Behavioral Health
mental health services

Community and Hospital Outreach
Community Mental Health Liaison (CMHL)
The CMHL works to form better community partnerships between COMTREA, law enforcement, and courts to save valuable resources that might otherwise be expended on unnecessary jail, prison, and hospital stays, and to improve outcomes for individuals experiencing behavioral health crises. The CMHL also follows-up with those referred, from Jefferson County, in order to track progress and ensure success. Through the CMHL program, those experiencing behavioral health crises, who have frequent interaction with law enforcement and the courts will have improved access to behavioral health treatment. This is done through a collaboration with local partners, including law enforcement in the Crisis Intervention Team.
Emergency Room Enhancement (ERE)
The ERE program encourages communication and collaboration between hospital and community mental health center staff. When an individual presents to a local ED three times in three months or six times in a year, the hospital will contact the ERE Coordinator. Upon receiving the call, the ERE Coordinator meets with the referred individual at the hospital and assists with facilitation of needed services post discharge. Since the individuals being referred to the ERE program are typically quite vulnerable, the ERE Coordinator provides intensive case management services to the individual for up to six months. Once the individual is stable enough, the ERE Coordinator facilitates internal transfer to a lower level of care.
Hospital Community Linkage Inpatient Program
The HCL inpatient program involves collaboration between inpatient psychiatric staff and community mental health center staff. Psychiatric social workers identify inpatient individuals with a serious mental health or substance use disorder. HCL staff travel to the hospital to meet with the referred individual and assists with connection to services post discharge, if desired.
Disease Management 3700 (DM 3700)
In the DM 3700 program, the Department of Mental Health compiles quarterly lists of unserved Medicaid consumers with a serious mental health or substance use disorder and over $20,000 in Medicaid expenses over the past year. The list is provided to the DM 3700 Coordinator to contact all individuals and connect them to needed services. The goal of the program is to reduce the amount hospital visits the individual has, thus reducing the overall Medicaid costs.

Community Support / CASE MANAGEMENT
Case management services are available for current clients needing assistance gaining care, navigating applications, or receiving support in day-to-day tasks. Furthermore, we offer community support to increase health education, community resource knowledge, and individual support.

Disaster and Crisis Response
Services by licensed clinicians are offered to individuals and groups in clinical settings, via telehealth or in the community. Services offered at no charge with support by the Disaster State Response Grant.
- Individual Crisis Response
- Group Critical Incident Stress Debriefing
- Community Education: Trauma Informed Training, Mental Health First Aid,
Crisis Intervention Training - Community Healthcare Referrals

Evidence-Based Therapy and Coaching
Our skilled and licensed therapists and counselors offer a variety of evidence-based practices when providing services to children, adults, and families. Our team works with you to find the most suitable services in meeting your goals. Services are provided in offices and school settings.
- Child-Centered Play Therapy
- Cognitive Behavioral Therapy
- Dialectical Behavior Therapy
- Eye Movement Desensitization Reprocessing Therapy (EMDR)
- Family Therapy
- Motivational Interviewing
- Parent-Child Interaction Therapy
- Play Therapy
- Trauma-Focused Cognitive Behavioral Therapy
- Wellness Coaching

Housing Services
Assisted Living Facility
The Keaton Center Assisted Living Facility offers housing and around-the-clock care to residents. The facility provides two semi-private and 12 private bedrooms, two common areas, full kitchen service, and scheduled activities and outings for residents. Residents have access to all COMTREA services to ensure their overall health and well-being.
Community Housing Services
We seek to reduce the incidence of homelessness and domestic violence in Jefferson County and assist individuals and their families with mental illness, addiction disorder, and other disabilities with obtaining and sustaining safe and stable housing.
Our staff provides resources and intervention as appropriate to the goals and needs of the individual as assessed during the intake evaluation or initial contact. Our staff provide a minimum of linkage and referrals to individuals who request services but are not eligible for a specific program.
Referrals may come from the individual or from hospitals, family members, guardians, state inpatient psychiatric facilities, and other professionals providing services. The current housing program is the Supportive Community Living Program.
COMTREA is involved in the Missouri Balance of State Continuum of Care to assist those who are currently *literally homeless or fleeing or attempting to flee domestic violence or stalking. Those who meet the criteria can apply to the housing-first prioritization list (this is not a waiting list). To apply, current clients should contact their case manager or community support specialist; new clients may contact the Housing Department.
Rental Assistance Program (RAP)
The Emergency Rental Assistance Program (ERAP) provides assistance to income qualified households whose ability to pay rent and utilities has been impacted by COVID-19. Eligible tenants can apply for financial assistance to be
paid directly to their landlord or utility provider. Financial assistance includes rent, utilities, rent arrears, and utility arrears. This program is being offered in partnership with Jefferson County. This project is being supported, in whole or in part, by Federal Award Number ERA 0433 awarded to County of Jefferson by U.S. Department of the Treasury.
Learn more at www.jfcac.org/erap.html.
*Literally homeless, according to Housing and Urban Development (HUD) is defined as: someone living in an INHABITABLE environment, such as sleeping outside, sleeping in an abandoned building, sleeping in a vehicle, staying at a homeless or DV shelter, etc. The applicant can be staying in a hotel and motel and apply if their stay is being paid for by an agency, church, organization, etc. and not paid for by self, friends, or family. ‘Couch surfing’ does not account as being literally homeless according to HUD.

Integrated Treatment for Co-Occurring Disorders
Integrated Treatment of Co-Occurring Disorders (ITCD) is an evidence-based practice for individuals with mental health and substance use disorders. Treatment is designed to address co-occurring disorders and accommodate individuals in various stages of change with mental illness and substance use. Treatment is offered until the individual is completely recovered, and is based on individual needs and preferences.
ITCD has an integrated team approach to treatment including:
Individuals may be identified for referral from the Welcome Center or after establishing care with a COMTREA case manager, therapist, or community support specialist. Staff working within the ITCD program receive ongoing specialized training and supervision.

Peer and Family Support
Individuals with mental health disorders meet with others who have lived through similar experiences. Peer support provides real-life examples, stories, and applicable care resources for the individual.
Family support offers tools, resources, and coaching to families with a loved one who has a mental health disorder. Families are given goals, structure, and a framework to navigate as they care for their loved one.

Psychosocial rehabilitation program
The Psychosocial Rehabilitation Program (PSR) is designed to meet the needs of individuals with serious and persistent mental illnesses living in residential care, assisted living facilities, and private residences. PSR services are offered Monday, Tuesday, Wednesday, and Friday at the COMTREA Annex in Festus. The program focuses on stabilization, time, teaching, effort, progress, and success (STEPS).
PSR Full-Day STEPS
The STEPS group functions to assist and provide support to the individual in community integration. The overall goals:
- Socialization
- Independent Living Skills
- Health and Wellness
- Diet and Nutrition
- Management of Illness and Symptoms
- Activity Therapy
- Support and Advocacy
PSR Half-Day STEPS
The half-day STEPS program is designed to develop skills, interests, self-satisfaction, and independence to the individual's maximum potential. Program objectives are to develop and educate individuals to be self-reliant and function to their highest ability.
Participants are involved in all program aspects including selecting group education topics, outing choices, nutrition and menu planning, and maintaining the program area. Counseling professionals and paraprofessionals conduct the program. Other mental health professionals are available for additional services and support.

School Services
COMTREA provides school-based therapy to area schools and colleges.
- Individual or group counseling for students at the school- students become COMTREA clients
- Psycho-educational presentations in the classroom
- Staff, faculty, and parent consultation
- Support for individual education plans (IEP’s) as needed
- Collaboration with physician for medication management
- Crisis response and assessment for students at risk of suicide or harm
- Behavioral Health Educational programming for CARE Teams, parent teacher organizations, etc
- Family support and resources along with appropriate referrals for family system wellness
- Training for school staff on topics including trauma awareness, resilience, classroom strategies, grief, anxiety, etc.
- Easy access to referrals to mental health services, dental care, and primary care
- School-based day treatment program
Group topics and resources include grief counseling, friendship issues, social skills, anxiety or anger management, divorce, and additional topics request by school staff.
An initial signed legal guardian consent form and then an intake packet are required for services. Counselors coordinate with teachers and the school-based therapist for a convenient time to meet with the student. A school-based therapist will refer students to community resources if the circumstances cannot be effectively served in a school-based setting.

Supportive Employment
Individual Placement and Support (IPS) helps individuals with behavioral health issues find employment. IPS uses evidence-based practices through supported employment.
Approximately 60% of participants receiving this service achieve employment, compared to a 23% success rate for more traditional avenues. Research shows having a job increases personal recovery goals and performance.
Principals and services of IPS:
COMTREA is a Certified Community Behavioral Health Organization in the State of Missouri
