Everyone is in agreement that Colorado’s safety-net mental health system is in crisis. All you have to do is drive downtown Denver to get a sense of the vast need. Not everyone living on the streets is struggling with a mental illness, but many are, and when you add in substance abuse, the immediate need for a robust treatment and care operation becomes apparent.
And thanks to the investigative work of Susan Greene with the Colorado News Collaborative, we are hopeful there may finally be the political will to do something to close the gaps in our mental health safety net.
Right now, Colorado’s system is run almost exclusively by nonprofits that have sole-source contracts with the state and little external oversight. There has never been a more essential time for externally funded performance and financial audits of these 17 regional community mental health centers. The state must demand operational efficiencies so more money can be put into treatment.
We do want to be clear – there are varying degrees of problems across the network – and no one is accusing these agencies of financial wrongdoing or even of gross negligence. And the health care workers on the front lines of this American mental health crisis – in the middle of a pandemic – need our support and gratitude.
In fact, some agencies, particularly North Range Behavioral Health in Greeley, use federal and state dollars efficiently and effectively, reporting lower overhead costs and shorter wait times in the community for treatment.
However, candor from past employees at other regional mental health care facilities, a letter to the governor from officials across the state concerned about the system, and an incredible willingness to voice concerns by Robert Werthwein, director of the Office of Behavioral Health, paints a picture of a state mental health network in need of reform.
Werthwein perhaps summed it up best, telling Colorado News Collaborative: “The centers and the state have been failing people.” Werthwein, who also opened up about his own struggles with mental health for a poignant article written by Greene, announced last week he was resigning, and we are sad to see him go at such a critical juncture.
So what needs to happen?
Well first, we must do no harm.
The Mental Health Center of Denver serves 20,000 people a year with not only doctors capable of treating complex mental health cases, but also wrap-around services including housing, a food pantry, and crisis services available 24 hours a day 7 days a week.
“We are out there trying to serve everyone,” said Kristi Mock the vice president and COO of the Mental Health Center of Denver, pointing out one of their struggles is finding patients on the street who have stopped coming in for treatment. Mock said they have staff on the STAR co-responder team working with first responders and social workers paying for hotel stays while homeless patients stabilize.
Doing anything to jeopardize that care is unacceptable. The center has plans to increase pay for all employees to a living wage of around $50,000, hoping to stem the tide of resignations and also to attract new employees.
However, it is also clear that the need is far greater than these 17 regional centers can handle on their own even when they are operating at full capacity.
Individuals are falling through the cracks, and we do think one possible solution is to open up the system so that more care providers; more centers focused on homelessness or medical treatment are eligible for the increased Medicaid reimbursement rates if they serve Medicaid or indigent patients with mental health needs.
The state could encourage growth in the system by generally increasing the Medicaid reimbursement rate. And Gov. Jared Polis is proposing to put $450 million in federal coronavirus relief dollars toward mental health.
That being said, the investigation from the Colorado News Collaborative has raised serious questions about whether throwing that money into the current system would give the state the most bang for its buck. Money should come with strings attached that include reducing overhead costs, treating the most difficult cases and increasing psychiatric beds for inpatient care.
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