Colorado’s need for mental health care has never been greater, after a year of living under the dark clouds of COVID-19, economic disruption, social unrest, record wildfires and another mass shooting.

Government money has never been easier to come by. Peanut butter, meet jelly.

The problem for the General Assembly, with billions to divvy up, is priorities and follow-through, more than politics or money, according to advocates and lawmakers engaged in figuring it out.

They don’t lack legislation to get there. More than a dozen significant bills this year take aim at mental health care shortcomings in Colorado that span years, if not decades, to address the growing awareness of the mental well-being, touching the tar-papered barns of the Eastern Plains as much as mountaintop mansions of Telluride.

With billions coming from the federal government, lawmakers also are flush with budget cash left over from cuts that were too deep a year ago and the prospects of a robust economy returning faster than expected. Sen. Brittany Pettersen contends there’s never been a more important time to rebuild the state’s emotional well-being alongside its infrastructure and economy.

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For years, Pettersen, a Democrat from Lakewood, has invested political capital on Sisyphean fights to fund substance abuse programs, as well as other mental and behavioral health care. 

She is sponsoring the most important piece of legislation this session: the Behavioral Health Care Recovery Act, Senate Bill 137, a $34 million proposal that covers a rainbow of old and new programs with state funding and a fair share of one-time federal recovery money.

“It’s really important that as we look at economic recovery, we’re also looking at the health and well-being of Colorado and of Coloradans,” Pettersen told the Senate Health and Human Services Committee as she unveiled her master plan on March 31.

Legislators, however, will have to bear in mind that state and federal stimulus money, by definition, is temporary, and means initiatives started with it will have to be funded by taxpayers or cut later on. That’s the balance forward-thinking lawmakers must consider.

Colorado’s Taxpayer’s Bill of Rights will force cuts in government spending, if the new programs push the state past its constitutional spending cap triggered by, ironically, a growing economy.

Besides restoring cuts from a year ago, Pettersen’s bill expands funding for rural mental health partnerships, wipes away expiration dates on existing pilot programs and invests on the law enforcement side of the equation to quell trade in methamphetamine, fentanyl and opioids.

“The bill is very big,” Pettersen said. “We’re doing a lot in this, but it’s going to be critical to not only adults’ mental well-being, but also for our kids.”

Big problems demand big solutions, she contends.

As the federal dollars materialize, Pettersen  expects some “significant amendments” as her bill makes its way to the governor’s desk through the Democrat-led Legislature.

She advised “going bigger to put money where it needs to be.”

Of 12 bills that specifically address mental health, only two lack bipartisan sponsors. One is Pettersen’s comprehensive package. The other would require insurers to cover annual mental health wellness exams.

Lawmakers seem likely to create a state Behavioral Health Administration to put efforts under one administrative roof, a recommendation of a task force that looked at improving how Colorado provides services and spends money.  

Other bipartisan legislation would:

• Allow the Public Utilities Commission to set a telephone surcharge to pay for the 9-8-8 suicide prevention hotline.
• Strengthen peer counseling.
• Fund mental health programs for police.
• Expand suicide prevention training.
• Train court officials who deal with domestic violence and child abuse cases.

Worsening issues

What the pandemic gives Colorado in stimulus dollars, it has taken away in terms of emotional and financial stability, especially for the unemployed, struggling families and children across the economic spectrum, according to researchers.

Mental Health America calculated that 9.7% of youths in the U.S. have major depression, up from 9.2% the year before. In children who identify as more than one race, the rate is 12.4%.

The rate also soars for gay teens. In September, more than half of LGBTQ children ages 11 to 17 said they had had thoughts of suicide or self-harm in the previous 14 days, according to the survey.

In 2019, before lockdowns and layoffs, 1,312 Coloradans took their life — the highest number of suicides on record, according to the U.S. Centers for Disease Control and Prevention. 

Colorado ranked fifth in the country in the country then with 22.1 suicides per 100,000 residents, or more than four times the suicide rate of Brooklyn. 

Freshman Rep. Lindsey Daugherty, D-Arvada, passed a key suicide prevention out of the House, 57-6, on March 31.

She called House Bill 1119 a comprehensive approach, providing more access for students and teachers to get the guidance they need to help others.

She worries about dark thoughts being contagious, pointing to research that indicates people who knew someone who committed suicide were 1.6 times more likely to have suicidal thoughts about themselves, and 3.7 times more likely to attempt suicide. Children or adolescents who know about a friend’s suicide attempt are nearly twice as likely to attempt suicide.

“Far too many Coloradans have felt the gut-wrenching sadness and heartbreak of a suicide attempt,” she said.  

Overdoses also spiked in 2020. The 443 recorded overdose deaths from January to April 2020 represented a 35% increase over the same period in 2019, according to the Colorado Health Institute.

Another sponsor on the omnibus bill, Sen. Faith Winter, D-Westminster, called drug abuse an “epidemic in a pandemic.”

“Even with these advancements, there’s still so much work that needs to be done,” Winter said, “and more work can be done with the support of the General Assembly.”

Mental Health America found a five-fold increase in mental health screenings for stress over the last year, and a 600% spike in screenings for depression.

Meanwhile, Colorado ranked 47th when Mental Health America measured the prevalence of mental illness against access to care.

Urgency of violence

In years past, mental health has had to get in where it would fit into the state budget, but after 10 people were killed at a Boulder grocery store on March 22, those who don’t want to talk about regulating guns are more eager to focus on mental health.

Senate Majority Leader Steve Fenberg, a Democrat from Boulder, said that mental health is part of the conversation on how to respond to Colorado’s latest mass shooting.

“It’s an area that we absolutely have to do a better job on, and I think there will be bipartisan support to do so,” he said.

In 2019, Democratic majorities in the House and Senate overpowered Republicans to pass a red flag gun law to temporarily seize guns from those who are a danger to themselves or others. The family of the accused killer in Boulder had concerns about his weaponry, but they never contacted authorities, so the precaution was of no use. 

“I don’t know if the law needs to change, but I do think we need to make sure that people know about it,” Fenberg said.

A Columbia University study published in the journal Psychological Medicine in February looked at 1,315 mass murders worldwide and found that only about 11% of the perpetrators had a diagnosable mental illness, such as schizophrenia or mood disorders, and fewer than 1 in 5 involved a weapon other than a gun.

Instead, researchers found mass shooters typically faced legal issues, used recreational drugs, abused alcohol or exhibited anti-social but nonpsychotic symptoms.

Those are exactly the types of mental health programs, however, covered by legislation on the table.

Being aggressive

Children have lost what they can never recoup, time. High school students have missed school activities, social development, proms, graduations, the snapshots of life those before and after will share.

Logan County Commissioner Byron Pelton said that he knew of 10 suicides in northeastern Colorado since last fall; eight were school-age children, he said.

Summit County Commissioner Tamara Pogue worked in behavioral health for 10 years before she became an elected official.

“I have held a parent’s hand when their 13-year-old committed suicide. I’ve seen families torn apart because of their inability to access behavioral health care,” she said. “Quite simply, no matter where you look, the system is underfunded and it is a crisis.”

Moe Keller has watched from her front-row seat at the Colorado Capitol for two decades.

She has advocated for Mental Health Colorado for 10 years, after she spent eight years in the Legislature fighting for mental health issues to have a place at the negotiating table.

“This is aggressive,” Keller said of this year’s bills.

By taking significant steps to address mental health, lawmakers are following the example of local leaders across Colorado, who see the impact of failing to take mental health seriously:  homelessness, drug abuse, alcoholism, disrupted classrooms and broken families, she said.

The pandemic brought those issues into sharper focus.

“Our state is undergoing a collective trauma,” said Frank Cornelia, deputy director of the Colorado Behavioral Healthcare Council, which represents the state’s 17 mental health centers, service organizations and clinics.

“This funding would change and save lives in so many ways.” 

Gov. Jared Polis spoke of the tough times during the kickoff of National Child Abuse Prevention Month online and promised hope over the horizon.

“This crisis is cause for us to reinvest in the things we once took for granted, like safe, nurturing places where our kids could learn and thrive and play and grow.”

If you or someone you know is having mental health struggles, including thoughts of suicide, Colorado has a free 24-hour help line. Colorado Crisis Services offers free, confidential, professional support. Call 1-844-493-8255 or text “TALK” to 38255.