Everyone agrees that Colorado’s safety-net mental health system is in jeopardy. All you have to do is drive into downtown Denver to get a sense of the huge need. Everyone living on the streets struggles with mental illness, but there are many, and when you become involved in substance abuse, the urgent need for a robust treatment and care operation becomes clear.
And thanks to the investigative work of Susan Green with the Colorado News Collaborative, we hope there may be a political will to finally do something to close the gaps in our mental health safety net.
Right now, Colorado’s system is almost exclusively run by nonprofits that have sole source contracts with the state and little external oversight. There has never been a more pressing time for externally funded performance and financial audits of these 17 regional community mental health centers. The state should demand operational capacity so that more money can be invested in the treatment.
We want to be clear – there are a variety of problems throughout the network – and no one is accusing these agencies of financial misconduct or gross negligence. And 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, notably 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, clarity from past staff at other regional mental health care facilities, a letter to the governor from officials across the state concerned about the system, and an unrelenting willingness to voice concerns by Robert Wortheven, director of the Office of Behavioral Health, paint a reform. Picture of a state mental health network in need.
Worthwin probably summed it up best, telling the Colorado News Collaborative: “The center and the states are failing the people.” Worthwin, who also opened up about his own struggles with mental health for a poignant article penned by Green, announced last week that he was resigning, and we’re sad to see him at such a turning point. Huh.
So what should happen?
First of all, we must not do any harm.
Denver’s mental health center serves 20,000 people a year, with not only doctors able to treat complex mental health cases, but also wrap-around services, including housing, a food pantry, and crisis services, which last for weeks. Available 24 hours a day 7 days a day.
“We are trying to serve everyone,” said Christy Mock, vice president and COO of the Mental Health Center of Denver, one of her struggles is finding patients on the street who have stopped coming for treatment. Mock said he has staff from the Star co-responder team working with first responders and social workers who pay for hotel stays while homeless patients stabilize.
Doing anything to jeopardize that care is unacceptable. In hopes of stemming the tide of resignations and attracting new employees, the center plans to increase the salaries of all employees to about $50,000.
However, it is also clear that the requirement 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 think one possible solution is to open up the system so that more care providers; More centers focused on the homeless or medical treatment are eligible for increased Medicaid reimbursement rates if they serve poor patients with Medicaid or mental health needs.
The state can generally encourage growth in the system by 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 Colorado News Collaborative’s investigation has raised serious questions about whether throwing that money into the current system would give the state the most bang for its buck. There should be strings attached to funding that includes reducing overhead costs, treating the most difficult cases, and increasing psychiatric beds for patient care.
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