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Mind, Body and Crime in the Country How Drug Addiction and Untreated Mental Health Issues Lead to High Crime Rates in Rural Missouri

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Above image credit: Robert Cox's stepson, Tristn Jevon, passed away in February from an accidental fentanyl overdose. (Contributed Robert Cox)
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9 minute read

RAY COUNTY, Missouri – Early this month, the FBI released its annual crime data. Missouri’s violent crime rates were trending up, as they have been for several years.

At the local level, nearby Ray County had the highest per-capita rates of violent crime in the metropolitan area.

Scott Childers has only been the Ray County Sheriff since January.

Even in his short time, Childers was not surprised at the high violent crime rate in his county. In fact, he said the actual numbers were probably higher, because not everything gets reported.

The FBI defines violent crime as murder and nonnegligent manslaughter, rape, robbery and aggravated assault. Ray County’s violent crime breaks down to mostly aggravated assault.

Childers said there are several reasons for this. Untreated mental health issues and drug addiction top the list, he said, but the county is also served by a limited number of deputies and its overcrowded jail is in need of replacement.

Starting at the Root

Drugs and mental health concerns are issues in most counties, but Childers said it affects rural counties, like Ray, disproportionately. Put simply, it’s easier to hide in a rural area.

“It’s still there, it’s just more spread out, you have (fewer) deputies to deal with (the drugs),” Childers said. “It’s harder to follow that stuff in the county.”

Sheriff Scott Childers of Ray County
Sheriff Scott Childers of Ray County says drug abuse and mental health issues are the leading causes for Ray County’s high crime rates. (Contributed | Ray County Sherriff’s Department)

The two go hand-in-hand, Childers said. Most people suffering from addiction also suffer from mental health issues, typically stemming from childhood trauma.

“I promise you … if you take a look at a lot of drug addicts, they’ve got childhood trauma,” Childers said. “We have got to also start combining trauma related therapy with drug abuse (treatments).”

In rural counties mental health facilities are few and far between, especially in Missouri where less than 6% of need is met, according to a 2021 report by the Bureau of Health Workforce, Health Resources and Services Administration and the U.S. Department of Health & Human Services.

Thankfully, several providers have seen the need in Ray County, and stepped in.

For Robert Cox, mental health and addiction recovery are personal topics.

He’s dealt with both in his life, and for the past 30 years, Cox has worked as a licensed professional counselor to help others overcome issues with childhood trauma and addiction.

This past year, his profession became extremely personal again.

Cox’s stepson, Tristn Jevon, passed away in February from an accidental fentanyl overdose. The 22-year-old was a victim of childhood abuse from his birth father. As he got into his teens, the buried trauma led to drug usage.

Cox said his stepson was clean for a while, but a dental surgery this year sent him to the streets looking for pain medication. The batch he bought from was, unfortunately, laced with fentanyl and took his life.

Fentanyl is a synthetic opioid similar in effect to morphine, but 50-100 times more potent. When taken in high doses, or combined with other substances, it can be deadly.

Cox said it’s a huge problem in the area. The same night Jevon died, several others in the area passed away from the same drug.

Fueled by the passing of his stepson, Cox decided to do what he’d wanted to for many years, and convert his private practice into a nonprofit dedicated to helping people overcome trauma and substance abuse.

In August the Tristn Jevon Center for Recovery received its 501(c)(3) accreditation. Now, Cox will get government assistance for the sliding scale practice he’s been running for the past five years.

“Somewhere along the way, I began to doubt whether it was possible,” Cox said. “Quite honestly, my son’s death changed that. It lit a fire under me.”

Robert Cox operates the Tristn Jevon Center for Recovery
Robert Cox operates the Tristn Jevon Center for Recovery on a sliding scale so he doesn’t have to turn patients away from the care they need. (Contributed | Robert Cox)

But how is childhood trauma related to violent crime in Ray County? Trauma can lead to self-medication and difficulty regulating emotions. Both are contributing factors to violence.

Many people with traumatic pasts have trouble regulating their emotions. Cox compared it to a learned skill. He said it was akin to someone who didn’t know how to change the carburetor in a car. The fact that they couldn’t do so doesn’t make them a bad person, he said, it just means they were never taught that skill.

“How then do we take that kid who not only was in a violent atmosphere his first year, but clear up until he was 15 years old? How do we punish him for being an addict?” Cox asked. “You come from a violent family, you never learned how to regulate your emotions and you find methamphetamine or heroin or something else that helps you regulate your emotions. And now it’s taken away from you. Your emotions are again unregulated and yes, violence and crime will ensue.”

Experimentation with drugs or alcohol is natural for curious teens, Cox explained. But it can be costly for those that don’t have the right support system around them, or who have been unable to process the pain from buried trauma.

“What we begin to realize is when I use (drugs), I don’t hate myself,” Cox explained. “When I use, I’m not constantly in pain from things that have happened to me … And that’s when we start down the rabbit hole.”

Once you’ve started and you become inebriated, Cox said the barriers you might have set get blurry. Cox never thought he’d do meth when he was a user more than 33 years ago, and then one night at a party, he found himself saying yes. It can escalate that easily, he said.

“Addiction doesn’t just start,” Cox said. “It’s a way of numbing out. One of the best things we can teach addicts is that pain is a guarantee in life. Suffering is a choice that we make when we continue to try and numb that pain out.”

Ray County sits near a major drug trafficking route, Interstate 35. Cox said from his work, he knows the towns around the interstate are home to “cook labs.” Those drugs then spread into Ray County and fill the hard-to-patrol area.

The availability of more extreme drugs creates a demand as users experience the new numbness. But Cox said hard users often are not employable. So they resort to theft or other illegal means to get the money they need.

“Cartels and drug dealers and the system that develops around that, they don’t care what it takes to get their money,” Cox said. “So in that sense, alone, addiction is driving the demand for that drug.”

Rural Spread

Ray County is the perfect setting for this type of crime. The county stretches 574 square miles, with a population around 23,000, meaning it’s spread out. Childers said a lot of residents live down dirt roads, making it difficult for responders to get to the house quickly.

With the small population, there’s not a lot of tax money going to public services like the sheriff’s department.

At any given time, Childers said he only has two deputies on patrol.

Simply put, it’s easier to get away with crime in a rural area because of secluded properties and the low manpower of the sheriff’s department. It also makes it difficult to patrol the drugs entering and exiting the county, run surveillance on potential drug houses and conduct traffic stops.

“We have two deputies on shift to cover a county that’s only 30 square miles smaller than Jackson County,” Childers said.

Because his force is stretched so thin, it can take deputies 30-45 minutes to respond to a call. In that amount of time, a crime has more likelihood to become violent.

“A crime might not become violent,” Childers said. “If we can’t get there, when they start calling and say, ‘hey, we think we’ve got somebody breaking into our residence,’ we can maybe stop that if we’re close enough. But if we’re 30-45 minutes away, it’s going to be very difficult to stop that.”

Childers would like to have enough funding to staff three deputies at a time and state support for mental and addictive services.

No Quick Fix

In a system where addiction, trauma and crime are so intertwined, the road to recovery is long and will require a community that works together.

Tom Petrizzo is the chief executive officer of Tri-County Mental Health Services, which serves Platte, Clay and Ray counties.

An outreach facility like the Tri-County office in Richmond helps Ray County residents with substance abuse treatment, and to identify a mental health issue. This means an individual can be properly medicated under a doctor’s supervision, rather than self-medicating with potentially fatal drugs like meth or opioids.

Petrizzo said Tri-County also supplies Community Behavioral Health Liaisons (CBHL) to local law enforcement to help get individuals to mental health treatment before being arrested or taken to a hospital.

The CBHL are trained clinicians who can arrive on site with a law enforcement officer to help get an individual to treatment, or make an assessment on the scene.

“Instead of being arrested and charged, the person can be diverted into our outpatient treatment,” Petrizzo said. “That’s very helpful having (CBHLs). Without that, more people would be arrested and jailed.”

Tom Petrizzo, CEO of Tri-County Mental Health Services
Tom Petrizzo is CEO of Tri-County Mental Health Services, which serves Clay, Platte and Ray counties. (Courtesy | Tri-County Mental Health Services)

Petrizzo said his organization was able to fund a liaison for Ray County and Excelsior Springs because of the demonstrated need for such a professional.

“I know Sheriff Childers, so it’ll be really helpful to him. It’ll be nice to have another person on board.” Petrizzo said of the fourth addition to the team of CBHL under Tri-County.

It’s more than just keeping people out of jail. When these individuals get treatment for addiction or mental health issues, it can help them return to society and prevent future crimes.

“That’s one of those, ‘let’s do what’s right for the community,’” Petrizzo said. “Let’s get mental health treatment out there available, and partner it with law enforcement. So we’re helping the law enforcement as well as the people in our community.”

Petrizzo said Tri-County also does a lot of preventative work in its counties. A lot of the time, this means going into schools and talking about developing healthy behaviors, abstaining from tobacco or vaping, and even suicide prevention courses.

Preventative care, he said, is just as important as the outreach care provided by Tri-County.

“You know they help reduce criminal offenses and people making attempts to hurt themselves,” Petrizzo said.

Mental health professionals also are stretched thin at the moment. The COVID-19 pandemic has caused an increase in demand for mental health care, but the providers can’t keep up.

Petrizzo said Tri-County is no exception. It has become increasingly difficult to find people to fill the open positions.

“We’ve got like 20 positions open, mostly clinical, where we’re trying to recruit master’s level, trained clinicians, and that is hard,” Petrizzo said. “We’ve gotten a little bit of COVID relief money and state money to expand our services, because mental health (care) has become much more needed during the pandemic.”

Even with the funding, he can’t find the people to do the jobs.

Cox also is feeling the demand.

He’s working with local churches to establish telehealth locations in the area, so people who don’t have internet access, or cannot physically travel to Cox’s office in Richmond, can come to a nearby church for a session.

He’s also created a scholarship fund to treat patients who can’t afford care.

His hope is to get people the care they need before they become addicts or commit a violent crime. But for those that do, he’s working with Childers to provide mental health and addictive care within the jail.

This is important as jails can often exacerbate untreated mental health problems and lead to repeat offenses.

In its current state, Cox said the Ray County jail couldn’t sustain the program. But he and Childers are working to create an introduction to trauma course in the jail, to help teach long-term inmates the connection between past trauma, addiction and violence.

Falling Apart at the Seams

The jail is the final element to Ray County’s perfect storm.

Earlier this year, Childers proposed a county tax to fund a new jail. The current jail, he said, has so much mold in it that he can’t incarcerate people with respiratory problems. The metal walls are so decrepit that inmates pass drugs through holes, or pull pieces of metal off to make weapons.

“We’re really, desperately in need of a better jail,” Childers said. “You could house more people, it would be more effective, and we wouldn’t have the problems with having to release people as much as we do.”

The rusted metal walls of the Ray County Jail allow inmates to pass contraband towards one another, or even create weapons.
The rusted metal walls of the Ray County Jail allow inmates to pass contraband towards one another, or even create weapons. (Contributed | Ray County Sherriff’s Department)

The 200-person jail also is overcrowded. Childers said he often has to release people from the jail and put them on house arrest as new, or more dangerous individuals need to be housed in the jail.

In the 10 months he’s been sheriff, Childers has seen the same people coming in and out of the jail. The bond will get low enough that they can get out with an ankle bracelet, but they usually end up back in jail.

“It’s just a continual cycle of that, and (it) comes down to drug use, definitely, or it could be mental health. It’s just a very difficult process,” he said.

When the half-cent jail tax went on the ballot on Aug. 3, Ray County residents overwhelmingly voted no.

Childers said he doesn’t blame residents. No one wants to pay higher taxes, and he admits his proposal was rushed.

“I still support the tax because the need is there, but it was rushed and there’s no doubt about it. I had two weeks to come up with a blueprint, architects and get it all on the ballot,” Childers admitted.

Childers plans to revisit the matter in the future, either with a new tax proposal or a bond. He sees the issues facing Ray County as part of a bigger story, one of a lack of resources and support in rural America.

“Not only do we need a new jail facility, but we need more deputies on patrol,” Childers said. “I need at least three on each shift.”

Cami Koons covers rural affairs for Kansas City PBS in cooperation with Report for America.

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