Other states would do well to take note of what’s happening in the Rockies, where work is underway to redefine the way behavioral health care is delivered
By Veronica L. Holyfield
In April 2019, Colorado governor Jared Polis told legislators it was time to place major attention on improving behavioral health outcomes for residents of the Centennial State. He also made a commitment to his constituents to bolster mental and behavioral health services in response to substance use disorder (SUD) within the state’s marginalized and disenfranchised communities. And by September 2020, the Blueprint for Reform was set into motion, headed by the Colorado Behavioral Health Task Force.
The governor was right to enact his initiative. According to WalletHub, the outlook in the state is bleak. The website ranks Colorado at No. 4 for problematic drug use and says the state has the highest percentage in the nation of adults with unmet drug-treatment needs. Meanwhile, the Colorado Department of Public Health & Environment’s data indicates that 224,000 residents misuse prescription drugs, and Denver Public Health estimates that as many as 25% of the city’s adults binge-drink.
In April 2021, Polis signed bill HB 21-1097, which established the new Behavioral Health Administration. “An estimated one million Coloradans live with a behavioral health condition, and we know the compounding traumas of [the COVID-19 pandemic in] the last year have only worsened mental health and substance use challenges for many,” Polis said at the signing of the bill. “We need a system that can deliver timely, affordable and responsive services that truly put people first. I am proud to sign this landmark piece of legislation that lays the groundwork for bold transformation.”
The Mission of the Behavioral Health Task Force
The Behavioral Health Task Force is made up of more than 40 people statewide, ranging from lieutenant governor Dianne Primavera to Selwyn Whiteskunk, a member of the Ute Mountain Tribe and advocate for Indigenous peoples. Leveraging the power within government to influence the impact of health outcomes, Colorado is committing to long-term systemic change that also makes an immediate impact. The task force has six pillars for building better behavioral health: access, affordability, workforce and support, accountability, consumer and local guidance, and whole-person care.
Access and affordability are particularly key. According to the Blueprint, the need for help is much greater than what is being delivered, with an estimated 27% of the population of 5.7 million people reporting that they or someone they know has experienced active addiction at one time or another. Approximately $1.4 billion in federal and state funds were identified as supporting behavioral health services in Colorado, yet there isn’t a statewide, cohesive approach, or infrastructure to meet the demand. To understand how the dollars are being spent, the task force is examining discrepancies, with an eye toward reallocating money throughout community organizations.
This is where the accountability pillar comes into play. For instance, Denver Health—one of the highest-volume medical centers in the state and which houses the Center for Addiction Medicine (CAM)—reported that it received $8.8 million in new grants in 2019, in addition to its $4.9 million in anticipated funding. In 2020, CAM reported that it treated a total of 1,629 new unique individuals through both in-person and telehealth services. While funding for CAM is necessary for both treatment and research, Denver Health may see some of those funds reallocated once the task force develops a better feel for the cost/benefit of each program.
Also under the microscope are the plights of minority and marginalized populations. Study after study has confirmed that people of color, Indigenous communities, LGBTQ and gender-nonconforming groups, and people with disabilities have the highest rates of mental health and SUD issues but are burdened with the least access to affirming care. Missing or inaccurate data about these populations, as well as a distrust of the medical profession among those within them, has only widened the disparities.
Filling the Healthcare Gaps
The task force intends to help fill such gaps. First and foremost, treatment options must be expanded and made more consistent, and sustainable approaches must be available and abundant. Those service solutions fall under the task force’s pillar of consumer and local guidance.
Finally, there’s whole-person care, which focuses on bringing treatment beyond crisis mitigation and creating and executing plans that lead to long-term care solutions. Law enforcement is part of the equation here. In order to promote harm reduction and decrease the number of incidents that needlessly escalate into arrests, education opportunities for law enforcement, first responders, judges and court officials around behavioral health and cognitive disabilities will also be implemented.
With the Blueprint for Reform by the Colorado Behavioral Health Task Force, Colorado has come to understand that a thriving state starts from within. The Blueprint is enacting the belief that all Coloradans deserve the opportunity to achieve mental wellness, regardless of severity of need, ability to pay, disability, language, geographic location, racial or ethnic identity, socioeconomic status, sexual orientation, age or gender identity. By challenging the systems in place, Colorado is attempting to transform a disaster into a shining example for the rest of the nation.
Top photo: Denys Nevozhai; bottom photo; Matthew Ball