Millions of Americans are affected by mental health conditions every year. The statistics are overwhelming. In 2017, Colorado saw a record 1,175 suicides and an all-time high number of drug overdoses, according to the Colorado Health Institute.
“There’s a severe shortage of mental health professionals in rural areas.” Jen Fanning, Director of the Grand County Rural Health Network, said, “Solving a complex social issue like mental health and wellness requires participation from many partners in a coordinated effort. We have a real problem. If we align common goals and work together, I believe we can build momentum and help fill in some of the gaps.”
Mind Springs Health, behavioral health provider on Colorado’s western slope, maintained a contract with the state that provided mobile and walk-in crisis services across its 10-county service area, which included Grand County. On July 1st, that region was expanded to 22 counties and the state transformed responsibilities, coverage and funding allocations which made it an extremely difficult region to service.
Mind Springs Health’s Granby clinic is still providing local outpatient services, but when the announcement came to light that Mind Springs Health would no longer be contracting with the state to provide emergency services, the nationwide crisis became reality for Grand County and the other counties they serviced.
At that point, Rocky Mountain Health Plans, a Grand Junction-based mental health organization, announced it would begin providing crisis services for the region. Fanning said, “The problem is Rocky Mountain Health doesn’t have the infrastructure in place at this time and the bulk of the crisis work unfortunately falls into the hands of local law enforcement.”
A mental health crisis is described as any situation in which a person’s actions, feelings, and behaviors can lead to them hurting themselves or others, and/or put them at risk of being unable to care for themselves or function in the community in a healthy manner.
By law, mental health benefits are supposed to be as good as medical coverage. But that’s on paper. In real life, the reasons for the disparity — set in place decades ago, when mental health care was isolated from the rest of health care — are multiple. Determining what is “medically necessary” in mental health is more loosely defined than in the rest of medicine. Federal and state regulators are often too overburdened to enforce parity laws. Mental health insurance parity is not happening, according to multiple research projects and highlighted in the stories of those who try to get coverage for treatment of depression, anxiety and addiction.
An effort to enforce the nation’s mental health parity laws is in the works in Colorado, where insurance companies pay mental health doctors 30 percent less than they pay other medical professionals. “That parity is part of the problem,” said Fanning. Mental health is extremely underfunded throughout the state. “If you are very wealthy, you have access to behavioral health care,” according to Fanning, “If you are very poor and can get into the safety-net system, you can get good care. Everybody in the middle? It’s pretty much not there.”
Transitional conversations are ongoing between Mind Springs Health, Rocky Mountain Health Plans and other local providers. Fanning said, “We have many challenges to navigate in this very complex issue and adequate funding is part of the problem.”
Grand County Commissioner Rich Cimino is floating a new idea that may be put forth on the 2019 ballot. “Currently much of the Mental Health crisis work falls on the back of our Sheriff’s Department.” Cimino said, “The idea to raise money for the ongoing mental health issues in our community has come forward and I believe we may have a solution.”
The designs for the new ‘Detention Facility’ has identified a mental health component and currently the county commissioners are trying to navigate a funding base for the entire complex. One of the funding options is to increase the sales tax by .2% for the county. Cimino feels that if you took 20% of that amount and put it into a mental health account, you could raise more than $200,000 a year according to county accounting estimates. “That money could be used to pick up some of the shortfalls in the system,” said Cimino.
“We are discussing all possibilities. We want to bring it to the people and let the vote decide what is best for the community.” Cimino added, “We know we have a mental health care shortfall in our community. How can we provide the necessary funds is the question.”
Wrapping a mental health component into a facility funding ballot can be a risk. Cimino said, “We are still discussing the best way to fund the project and provide mental health funding.”
“If a ballot measure doesn’t pass, we will roll up our sleeves and figure it out. It may be necessary to delay construction and/or possibly downsize the facility.” He added, “at that point we don’t believe there would be enough funds to include a mental health component.”
The county will hold a presentation and public comment period in Hot Sulphur Springs, Board of Commissioners meeting room, Monday night, August 5th from 6pm-8pm.