This article by Tina Griego and Susan Greene, is part of the Colorado News Collaborative ‘On Edge’ project.
On Denver’s west side, an elderly man had been managing his solitude just fine until the pandemic hit, taking with it what social life he had and leaving in its place a loneliness he had not felt for years. Not far from his house, a young woman fights panic attacks after COVID-19 killed her grandfather and landed her in the hospital. Now, she fears the virus will come for her again and this time she will die.
In Fort Collins, the school district announces an early return to online learning, and moments later, a struggling mother calls the local mental health center: “I can’t do this again.”
On the Eastern Plains is a third-generation farmer, and if the pandemic does not weigh on him heavily, this year’s record drought and the crop failure it caused do. It sets off an irritability and dread that words do not capture in the same way they cannot capture the layering of crises that marks this time: the body blows dealt by the pandemic, the shaky economy, climate-change driven fire and drought, civil rights reckoning and a polarizing election.
Coloradans are on edge. As individuals. As families. As communities. Colorado already had greater demand for behavioral health services than it could provide. And the safety net that even the state’s top mental health official said has “too many holes” might be further frayed by the tight state budget.
These crises have led to a well-documented flood of calls to crisis and referral lines, and nearly half of Coloradans recently reported experiencing anxiety or depression.
“Everyone is really struggling with the same things,” said Kristen Cochran-Ward, director of Connections, a mental health and substance abuse program at the Health District of Northern Larimer County. “I have heard people saying that we are all in the same boat. We are not all in the same boat. We are all in the same storm. And some people might be in a cruise ship and some might be on a tire raft.”
Whatever you’re going through, crisis counselors and professionally trained peer specialists are available to help. Call the Colorado Crisis Service hotline at 844-493-TALK(8255). There is no wrong reason to reach out.
To capture the current psyche of our state, nearly 100 news organizations across the state partnered through the Colorado News Collaborative, or COLab, to document how Coloradans are coping. The hope is that in a state where stigma around mental health struggles runs high, this reporting and the conversations that follow will prompt better understanding of widely misunderstood and hidden experiences.
If there is a silver lining to this time — and we choose to believe there is — it is the realization that even if we find ourselves isolated, we are not alone.
“This has affected all of our wellbeing, all of us,” said Dr. Carl Clark, president and CEO of the Mental Health Center of Denver. “So, I think it has kind of washed away that us-them thing around mental health. I think it is making people realize: ‘Hey, it’s not us-vs-them. It’s us.’”
Colorado was in poor shape to handle 2020’s confluence of crises. This year’s heightened mental health needs have run headlong into a complex, ever-shifting constellation of decades-old challenges: the state’s higher-than-average prevalence of high-risk mental health conditions; a backlog of demand caused by a thicket of red tape among state agencies and private insurers; a behavioral health workforce shortage compounded by low rates of psychiatrists and psychologists who accept public or private insurance; cultural stigma; and slow public and political recognition that mental health is as important as physical health.
For communities of color that have a history of trauma and lack of access to health care, the need has been especially acute. The Colorado Health Institute has been surveying residents about behavioral health and access to care since 2009 and found the situation generally deteriorating ever since. Based on its data, 870,000 Coloradans were in significant distress in 2019.
Nationally, Colorado has the third highest prevalence of mental illness among adults, according to the most recent annual report by Mental Health America. That report, based on data from 2017 and 2018, also finds Colorado has the nation’s highest percentage of adults with substance abuse disorder and the third-highest percentage of adults considering suicide. Colorado’s suicide rate hit nearly 22 per 100,000 in 2018 compared to an average of 14 per 100,000 people nationally. Our national rankings for young people are not much better.
Theories about what explains Colorado’s grim statistics run the gamut from altitude to higher rates of gun ownership to a culture of Western self-reliance that downplays emotions.
“‘Pull yourself up by your bootstraps’ is probably the most misleading statement ever,” said Colorado Department of Human Services Office of Behavioral Health Chief Robert Werthwein, noting the credo wrongly assumes mental health hinges solely on individual will rather than on genetics, brain chemistry, trauma and other factors.
State government is partially responsible, Werthwein said bluntly. A recent study by the Colorado Department of Human Services finds fault with a bureaucracy in which 10 different state agencies run 75 different behavioral health programs, with hundreds of funding streams, thousands of billing rules, and no shared vision for care. Seventy-five programs “means there are 74 wrong doors,” Werthwein said. “There are too many holes in the net.”
Some of the most gaping are sparsely populated communities, many of which have disproportionately high overdose and suicide cases and high rates of stigma around mental health challenges. The need for counseling or treatment doubled or tripled in many rural counties over the past six years.
In the state study of Colorado’s behavioral health system, lack of access to care was repeatedly cited as the greatest problem. Even as COVID began its spread, the state Legislature cut hoped-for expansions of pilot programs and new money for mental health and substance abuse programs targeting people living in underserved communities and youth and adults in the criminal justice system.
Read Part Two, tomorrow…