Too often, the public conversation around mental health begins with a tragedy. In Colorado, the Aurora theater shooting and at Columbine High School – as well as similar events across the United States – the discourse in news coverage and public-policy discussions is heavily infused with examinations of perpetrators’ mental-health struggles and how to prevent future tragedies. That is wholly appropriate but is just one small – albeit devastating – piece of the mental-health landscape.
From depression to substance abuse to schizophrenia to trauma-related disorders, mental-health challenges have profound implications for individuals, families and communities. The emotional and behavioral conditions that affect Coloradans’ lives are complex and manifold, as are their impacts on public and private health-care providers, schools, employers, the criminal-justice system, law enforcement and the state’s economy. Helping those struggling with mental-health issues must be similarly comprehensive, in terms of proactive and ongoing care, responding to large- and small-scale crises and in public policy. There are many such efforts afoot in Colorado and nationwide that hold much promise for addressing a widespread challenge.
According to the National Alliance on Mental Illness, about 1 in 5 Americans “experiences mental illness in a given year,” and in Colorado, 1 in 4 is affected by it – either as individual sufferers or as family members of those with a mental illness, according to Mental Health America of Colorado. The implications on the state’s hospitals – where 90,000 people sought emergency-room care in 2005 for mental-health issues, at a cost of $90 million – are significant, as are those for jails. More than 35 percent of inmates in the Colorado prison system have a mental-health diagnosis, and 27 percent struggle with substance abuse in addition to their mental-health challenges. These conditions present costly challenges to the state Department of Corrections and suggest – strongly – that treating mental illness early could forestall negative impacts for individuals, families and communities.
In order to do so, there are efforts in Colorado and beyond to destigmatize mental-health issues. Integrated care, where patients can receive services for physical, and behavioral health in the same location or through the same network of providers, is an effective means of doing so and is a key provision of the Affordable Care Act, both for public-health providers and private networks. Colorado received a $65 million grant in December to develop a plan for such an integrated system. Specifically, the work will focus on four goals: “To create a coordinated, accountable system of care that gives Coloradans access to integrated primary care and behavioral health; to leverage the power of our public-health system to achieve broader population-health goals and support delivery of care; to use outcomes-based payments to enable transformation; and to engage individuals in their care.”
Axis Health System has opened two such clinics in Durango and Cortez, and the model is sure to grow statewide, as it should. At such facilities, people can seek help for any and all health concerns – mental and physical – in a setting where a holistic consideration of patients’ needs is guiding care. The result is reducing the stigma associated with mental-health issues and the challenges associated with finding help early – as well as warding off the long-term devastation that untreated mental illness can have on individuals, families and communities. The money and effort are worth spending.
