On Edge: Coloradans struggle with mental health in a state ill-prepared to help them

On Denver’s west side, an elderly man had been managing his solitude just fine until the pandemic hit, taking with it what social life he had and leaving a loneliness he had not felt for years. Not far from his house, a young woman fights panic attacks after COVID-19 killed her grandfather and landed her in the hospital. Now, she fears the virus will come for her again and this time she will die.

On the Eastern Plains is a third-generation farmer, and if the pandemic does not weigh on him heavily, this year’s record drought and the crop failure it caused do. It sets off an irritability and dread that words do not capture.

In this year of body blows dealt by the pandemic — the shaky economy, fire and drought, civil rights reckoning and a polarizing election — Coloradans are on edge. The state already had a greater demand for behavioral health services than it could provide. And the safety net that even Colorado’s top mental health official says has “too many holes” might be further frayed by the tight state budget. 

These crises have led to a well-documented flood of calls to crisis and referral lines, and nearly half of Coloradans recently reported experiencing anxiety or depression.

“I have heard people saying that we are all in the same boat,” says Kristen Cochran-Ward, director of Connections, a mental health and substance abuse program at the Health District of Northern Larimer County. We are not all in the same boat. We are all in the same storm. And some people might be in a cruise ship and some might be on a tire raft.”

“Too many holes in the net”

This year’s heightened mental health needs have run headlong into a complex constellation of decades-old challenges: the state’s higher-than-average prevalence of high-risk mental health conditions; a backlog of demand caused by red tape among state agencies and private insurers; a behavioral health workforce shortage compounded by not enough psychiatrists and psychologists who accept public or private insurance; cultural stigma; and slow public and political recognition that mental health is as important as physical health.

For communities of color that have a history of trauma and lack of access to health care, the need has been especially acute.

The Colorado Health Institute has been surveying residents about behavioral health and access to care since 2009 and found the situation generally deteriorating ever since. Based on its data, 870,000 Coloradans were in significant distress in 2019.

Nationally, Colorado has the third-highest prevalence of mental illness among adults, according to the most recent annual report by Mental Health America. That report, based on data from 2017 and 2018, also finds Colorado has the nation’s highest percentage of adults with substance abuse disorder and the third-highest percentage of adults considering suicide. Colorado’s suicide rate hit nearly 22 per 100,000 in 2018 compared to an average of 14 per 100,000 people nationally. Our national rankings for young people are not much better.

Theories about what explains Colorado’s grim statistics run the gamut from altitude to higher rates of gun ownership to a culture of Western self-reliance that downplays emotions.

“‘Pull yourself up by your bootstraps’ is probably the most misleading statement ever,” says Colorado Department of Human Services Office of Behavioral Health chief Robert Werthwein, noting the credo wrongly assumes mental health hinges solely on individual will rather than on genetics, brain chemistry, trauma and other factors.