Reform our mental health safety net and then fill in the holes

Everyone agrees that Colorado’s mental health safety net system is in crisis. All you have to do is drive through downtown Denver to identify the massive need. Not everyone living on the streets suffers from mental illness, but many do, and when you add substance abuse, the immediate need for a robust treatment and care process becomes apparent.

And thanks to the investigative work that Susan Green has done with the Colorado News Collaborative, we hope there will finally be the political will to do something to fill the gaps in the mental health safety net.

Currently, the Colorado system is operated almost exclusively by nonprofit organizations that have single-source contracts with the state and little outside oversight. There has never been a more significant time for the externally funded performance and financial reviews of these 17 regional centers for community mental health. The state should demand operational efficiencies so that more money can be invested in treatment.

We 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 gross negligence. And health care workers on the front lines of America’s mental health crisis – amid a pandemic – need our support and gratitude.

In fact, some agencies, notably North Range Behavioral Health in Greeley, use federal and state dollars more efficiently and effectively, and report lower overhead costs and shorter waiting times in the community for treatment.

However, candor from former employees of 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 their concerns by Robert Worthwin, director of the Office of Behavioral Health, paint a picture of the mental health network. The country needs reform.

Worthwin probably summed it up best, telling the Colorado News Collaborative, “Centers and the state are letting people down.” Werthwein, who also opened up about his struggle with mental health for an influential article written by Greene, announced last week that he is quitting, and we’re sad to see him go at such a critical juncture.

So what should happen?

Well first, we shouldn’t hurt.

The Denver Mental Health Center serves 20,000 people annually with not only physicians capable of treating complex mental health conditions, but comprehensive services including housing, food pantry, and crisis services available 24 hours a day 7 days a week.

“We are trying to serve everyone,” said Kristi Mok, vice president and director of operations at the Center for Mental Health in Denver, noting that one of their struggles is finding patients on the street who have stopped coming for treatment. Mock said they have staff on the STAR joint response team working with first responders and social workers who pay for hotel accommodations while homeless patients settle down.

Doing anything that jeopardizes that care is unacceptable. The center has plans to increase the salaries of all employees to a living wage of about $50,000, hoping to stem the wave of resignations and also attract new employees.

However, it is also clear that the need is much greater than what these 17 regional centers can handle on their own even when they are operating at full capacity.

Individuals are falling through the loopholes, and we believe one possible solution is to open up the system so that more caregivers can; More centers that focus on homelessness or medical treatment are eligible for increased Medicaid reimbursement rates if they serve Medicaid patients or indigent patients with mental health needs.

The state can encourage growth in the system by increasing the Medicaid reimbursement rate overall. Governor Jared Polis is proposing $450 million in coronavirus relief for mental health.

However, the investigation from the Colorado News Collaborative raised serious questions about whether dumping this money into the current system would give the state as much money as possible. The funds must come with terms that include reducing overhead costs, treating the most difficult cases, and increasing psychiatric beds for inpatient care.

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