According to data released by the American Farm Bureau Federation in December 2020, two-thirds of rural adults in the U.S. between the ages of 18 and 44 reported personally experiencing more mental health challenges than in the prior year.†Sgt. Katie Otto from the El Paso County Sheriffís Office has witnessed continued increases of rural mental health challenges in the Falcon area, both in her work as a first responder to mental health crises and as a Falcon resident of 20 years. Otto said she has seen a rise in the number of mental health-related distress calls, especially since the start of the COVID-19 pandemic ó coming from her community.†ìI think the truth historically is that life has always been harder in rural and frontier communities,î said Vincent Atchity, president and chief executive officer of Mental Health Colorado. ìWe know that people experience a lot of isolation and economic-related anxiety and stress due to issues with how difficult the agricultural economy is and the culture of self-sufficiency. Itís a lot harder to feel sustained by a community when people are spread thin.î†Resources are also spread thin, which is one of the unique obstacles that comes with handling mental health issues in rural areas.††ìWith regard to resources, one of the considerations is that a lot of the bigger communities weíve worked with have a bunch of money and a bunch of people and are able to do more innovative programming, thanks to those upsides of being part of a really large community ó things that are just out of reach for smaller communities,î Atchity said.†Space is another rural-specific obstacle to work through.†ìFor the folks in rural communities, they sometimes have hours of territory between the first responder agency and someone whoís in distress,î Atchity said. ìAnd then hours of distance between that point of distress intervention and in-patient hospitalization care. Itís also a challenge because you have a smaller first responder agency to begin with. And, if youíre going to take responders out of action to go respond to something thatís a 45-minute to one-and-a-half-hour drive away and theyíre going to be gone for five hours, thatís a major burden on a small community.î†These obstacles combined with the inadequate systems of care in place heavily contribute to the core problem, Atchity said. People have fallen into a cycle of being arrested and incarcerated without having any underlying health issues addressed, he said. In many cases, if health issues are acknowledged by law enforcement, people are then cyclically taken to the hospital and immediately discharged.†ìSheriffs have been some of the best advocates because they see it plainer than everybody, as they are picking up the same people over and over and over again,î Atchity said. ìAll it takes is the recognition of a sheriff that arresting people and repetitively charging them with petty offenses and putting them in jail or a hospital is not effective, and there has to be a better way of doing it. Ö Itís one thing for me, a mental health advocate, to be talking about how taking people to jail is the wrong thing to do, but as soon as you get your sheriff saying that, then people start showing up for meetings and partnerships start coming together.î†Atchity said the most effective partnerships are multi-sector partnerships that involve law enforcement and behavioral health providers. ìThe broad characteristics of these programs across the nation are similar, thereís just a unique local flavor to the way each community implements the effort,î he said. ìWhatís distinct about these efforts is law enforcement leadership, which is the key to why these models have been so effective in getting the ball rolling.îIn 2017, Sheriff Bill Elder began working toward bringing a multi-sector co-responder program like the one mentioned above to rural and unincorporated areas of the county; and, in 2018, the El Paso County Sheriffís Office launched the Behavioral Health Connect program, or BHCON, supported by a grant provided by the Colorado Department of Human Services, said Carey Boelter, the BHCON program manager. BHCON is a crisis response team that partners one Crisis Intervention Team trained law enforcement officer with one licensed mental health clinician from UCHealth to respond more effectively to mental health-related calls.In April 2022, BHCON served 123 individuals and kept people out of the emergency room 85% of the time and out of jail 100% of the time, according to the EPCSO website.†BHCON is one of few co-responder teams that also has a designated case manager to help with the long-term efficacy of the program, the website states. Since December 2019, the case manager has provided 3,368 follow ups and care coordination tasks, and 42% of their clients are in mental health treatment.††Boelter said, ìItís not only our community thatís had a positive response and felt like theyíre now getting more effective intervention when they have a mental health crisis; we also have our patrol division.î She said those officers are appreciative of the team and regularly call to request assistance. They are also trying to learn how to be more effective when the mental health team is not available.Funding for the five-year pilot program was set to expire June 30 of this year, but the success of the program and plans for growth have extended the funding on a year-to-year contract basis.†ìOur sheriffís goal has been to expand the team, but our staffing is whatís creating the expansion slowdown,î Boelter said. ìAs soon as we are able to staff our patrol and our jail to safe staffing, weíll be able to expand and get another patrol deputy and an additional clinician from UCHealth, so that we can get another unit or two or three. Ultimately with the number of mental health calls we receive, we really need six.îShe said there are currently three BHCON units. An additional UCHealth clinician has been hired and training is underway, so theyíre aiming to officially add their fourth unit to the program by the end of July.
