In the 2023 “State of Mental Health in America Report” (compiled by Mental Health America [MHA]), Colorado ranked at #30 of all states based on a combination of statistics as to how prevalent mental illness is and how available mental health services are. This means 29 other states were doing better overall—i.e., they had a combination of lower prevalence of mental illness and greater availability of services. When the report zeroed in on only the adult populations in the states, Colorado’s rank fell to #45.

Also on the national level, MHA found that fully one-fifth of adults in the U.S., over 50 million people, have a diagnosable mental illness at some point, but more than half of these people receive no treatment. One reason being that about 11% of them are uninsured. There is also a sizable number whose insurance doesn’t cover the mental health care they need. And in many places needed care is simply unavailable or inaccessible.

Meanwhile Kaiser Health News reports that the U.S. Preventive Services Task Force (USPSTF) suggested in 2022 that adults be screened for anxiety. (USPSTF is a federally funded, independent panel of experts that makes evidence-based recommendations about the effectiveness of specific preventive-care services for patients.) But, inexplicably to many, the USPSTF left out one group for this anxiety screening recommendation: adults age 65 and older. Why? The Task Force said there was “insufficient evidence” to assess the balance of benefit vs. harm in screening for this age cohort.

This, despite the fact that research indicates up to 15% of people age 65 and older who live outside of nursing facilities have a diagnosable anxiety condition. An editorial in the journal JAMA Psychiatry stated only about one-third of seniors with anxiety disorders receive treatment. Which is concerning since such disorders can have links to stroke, adverse heart conditions, and neurodegenerative problems such as dementia. Other anxiety disorders in seniors can include phobias, panic disorder, social anxiety, hoarding, fear of falling, and post-traumatic stress disorder (PTSD). 

A Colorado “aging vulnerability index”

The Colorado Health Institute (CHI) in 2018 created an index that pinpoints counties with the highest proportion of vulnerable seniors. It was based on two factors — risks such as poverty, age, or living alone, and needs such as physical or cognitive difficulties. A score of 10 indicated areas with the most vulnerable seniors. A score of 1 meant an area had the least vulnerable seniors. CHI’s aging vulnerability index showed that older Coloradans in some parts of the state were more vulnerable and would most likely need more health care and supportive services than others. The index cited four factors as leading to higher vulnerability: being over age 80, having no more than a high school education, living alone, and being below the poverty level.

Among the specific findings were:

  • Colorado’s overall aging vulnerability score was 4.9.
  • Counties on the Eastern Plains and in the San Luis Valley had the highest concentrations of vulnerable seniors.
  • Otero County scored 9.2 on the overall vulnerability scale — the highest in the state. Baca, Costilla and Crowley counties were second, each at 9.1. Park County had the lowest vulnerability score in the state at 1.6.
  • Mountain counties, including Park, Summit, Ouray, and Clear Creek, were the least vulnerable, with seniors reporting lower levels of both risk and need.
  • Front Range counties had overall lower levels of vulnerability than rural ones, but were home to larger numbers of seniors.

Colorado targets action on mental health

Colorado has taken note of its shortcomings in the area of mental health services. One step to addressing them occurred in 2019 when the Colorado Department of Human Services created the state’s Behavioral Health Task Force, which was charged with creating a blueprint for better serving people who are struggling with mental health issues. This in turn led to establishing the cabinet-level agency called the Behavioral Health Administration (BHA). BHA’s aim is to foster collaboration across state agencies dealing with mental health and consolidate public funding streams in hopes of making services more readily accessible to more people.

Through BHA, more than $130 million in federal funds was reportedly made available in late 2022 to Colorado communities to support care programs. Last year the Colorado legislature also reportedly disbursed about $80 million in COVID funding to train behavioral health providers. One specific enhancement is implementing the new 988 Suicide and Crisis Lifeline in Colorado that connects people to the existing National Suicide Prevention Lifeline, where care and support is available for anyone experiencing mental health–related distress. Another enhancement is boosting telehealth services for accessing mental health counseling. The latter is a gap filler that is particularly vital in rural areas where mental health personnel and clinics are in short supply. (See details on the 988 Crisis Line in Colorado at https://bha.colorado.gov/behavioral-health/988.)

A closer look at BHA in Colorado

In line with its collaboration goal, the BHA on its website at https://bha.colorado.gov/ presents a wide variety of options to access mental health services. Here are several key ones.

Own Path. You can use this option to find BHA licensed providers by zip code. Through BHA you can also connect to Colorado LADDERS, which is a database of providers and services available in the state.

Colorado Crisis Services (CCS) is a statewide behavioral health crisis response system offering residents mental health, substance use or emotional crisis help, information and referrals. CCS is an AgeWise Colorado Provider (see https://agewisecolorado.org/provider/colorado-crisis-center/.)  CCS provides Coloradans with greater access to crisis services wherever they are regardless of ability to pay. Crisis clinicians and peer specialists are available 24/7/365 via phone, text, or in-person at walk-in centers. If you don’t know where to begin getting help with a mental health, substance use or emotional concern—for you, or for someone you know—this is a good place to start.

When you call CCS, you will be connected to a clinician—or you can choose to speak with a peer specialist who has gone through experiences similar to yours. Translation services are available in more than 200 languages. CCS engages in immediate problem solving and as needed can make follow-up calls to ensure you receive continued care. CCS says “No problem is too small.” Common call topics include: depression, substance use, grief and loss, self-injury, suicidal thoughts, stress, trauma, drugs and alcohol, relationship problems, family crisis, anxiety, COVID-related challenges, domestic violence, homelessness, disability, concerns for a friend or family member, recovery support, and resource questions.

Services are most often provided via phone, text or telehealth. If you prefer and can readily access walk-in service, you will complete a brief screening to determine the next steps, which will likely involve meeting with a clinician for a thorough evaluation. This process helps decide what next steps are needed. This may also include a brief physical health screening by a medical professional. Walk-in services are available regardless of one’s ability to pay. If an individual has private insurance, a co-payment and other out-of-pocket expenses may be required depending on the plan coverage. However, no payment is required at the time of service, and no one will be turned away for crisis services, regardless of ability to pay.

CCS can in some instances come to you. If a clinician determines that the best intervention requires face-to-face interaction, a Mobile Crisis Clinician may be dispatched. A mobile clinician may travel to a variety of locations in the community (schools, homes, churches, etc.), including a discrete location of your choosing. Note that in rural areas, this could take up to two hours for the team to arrive (up to one hour in urban areas.)

You can contact Colorado Crisis Services at 844-493-TALK (8255) or text “TALK” to 38255. Learn more at https://coloradocrisisservices.org/.

Connect to Community Mental Health Centers in Colorado

The BHA contracts with close to 20 community mental health centers (CMHCs) throughout Colorado for the provision of mental health treatment services to individuals and families who are low-income or not covered by insurance. Visit the CMHC web page for more information and to see a county-by-county key to locating a CMHC in your area. (See additional information about CMHCs in the description of the Colorado Behavioral Healthcare Council at the end of this article.)

Colorado Wellness Recovery

The challenges a friend or loved one experiences with mental health or substance use can also affect the circle of individuals around them, especially their caregivers. While the care and encouragement you offer your loved one is critical, it is also important to recognize your need for support as well. Seeking support for yourself to maintain your own mental wellness may be the most important step you can take to help your friend or family member.

The BHA can connect you with Colorado Wellness Recovery, described as a Mental Wellness and Addiction Recovery Guide. With the Guide you can explore resources and community networks that can help you with:

Individual counseling. Meet with a mental health professional to discuss some of the unique challenges you are facing. A counselor can help you identify healthy coping, manage stress, and support in maintaining your own mental health. Find a counselor using the Office of Behavioral Health’s treatment search website, the search tool mentioned above in conjunction with BHA’s “Own Path.”

Networks and communities. Connect with caregiver or support groups for friends and family of people with mental health or substance use disorders. These groups can help you learn from others who have been or are going through similar experiences, as well as increase the chances that you receive support from a community of understanding individuals. Learn more and see how to find either in-person support groups or online networks at https://cowellnessrecovery.org/.

Colorado Crisis Center

Colorado Crisis Services is the statewide behavioral health crisis response system offering residents mental health, substance use or emotional crisis help, information and referrals. Its mission is to strengthen Colorado’s mental health system by providing Coloradans with greater access to crisis services wherever they are at 24/7/365 regardless of ability to pay. Visit them at: Colorado Crisis Center – AgeWise Colorado

As of July 16, 2022, Colorado, along with the rest of the United States, is using the 988 dialing code.

988 is the new, easy-to-remember three-digit number for calls (multiple languages), text, or chat (English only) that connects people to the existing National Suicide Prevention Lifeline (Lifeline), where compassionate, accessible care and support is available for anyone experiencing mental health–related distress. The chat feature will be available through the Lifeline’s website.

Rocky Mountain Crisis Partners

Rocky Mountain Crisis Partners (RMCP) is a statewide, 24/7, year-round, community-based system of crisis intervention services which people experiencing mental health and/or substance abuse crises can get in touch with to be assessed, safely and effectively stabilized, and efficiently linked to appropriate follow-up care and services. RMCP is an independent, nonprofit charitable organization that offers skilled care to individuals and families in crisis through a staff of compassionate professionals and peers. This system uses what it calls a Care Team Model that “weaves varying expertise,” including peers who have lived experience or are currently living in recovery.

RMCP operates “Crisis Line” services year-round, primarily through telephonic and electronic communication. (A texting option is available for individuals that would prefer that or those who find direct verbal communication challenging.) The services are for anyone who is personally struggling with a mental health, emotional problem, or substance problem or who is looking to help another find a path to recovery. RMCP says, “All calls and messages get immediate, expert, crisis care.” The RMCP team “rapidly evaluates complex behavioral health situations, then develops, recommends, and supports clinically appropriate and least restrictive crisis interventions to be implemented with individual clients, their families, and a wide variety of community helpers.”

Crisis Counselors will ask questions about your situation, your safety, your thoughts and emotions to work with you to develop effective plans. If a Crisis Line specialist feels you are in danger, he/she will discuss with you accessing emergency services and taking next steps to make sure you are safe. RMCP offers mobile dispatch through Colorado’s Crisis Services System (mentioned previously).

RMCP also offers the following:

Peer Support Line, which enables someone coping with mental health issues to, as RMCP says, talk to someone who is “like me.” Peer specialists listen, provide support, validate experiences and explore each caller’s story in a confidential non-judgmental conversation. This confidential telephonic support is available 365 days a year, from 7:00 a.m. – midnight.
Follow-up services, which may include further assessment of the presenting problem(s), continued safety screening, assistance with any needed additional resources, and identifying ongoing support.

Hospital follow-up, providing telephonic follow-up to recently discharged patients.

Opiate follow-up, to connect individuals to programs that utilize Medication Assisted Therapy or substance use related resources specific to opiate issues.

RMCP notes that research shows follow-up measures reduce future incidences of behavioral health crises and encourage follow through with treatment plans while improving self-report scores of depression and social isolation.

You can contact the RMCP crisis line at 844-493-TALK (8255) or text “TALK” to 38255. (The same contact points for Colorado Crisis Services described earlier.) Learn more about RMCP specifically at https://rmcrisispartners.org/.

Jefferson Center for Mental Health

The Jefferson Center for Mental Health (JCMH) is another AgeWise Colorado Provider that focuses on mental health matters. (See https://agewisecolorado.org/provider/jefferson-center-for-mental-health/.) The Center is a nonprofit, community-focused mental health care and substance use services provider that offers services for adults, including senior adults, veterans, and families. JCMH has a staff of approximately 700, about 400 of whom are clinicians. In addition to direct services, the Center also makes available an on-demand library of mental health webinars, online training, interactive online events where you can discuss and interact with presenters and other participants, and a variety of wellness classes for clients and the community to help foster health and recovery.

Clinicians on the Center’s Senior Services team have experience working with specific concerns of older adults, including chronic pain, isolation, grief and loss, dementia and other cognitive disorders, caregiving for such disorders, hoarding, and end-of-life transitions. Services for older adults through the Senior Services program at JCMH are delivered by way of two teams: 

  • Senior Services Outpatient offers an outpatient level of care and longer-term therapy. SSOP provides individual and group behavioral health services that address specific mental health needs. It also offers an anxiety clinic. JCMH accepts any payors on SSOP, including Medicare and private insurance.
  • Senior Reach is a nationally recognized, evidence-based program that provides community-based, short-term services meant to improve access and reduce barriers to care for individuals with mild to moderate mental health concerns. Senior Reach clients typically receive support for concerns such as grief and loss, adjustment disorder, mild to moderate anxiety, and mild to moderate depression.  More information can be found on the Senior Reach website: https://www.seniorreach.org/

Both programs offer engagement in the larger array of Jefferson Center services to provide additional wraparound support and quality-of-life sustainability. Both programs offer in-person services as well as telehealth options.

Crisis services are available in selected locations by calling 303-425-0300. Or call Colorado Crisis Services to speak to a trained crisis counselor at 1-844-493-TALK (8255) or text TALK to 38255. JCMH has a Crisis Walk-In Center at 4643 Wadsworth Blvd in Wheat Ridge, CO. Otherwise, to schedule an appointment for yourself or family member, call the Center at 303-425-0300, or complete the JCMH Contact Us form. Learn more at https://www.jcmh.org/.  (Note: Although the Jefferson Center was originally a Jefferson County entity, it now serves a multi-county region in and around the Denver area.)

Hope for Tomorrow

Yet one more AgeWise Colorado Provider offering mental services is Hope for Tomorrow (HFT), headed by Annika Papke, a mental health therapist who specializes in life transitions. (See https://agewisecolorado.org/provider/hope-for-tomorrow-counseling-llc/.) Papke has been a licensed professional counselor for over 10 years and says she is well versed in “helping families navigate the tricky conversations that come up in older adulthood” that involve mental health challenges. She “helps

guide families to a solution that feels right for everyone involved.” HFT provides in-person services in Broomfield, CO, and Papke is licensed throughout the state so she is able to provide online services to anyone in Colorado. To learn more or schedule an appointment with HFT, call 720-507-1913 or visit https://hftcounseling.org/.

Colorado Behavioral Healthcare Council

The Colorado Behavioral Healthcare Council (CBHC) is a more than half-century-old statewide membership association for Colorado’s network of community behavioral health providers. Its member centers serve Coloradans throughout the state with community-based services that promote well-being and good health by providing or contracting for direct services in hundreds of service delivery sites. CBHC also acts as an advocacy organization at both the state and federal level to ensure the continuation and expansion of care across our state. CBHC says its 16 community mental health centers have served more than 200,000 individuals in one recent year.

Those centers, along with two specialty clinics offering “culturally informed” services, offer a wide range of treatment and community services, including:

  • Outpatient counseling and psychiatric services
  • Crisis and emergency services
  • Case management and connection to care
  • Detox treatment centers
  • Child, youth, and family services
  • Housing support
  • Vocational services
  • Well-being promotion
  • Community organizing

CBHC says the centers also work closely with the law enforcement, judicial, education, and public health systems to ensure access to care for anyone living with a mental health or substance use disorder. The goal is to “ensure that effective, high-quality behavioral health services are accessible to all Coloradans across the state.”

Learn more and connect to service providers at https://www.cbhc.org/.