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Responding to Crises, One Life at a Time

Olivia Booher Tri-County (434x640)As Crisis Manager for Tri-County Mental Health Services, Olivia Booher oversees several areas that can each make a life or death difference for a Northland resident. With a team of four, her work touches emergency rooms, law enforcement and, most of all, the lives of men, women and children who deal with mental illness.

Part of the team’s focus provides help for people in crisis, such as those who show up frequently in an emergency room with symptoms indicating mental rather than physical causes. These range from serious hallucinations to chest pains brought on by anxiety rather than a heart condition. Tri-County’s team focuses on the causes, not the symptoms.

“If a program identifies someone, Tri-County is notified and we meet with them,” Booher explained. “We can set them up with case management and work to address the things that have been sending them to a hospital. We can also address things like housing if they are homeless, or get them connected with a counselor.”

Part of this includes Tri-County’s Mobile Response Team that can assist at locations like Northland emergency rooms, including after hours when other resources are not available. For the Northland’s two smallest hospitals, Excelsior Springs and Richmond, Tri-County’s is the only such resource available.

The care varies with nearly every case, but a common denominator often is connecting people with services that are a better fit for their needs. “A lot of times, people just don’t know,” Booher explained. “We’re all kind of conditioned that the emergency room is where you go. But there is often more appropriate care elsewhere.”

Many of these efforts not only help people, but also save limited resources like emergency room services. Still, the work has grown slowly, often relying on grants to augment otherwise scarce funding.

One of the more visible areas involves Tri-County’s Community Mental Health Liaison who works with area law enforcement to deal with those who have frequent contact with police due to mental illness. A parallel to the growing police emphasis on Crisis Intervention Training, the effort has received praise for recognizing that a large proportion of law enforcement involves dealing with those who have a mental illness.

The efforts have brought dramatic change. Someone with a mental illness often responds better to non-traditional police techniques that may be less confrontational and, with the liaison’s help, connect them with mental health services. A recent staff addition—thanks to another grant—brought a case manager to better connect those Northlanders to the services they need and avoid police contact entirely.

Challenges still exist. One is the recent closing of the Kansas City office of the National Alliance on Mental Illness. Volunteers and organizations like Tri-County are helping to fill the resulting gaps, but important programs will need adjustment.

Another, ongoing issue involves service for rural areas. Booher noted that, while population density is obviously less, rural areas often see a higher proportion of issues ranging from substance abuse to suicide.

“There are many factors,” she noted. “Access to services can be difficult and there may be greater stigma attached to acknowledging mental illness and seeking treatment. Even the economic slump that began in 2008 hit rural areas hard.”

Booher joined Tri-County this year with a diverse background. She most recently served as an independent contractor serving adolescents and previously worked in areas from hospice to a mental health court.

“All of that helped because in crisis management, you never know what you’ll face,” she said.

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