JEFFERSON COUNTY MENTAL HEALTH

The Development of Mental Health Care in Jefferson County, COMTREA, an Introduction:

In 1973, the only Mental Health Care in Jefferson County was a
Saint Louis State Hospital resident who came to the Health Center in
Hillsboro on Wednesday afternoons to distribute drugs. Among the
many issues not addressed was that of alcohol and other drug abuse.
Judge John Anderson; Melvin Williams, Probation Supervisor; 

W.H.S. Stu Obrien, Public Defender; Sheriff Buck Burger; G. William Weier,

Prosecuting Attorney; and attorney, Brent Williams, incorporated an agency
that, they hoped, would address these problems. In February, 1973,
they chose Stephen F. Huss, an activist Social Studies Teacher from
Hillsboro to join them in the founding of Community Treatment Inc. (COMTREA).

For thirteen months, Huss worked without pay to develop the first
program, residential treatment for boys ages seventeen to twenty-five.
After grants, a state contract with the Division of Alcoholism and local
funding had been secured, it opened in June, 1974.
It quickly became obvious to the COMTREA leadership Jefferson County

had a great many unmet mental health needs. With the Board’s permission

and encouragement, Huss began addressing them as needs were

identified and funding streams developed. The services developed during

the first few years focused mostly on service to those with Substance

Use Disorders: individual, group and family counseling, prevention efforts,

evaluations for schools and courts, Drunk Driver programs, police training

and neighborhood seminars. COMTREA soon became a well-known and

admired agency across Missouri and drew positive national attention

from ABC World News.

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By 1985 it became apparent addressing mental illness and
domestic violence services were critical needs in Jefferson County. The
lack of funding to address the concerns also became obvious. The
County Government (administrative court at that time) formally
recognized COMTREA as its Jefferson County Community Mental Health
Center. They believed the agency would be more likely to obtain grants,
secure state funding and generate donations than any public entity that
they could create. COMTREA became a line item in the County Budget.
The State of Missouri’s Department of Mental Health (DMH) soon
recognized COMTREA as its Service Area Authority/Representative for
Service Area 22 (Jefferson County). Additional funding and public
responsibility accompanied the designation.

In 1986 COMTREA, with the encouragement of the County and
the DMH, successfully passed a mil tax for mental health care. The State
Statute encouraged counties to make the local mental health center
boards like COMTREA serve also as the Community Mental Health Fund
Boards. This was encouraged in order to assure a seamless “system of
care” between the State DMH and local communities.
After the passage of the tax, now “Dr.” Stephen Huss, led the
agency into areas not previously possible. A domestic violence shelter
was created, locations were opened in High Ridge and Arnold, and the
mission statement created: “COMTREA will serve as an innovative,
effective and responsive community treatment center for Jefferson
County.” Over the next few years, COMTREA introduced Divorce
Education programs, treated victims of the 1993 flood, opened the
Keaton Center psychiatric nursing home, facilitated the creation of
Behavioral Health Response, a regional mental health call center, took
over a bankrupt adolescent residential treatment center, created a

Child Advocacy Center that provided forensic sexual abuse evaluations
for the legal systems of nine Missouri counties, helped develop a
County Drug Court and, later, a County Mental Health Court.

Dr. Huss secured a grant to establish wide-spread mental health
counseling and early intervention to students in county schools—the
third “School Liaison” program in the nation. He presented the
COMTREA/Seven Habits model to an international symposium in 2001
and later received the National Behavioral Health Care Community
Collaboration Award. By 2004, it became again apparent that funding

for the needs of the county, especially children, was woefully inadequate.

COMTREA’s School Liaisons had been an innovative, highly successful program

that needed financial stability and expansion. Dr. Huss and a team of DMH
Service Area authorities were successful in passing legislation that
allowed counties to enact a sales tax for children’s services. The
statutes were amended to allow either “local existing CMHC Boards” or
“to be established County Boards” be responsible for the distribution of
funds. Jefferson County chose to retain COMTREA’s CMHC Board as the
local authority with some modifications. COMTREA was still the
Jefferson County Community Mental Health Care Center and
responsible for creating a “system of care” for the citizens.

Between 2004 and 2016, COMTREA drew national attention when
First Lady Roslyn Carter visited and asked COMTREA to present at an
international domestic violence conference. Huss also seized an
opportunity to have COMTREA purchase forty-five acres of land inside
the city limits of the county seat with a promise of the donation of
fifteen more acres at a later date. But, the major issue COMTREA had to
contend with was the lack of medical care for its growing mental health

care patient population. Diabetes, high blood pressure or other medical
conditions threatened psychiatric stability among its thousands of
patients. A group of county service and political leaders asked Dr. Huss
to lead an effort to obtain a Federally Qualified Health Center for
Jefferson County. After numerous “starts and stops,” the group finally
asked COMTREA to become the FQHC. Dr. Huss presented this idea to
the senior staff and Board who both approved it. The effort was
successful and COMTREA became an FQHC in 2013.
Before Dr. Huss retired in January, 2016, COMTREA further
expanded and began providing dental and medical care to those in
need regardless of the ability to pay. Of particular significance was the
creation of integrated health and behavioral health care within several
school systems. The COMTREA school model drew positive state and
national attention.