Colorado’s dismal behavioral health record should improve with these task force recommendations

For years, Colorado has ranked among the lowest-performing states on various measures of access to mental health and substance use treatment.

Then, the COVID-19 pandemic exacerbated depression, anxiety and addiction, while limiting how and when many people could get care. State lawmakers decided to address the crisis by directing $450 million in federal relief money — from the American Rescue Plan Act that Congress passed in 2021 — toward one-time investments in the behavioral health system.

A bipartisan, 16-member task force of state lawmakers and department heads, informed by a 25-member subpanel of behavioral health experts, met throughout the summer and fall interim when the Colorado General Assembly was not in session. The subpanel held its own slate of meetings over the interim.

“This was very time-intensive, and I want to thank the subpanel chair and vice chair (Vincent Atchity of Mental Health Colorado and Dr. Lesley Brooks of SummitStone Health Partners) for all of their work,” state Sen. Brittany Pettersen, the Lakewood Democrat who chaired the behavioral health task force, said during a Monday news conference. “I can’t tell you how long we spent every week just trying to plan what their meetings looked like, what our meetings looked like.”

A report released Friday contains the task force and subpanel’s final recommendations for how to spend that $450 million on improving behavioral health in Colorado.

The report provides a basic framework, but the work continues: Lawmakers now have to introduce and pass legislation that will dictate whether and how to spend money on each of the recommended priorities.

The Affordable Housing Transformational Task Force, structured similarly to the behavioral health task force, released its own final report Friday with recommendations for spending $400 million in federal money on affordable housing initiatives. The final recommendations are similar to those outlined in draft form last month.

While the state has a long way to go in making sure everyone can access the behavioral health care they need — and the American Rescue Plan Act money is for one-time investments, meaning that ongoing funding for task force priorities would require tapping new sources — Pettersen was optimistic.

“It’s exciting when I think about how different people’s experiences will be in the future than what mine has been with my mom,” Pettersen told Newsline, referring to her difficulty accessing substance use treatment for her mother. “That has been something that has motivated me every day in the Legislature.”

New psychiatric beds

The task force’s final report notes the high prevalence of substance use disorders among young Coloradans, and that youth suicide rates increased by more than 51% over the last decade in the state.

It recommended directing the biggest chunk of money, $111 million to $142 million, toward youth and family residential care, community services, and school and pediatric behavioral health care. Lawmakers and behavioral health experts want to make sure that young people needing residential care aren’t forced to go out of state to receive it — like many do currently.

To address the gap in residential care for young people, the task force recommends funding up to 16 neuropsychiatric beds in Colorado. Doctors who practice neuropsychiatry treat mental, emotional and behavioral problems as well as brain disorders.

Another 30 psychiatric beds, where young people can receive residential treatment for mental, emotional and behavioral problems, would also be funded under the proposal. The task force noted that children who need substance use treatment should be able to receive it at residential psychiatric facilities.

Some of the funding for children and families would go toward in-home and residential respite care, which provides caregivers with a temporary break from caring for a child or adult dependent.

Rep. Serena Gonzales-Gutierrez, the Denver Democrat who served as vice chair of the task force, lauded the proposed funding for Colorado’s young people. Gonzales-Gutierrez is a social worker who has worked with children involved in the juvenile justice system for 18 years.

“Together, we can make smarter investments to solve our behavioral health crisis and set ourselves up for success as we tackle the root causes of crime,” Gonzales-Gutierrez said during Monday’s news conference. “We want these federal dollars to directly impact the Coloradans who need resources the most so that we’re building safer, stronger communities now and in the years to come.”

Improved access to care in rural Colorado

The task force’s final report recommends investing $80 million to $83 million in Colorado’s behavioral health workforce. Relevant state departments and agencies would work out the details of the workforce investment plan.

The plan could include creating more levels of providers with various amounts of skills and training, encouraging people who live in rural parts of Colorado to become behavioral health providers in their communities, and expanding the availability of telehealth services.

Another element of workforce investments would be increasing Medicaid providers’ capacity and making sure they’re trained to treat complex behavioral health needs, including addiction. The task force also wants Medicaid providers to be able to treat patients with a history of sexual and domestic violence, and patients from various linguistic and cultural backgrounds. Ensuring such culturally competent care would include special training and potentially a new certification process.

Finally, the workforce recommendations include expanding opportunities for peer support professionals, who use their own personal experience with substance use to help people struggling with addiction.

Adult inpatient and residential care

To address the state’s severe lack of adult residential treatment, the task force recommends spending $65 million to $71 million to add beds in the highest-need areas of the state. The goal would be to serve people with intellectual and developmental disabilities, serious mental illness, and co-occurring physical or behavioral conditions; as well as people involved in the criminal justice system and people experiencing homelessness or housing insecurity.

The task force recommended adding 16 residential treatment beds at the Colorado Mental Health Institute at Fort Logan, one of two state hospitals that provide “competency restoration” for people deemed incompetent to stand trial. Another recommendation: adding at least 125 residential “step-down” beds where people can keep receiving care after being released from a hospital. The task force also wants to invest in addiction recovery services such as sober living homes and drop-in centers.

Other task for recommendations

Besides youth and family services, workforce investments and adult residential care, the behavioral health task force recommended spending:

• $65 million to $70 million to expand criminal justice diversion programs, early intervention and competency restoration services
• $44 million to $51 million for care navigation and coordination to help people locate and access the various behavioral health services they may need
• $35 million to $38 million to better integrate primary care with mental health and substance use treatment
• $35 million to $38 million for grants to local governments and community-based organizations
• $5 million to $10 million to expand residential treatment for Colorado’s Native American tribes

“I think that one of the first reckonings of the task force was that while it’s fantastic to have $450 million in one-time funds, the state of the state is that that’s not going to fix everything,” Vincent Atchity, who chaired the task force subpanel, told Newsline. “It’s not going to solve all of Colorado’s problems, but it will make a meaningful difference in the lives of many.”

As the executive director of nonprofit Mental Health Colorado, Atchity helps to serve and advocate for people with mental health and substance use needs around the state. Sometimes that means raising public awareness of existing resources for improving mental wellness, which his organization is attempting to do through “What’s Your Peace,” a campaign that launched in January and will run through Mental Health Awareness Month, which is May.

Mental Health Colorado wants people to visit mentalhealthcolorado.org/whats-your-peace/ to share a photo or video of ways they “find and create peace in their day.” This could be anything from spending time with family to gardening. At the campaign’s conclusion, Mental Health Colorado will share the photos and videos in a finished project.

“What’s Your Peace is about asking you to think to yourself about, ‘What are the things I do in the course of the day that really help me feel well?’” Atchity said. “So that by bringing those to consciousness, you are more deliberate about carving out time for yourself, but then also by sharing them with each other, we sort of expand our toolkit of available possibilities.”

How does Colorado measure up?

Mental Health America’s 2022 State of Mental Health in America report, which used data from 2018-2019, ranked Colorado in last place overall for adult mental health. The ranking accounted for a variety of factors related to the prevalence of mental illness and access to care.

Colorado had the sixth-highest prevalence of mental illness among adults and the second-highest prevalence of adults with substance use disorders.

Colorado had the fourth-highest percentage of adults with a mental illness who reported they were not able to receive the treatment they needed (31.8%).

Mental Health America’s latest report ranked Colorado 13th overall for youth mental health.

Among young people, Colorado had the 18th-lowest rate of severe depression and the sixth-highest rate of substance use disorders.

Colorado had the 12th-highest percentage of children with private insurance that did not cover mental or emotional problems (9.6%).

In Mental Health America’s 2021 report, which used 2017-2018 data, Colorado ranked 46th for the percentage of young people with severe depression who received some consistent treatment (21.5%). The state saw a big improvement the following year, when 43.1% of youths with severe depression got some consistent treatment — improving Colorado’s ranking to fifth place on that measure.

Editor’s note: This article first appeared on Colorado Newsline, which is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Colorado Newsline maintains editorial independence. Contact Editor Quentin Young for questions: info@coloradonewsline.com. Follow Colorado Newsline on Facebook and Twitter.