By Chris Adams

In a tiny Colorado town at the end of 2018, a police lieutenant named Roy Kinney shot and killed Daniel Pierce after an adrenaline-fueled car chase. Pierce had paranoid schizophrenia, believing he was God. Kinney knew Pierce’s diagnosis  but felt forced into the shooting that cost a man his life and Kinney his job.

It also prompted Rangely, population 2,300, to confront the inadequacies of its police force and the lack of mental health services.

The story of Kinney, Pierce and the patchwork nature of mental health in rural America was the focus of both a prizewinning article in The Colorado Independent and a National Press Foundation briefing with the two reporters who broke the story and an expert in rural mental health who is also a former police expert.  They noted that the first responder to a mental health crisis is likely to be a police officer who is not trained to handle mental health crises. Pandemic budget cuts are likely to make matters worse, they warned.

On the briefing were Niki Turner, editor of the Rio Blanco Herald Times; Susan Greene, editor of The Colorado Independent, a nonprofit in Denver; and Paul Force-Emery Mackie, a professor of social work at Minnesota State University, Mankato.

Turner (bio, Twitter) and Greene (bio, Twitter) won NPF’s Carolyn C. Mattingly Award for Mental Health Reporting for “Through the Cracks: A stranger, a police shooting, and a small town’s silence” (part one, part two). Their work highlighted how Pierce’s long history of mental health issues had been ignored; the role that a painkiller prescription played; and the officers’ reluctance to deprive Pierce of his liberty though an involuntary psychiatric commitment.

The issues addressed go far beyond little Rangely, Colorado. The dearth of mental health services in rural America is a very real problem in the age of COVID-19, as people struggle with its economic, health and social stressors.

“The pandemic will make things worse – but it can be a catalyst for the change we need,” said Mackie (bio, Twitter).

Compared with other Americans, Mackie noted that rural residents are older, more likely to lack computer skills and more dependent on primary care physicians and law enforcement to identify, support and treat mental illnesses. They also face significant barriers in getting the mental health care they need: 60% live in a mental health shortage area, while 90% of psychologists live in metro areas.

Technology could be a mitigating factor, but 15% of rural American lack access to broadband technology; that makes telemedicine iffy for many people who are also too far from mental health workers to get in-person care.

“This is not a new problem, but with COVID-19 we are becoming more aware of the digital divide,” Mackie said.

Among other hurdles, Mackie said, are licensing limitations that can restrict mental health workers’ ability to provide telemedicine across state lines. He offered several recommendations to develop comprehensive community mental health responses, change licensing requirements, boost rural broadband and integrate telemedicine into the training of mental health providers.

Turner and Greene detailed the difficulties of reporting their story, which eventually incorporated the insights of people close to Pierce, including his mother and his estranged wife. It also included comments from Kinney – unusual, given the tendency of police to lawyer up and circle the wagons after any police killing.

“Don’t give up, and don’t assume that people are not going to talk,” Greene said.

Turner, whose weekly newspaper was initially rebuffed in its efforts to document the Pierce killing, eventually teamed up with the Independent. She and Greene accessed hundreds of documents and hours of video and audio recordings, and interviewed more than 50 people, to tell the story of both the shooting and its aftermath.

The town has since taken “baby steps” to paying more attention to mental health issues, Turner said. But the pandemic has also exposed a growing “animosity” in rural America toward urbanites that are seen as vastly exaggerating the risk of the virus, Turner and Greene warned.