OSAGE COUNTY — As the holiday season approaches, stress, depression, and financial pressure often intensify for families across Osage County. Local officials say those challenges are increasingly showing up in 911 calls, jail bookings, and medical responses — but new partnerships and programs are beginning to offer alternatives that did not exist even a few years ago.

Osage County has long ranked among the worst in the nation for access to mental-health care. A December 2023 analysis placed the county 13th from last out of 3,142 U.S. counties, with only one mental-health provider available for more than 13,000 residents. Residents experiencing crisis have historically had few options, and both law enforcement and EMS say that lack of resources has strained systems never designed to function as frontline behavioral-health responders.

Osage County Sheriff Michael Bonham said his office continues to see an increase in calls involving mental-health issues, often linked to the growing financial strain residents are under.

“I see all the paper service for people who are behind on credit card debt or loans or whatever,” Bonham said. “I see every paper served in this county. That has tremendously increased this year.”

While he does not have a precise number, Bonham said the trend is unmistakable, going from one or two per week in early 2024 to every day now.

Bonham emphasized that law enforcement is not the ideal first contact for people in mental-health crisis. Although his office is training additional deputies in Crisis Intervention Team (CIT) techniques, Bonham said the arrival of uniformed deputies can sometimes escalate a situation before the first words are spoken.

They prefer instead to rely on trained EMS personnel, and on Compass Health for clinical expertise.

He also pointed community members toward local resources often overlooked. “There’s so many resources. And I think one of the bigger resources that a lot of people forget - their local church,” Bonham said.

While the sheriff’s office is working to pull back from situations better suited to clinicians, Osage Ambulance District (OAD) has spent the past year building a clinical alternative.

In September 2023, the district received a four-year, $800,000-per-year federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to build a Mobile Integrated Healthcare (MIH) program. The program trains paramedics in crisis intervention, expands follow-up care, and enables EMS to transport certain patients directly to Compass Health’s Crisis Intake Centers in Jefferson City or Rolla instead of hospital ERs.

“Traditional ER physicians are better equipped and trained for handling medical and trauma emergencies, and those suffering from mental health crisis should be transported to a center with trained mental health professionals on site - such as the crisis access centers,” said OAD EMS Chief Josh Krull. “We firmly believe in getting the patients to the right place, where their needs can be adequately met.”

Recently changed laws allow ambulances to transport patients to alternate destinations such as the crisis access centers; however, the implementation across EMS systems has been slow. OAD’s work under the grant was used to help support this important decision. Because insurance did not reimburse ambulance trips to mental-health facilities, the SAMHSA grant funds those transports.

Krull emphasized that the Community Paramedic/MIH program is designed to fill service gaps — not replace local clinics, home-health agencies, or physicians.

Residents seeking routine counseling or psychiatric care can also access Compass Health telehealth appointments through Community Health Center of Central Missouri in Linn, a resource intended to help alleviate some of the county’s long-standing provider shortage.

Compass Health is also spearheading a new regional prevention initiative that brings Osage County into a larger three-county effort focused on reducing substance use and suicide. The Tri-County Coalition will unite community members, service providers, and local leaders from Cole, Callaway, and Osage counties to strengthen prevention strategies, share resources, and coordinate approaches that support mental wellness across the region. The goal is to build community-level partnerships that address risks before they escalate into crisis situations.

The Coalition will hold its kickoff meeting on Thursday, Dec. 4, from 1–3 p.m. at Compass Health Network’s Amazonas Office (Dogwood Room) in Jefferson City. Organizers say the meeting will introduce the goals of the coalition, outline how collaborative prevention work can reduce suicide and substance-use rates, and offer opportunities for residents and professionals to help shape the coalition’s early direction. Those unable to attend can still register their interest through Compass Health’s RSVP link.

Across all agencies, officials emphasized the importance of providing options before crises escalate.

“Most of the time - not always - most of the time, people just need to be able to sit and talk,” Bonham said, They need to have somebody they can vent to, (who can) hear what’s going on in their head. We want to make sure that we do everything we can to foster that, and encourage (them to) get the help they need.”

As financial pressures rise and holiday stress sets in, the sheriff’s office, EMS, and Compass Health all encourage residents to reach out — whether to a local church, a clinic, or a first responder. “There is also the 988 number, which is for people in crisis as well,” Krull noted.

The goal, they say, is not only preventing tragedy, but building a system where people can get help early, locally, and safely — without fear that a moment of crisis will spiral out of their control.