trained to do.

"Identi­fy that there's a prob­lem, as­sess the prob­lem, de­vel­op a pos­sible solu­tion for the prob­lem and then im­ple­ment the solu­tion," Krohn said.

Krohn has since been in­volved with two pro­grams that have im­proved the way the Sher­iff's De­part­ment in­ter­acts with those with men­tal ill­ness. Vir­tu­al men­tal health courts have helped the de­part­ment be­come more ef­fi­cient. Crisis in­ter­ven­tion train­ing has been cru­cial to those on the job. The pro­gram cur­rently comes at no cost to par­ti­cipants, but it is in danger of dis­ap­pear­ing due to a lack of fund­ing.

Trans­port­a­tion trouble

If a doc­tor de­term­ines a per­son is men­tally ill and needs im­me­di­ate treat­ment, the in­di­vidu­al can be de­tained in a psy­chi­at­ric fa­cil­ity for up to 96 hours. A judge must ap­prove longer com­mit­ments.

While some pa­tients are will­ing to con­tin­ue treat­ment, of­ten the county pro­bate court de­mands fur­ther hos­pit­al­iz­a­tion. The per­son, along­side doc­tors and at­tor­neys, has to ap­pear be­fore a judge for this to hap­pen in an in­vol­un­tary com­mit­ment hear­ing.

The Sher­iff's De­part­ment depu­ties used to carry the re­spons­ib­il­ity of trans­port­ing con­sumers from treat­ment fa­cil­it­ies to the court­house for these hear­ings.

But the pro­cess was prob­lem­at­ic.

Even though some hear­ings las­ted just 10 minutes, depu­ties spent hours trans­port­ing pa­tients, wait­ing for hear­ings to fin­ish, tak­ing pa­tients back to treat­ment fa­cil­it­ies and fin­ish­ing pa­per­work.

Krohn no­ticed the de­part­ment was pulling depu­ties from oth­er du­ties to trans­port pa­tients from their psy­chi­at­ric fa­cil­ity to the court for these hear­ings. Doc­tors also left their daily du­ties at the hos­pit­al to testi­fy on their pa­tient's con­di­tion, adding to the work­load of those left at the hos­pit­al.

Depu­ties were re­quired to ex­er­cise stand­ard op­er­at­ing pro­ced­ures when trans­port­ing people suf­fer­ing from men­tal ill­ness, even when mov­ing people who were calm and non-vi­ol­ent. This meant hand­cuff­ing the per­son and put­ting him or her in the back of a locked squad car. The pro­ced­ures were meant to pro­tect against vi­ol­ent epis­odes, but they some­times had a jar­ring ef­fect.

In 2008, Krohn began work­ing along­side As­so­ci­ate Cir­cuit Judge De­borah Daniels, who presides over the in­vol­un­tary com­mit­ment hear­ings as the head of the county's pro­bate court, to re­search the pos­sib­il­ity of a vir­tu­al court. The concept al­lowed the court to set up a video­con­fer­ence sys­tem in which the per­son who is men­tally ill ap­pears in the courtroom through a video-call sta­tioned at his or her treat­ment site.

The new pro­cess is more ef­fi­cient for every­one.

"Those people who are at the Sher­iff's De­part­ment can get back to do­ing the busi­ness that we nor­mally as­so­ci­ate a sher­iff's de­part­ment with do­ing," Daniels said.

Con­front­ing crisis

It's hard not to no­tice the cir­cu­lar white, red and black CIT badge pinned onto the chest of Krohn's uni­form as he drives down a bumpy Boone County gravel road.

The badge is a pride point for the deputy. He has not only earned the Crisis In­ter­ven­tion Team train­ing cer­ti­fic­a­tion him­self, but provided the op­por­tun­ity for col­leagues statewide to be­come cer­ti­fied as well. But the pro­gram could dis­ap­pear if a new source of fund­ing is not found.

The train­ing pro­gram ori­gin­ated in Mem­ph­is. The 40-hour pro­gram teaches law en­force­ment sui­cide pre­ven­tion tech­niques and ba­sic phar­ma­co­logy les­sons. It edu­cates of­ficers and depu­ties - of­ten the first people on scene dur­ing a crisis - on how to re­spond quickly and ef­fect­ively to people in a crisis situ­ation.

Krohn was also cru­cial in bring­ing crisis in­ter­ven­tion train­ing to Boone County in 2008. He worked with oth­er law en­force­ment of­fi­cials in and out­side his de­part­ment to se­cure fund­ing for the train­ing.

The money ini­tially came from a $250,000 en­dow­ment from the Mis­souri De­part­ment of Men­tal Health.

But re­cent budget cuts mean money for the train­ing is dry­ing up.

The pro­gram is cur­rently run­ning on a two-year, $100,000 grant from the U.S. De­part­ment of Justice. The grant ex­pires in Septem­ber.

The ex­ec­ut­ive Crisis In­ter­ven­tion Train­ing Coun­cil, a group of Mis­souri law en­force­ment of­fi­cials in which Krohn par­ti­cip­ates, cur­rently or­gan­izes free train­ing for law en­force­ment work­ers.

The ses­sions will not be pos­sible if new fund­ing is not found.

"I hate to be that guy that has con­stantly got his hand out," Krohn said. "But I mean the fund­ing has got to come from some­where."


Project 573 provides innovative journalism that expands awareness and broadens perspective about a localized issue.

Made up of seniors at the Missouri School of Journalism, the capstone course brings together students from the school's different sequences (print and digital news, radio/TV journalism, magazine, photojournalism, convergence journalism and strategic communication) for an experiment in cross-platform storytelling.

To see the rest of Project 573's stories, visit the website here.