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Local providers cool to proposals

Programs geared more for Front Range, not rural areas, they say

Nick Beveridge, senior case manager at Axis Health System, talks with a client at the Crossroads acute treatment facility next to Mercy Regional Medical Center. Clients stay three to five days for evaluation at the adult-only center. Enlarge photo

JERRY McBRIDE/Durango Herald

Nick Beveridge, senior case manager at Axis Health System, talks with a client at the Crossroads acute treatment facility next to Mercy Regional Medical Center. Clients stay three to five days for evaluation at the adult-only center.

Mental-health care providers in Southwest Colorado can hardly be faulted for being cautious about how much they’ll benefit from Gov. John Hickenlooper’s proposed $18.5 million expansion of services for the people they serve.

“I’m not particularly excited,” Bern Heath, director of Axis Health System, said Wednesday. “The projects make sense in metropolitan areas but not here.”

Self-reliance has been the watchword at Axis, formerly Southwest Colorado Mental Health, Heath said.

Linda Lute, a licensed addiction counselor in private practice, like Heath, doesn’t think the governor’s projects hold a lot for rural areas.

“My overall thought around the governor’s initiatives is that a better alternative would be to provide localized monies to Axis Health to improve local crisis response and treatment services,” Lute said. “In the five rural counties in Southwest Colorado (Archuleta, La Plata, Montezuma, San Juan and Dolores), it’s often difficult to realize any benefit from statewide initiatives.”

The governor’s proposed mental-health system overhaul includes:

First, changes in the approach to the client. There would be trauma support groups and peer support specialists whose mantra would be “What happened to you in the past?” not “What’s wrong with you?”

The consolidation of three current processes to hold a person for involuntary commitment to a mental-health facility.

The immediate transfer of mental-health information to the Colorado Bureau of Investigation for background checks related to firearm purchases. The information currently is sent on a CD-ROM.

Increase response time for mental-health crises by creating a 24-hour hotline, walk-in crisis facilities open around the clock and a statewide awareness campaign on how to get help. Estimated cost: $10.2 million.

Building a 20-bed facility to hold people in the criminal-justice system who require competency evaluation. Estimated cost: $2 million.

Creation of two 15-bed residential facilities for short stays for people in transition from a hospital to the community, subsidies for people awaiting federal housing vouchers and the formation of a team to develop a service plan and help with transition.

After Mercy Regional Medical Center ceased inpatient mental-health treatment in 1999, area providers had to find beds elsewhere, Heath said.

“Then we lost 16 percent of our funding in 2004 when the state cut spending on mental health,” Heath said. “We laid off 22 people.”

Axis opened its own 15-bed acute-care center for adults in 2006, Heath said. Some state money has been restored but not to previous levels. Children are treated at home as much as possible because there’s no in-patient facility for them.

The Crossroads Mashaw Larson Center next door to Mercy provides detox services as well as in-patient quarters, said Mary Trujillo Young, senior director of clinical services.

Clients are brought by law-enforcement officers, referred by the Department of Human Services or self-admit, she said, for three to seven days for evaluation and to stabilize until they can find outpatient treatment.

Rusty Connor, supervising nurse at Crossroads, said planning for secure release begins as soon as the client arrives. No one is released to the street, she said.

Transportation to psychiatric hospitals in Denver, Pueblo or Grand Junction is a huge problem, said Pam Wise Romero, executive vice president for health-care services at Axis.

“We work hard to keep clients local,” Wise Romero said. “When we send them away, they lose the support of their family, friends and treatment team.”

Difficulty in booking transportation is a hardship on Mercy, said Dr. John “Kip” Boyd, chief medical officer at the hospital.

Combative patients, who must take involuntary medication or who need long-term, high-level treatment sometimes spend three days in the Mercy emergency room – perhaps under custodial guard – awaiting transportation, Boyd said.

Crossroads isn’t set up to house such people, Boyd said.

A statewide crisis hotline as proposed by Hickenlooper would duplicate service in Southwest Colorado, Lute said.

“We already have a 24-hour hotline that works very well,” Lute said.

Despite adversity, Axis is pulling itself along, Heath said.

He recalled that when he arrived in 2001, 122 patients were sent to mental hospitals outside the area. In fiscal 2012, Axis sent 15 people away for treatment.

“We’re still underfunded,” Wise Romero said. “The governor’s plan is important, but we’ve told the state that our needs in rural areas are different. Many pieces of state legislation are geared to the Front Range.”

The awareness campaign Hickenlooper proposes is a solid idea, Wise Romero said. If the stigma associated with mental health were erased, people with behavioral problems could feel comfortable seeking help.

Lezlie Mayer, director of La Plata County Department of Human Services, is waiting to see what’s on the governor’s mental-health agenda.

The department does some mental-health work such as family therapy and play therapy for children, Mayer said.

The department receives 80 percent of its revenue from the state and the remainder from La Plata County.

daler@durangoherald.com

Rusty Connor, acute nursing supervisor, and Mary Trujillo Young, senior director of clinical services at Axis Health System’s acute treatment unit, describe the operations of their facility. Enlarge photo

JERRY McBRIDE/Durango Herald

Rusty Connor, acute nursing supervisor, and Mary Trujillo Young, senior director of clinical services at Axis Health System’s acute treatment unit, describe the operations of their facility.

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