Bureaucracy Worsens Colorado’s Mental Health Crisis | Health

Bureaucracy Worsens Colorado's Mental Health Crisis |  Health

Let’s say your neighbor’s house is on fire. Let’s say you respond by gathering your neighbors in front of the house. Two determined people try to take control of the situation but cannot agree on who will lead. So you and your neighbors decide you don’t really need leaders, the whole group can handle that democratically, so you form a working group to discuss options. Soon you’re dividing into study committees to make lists of the best approaches — Get out the hoses or wait for the professionals? Call 911 or call the fire station directly? Spray water or use foam extinguishers?

Then let’s say you all form an agency of the boldest and bravest among you to fight the fire and have your new agency do a thorough study on how best to extinguish the fire and do report in a week. Then, as the house burned down at that time, you all decide to collect and buy smoke detectors for your telephone poles. Which, of course, won’t help.

I think we can all agree that this may not be the best way to put out a fire. Yet that is exactly what is happening with the mental health care crisis in Colorado, which I would argue is no less of an emergency than a raging fire in your neighbor’s yard.

Colorado Children’s Hospital has declared a state of emergency for youth mental health two years ago, in 2021, and the number of sick children has only increased since then. According to the 2021 Healthy Kids Colorado Survey, nearly 40% of high school students reported experiencing symptoms of depression. Just over 17% said they had seriously considered suicide in the past year.

The number of children in emergency rooms with a primary diagnosis of mental health or self-harm has more than doubled from 2,002 in 2016 to 5,168 in 2021, according to a review of data compiled by the Center for Improving. Value in Health Care.

And just last week, we learned that the head of the governor’s vaunted new bureaucracy created specifically to deal with this crisis, the Behavioral Health Administration, is stepping down after just over a year.

Dr. Morgan Medlock, formerly chief medical officer of the Washington, D.C. Department of Behavioral Health and clinical psychiatry researcher at Harvard Medical School, told the Colorado Sun she left the firm after a dispute with the new chief of governor’s office, Alec Garnet. She said she was basically told to hand over control of the agency to someone else from the Colorado Department of Social Services.

Looks like the turf wars have taken over the children of the state.

When the Medlock nonsense took over, many of us who worried deeply about the state of mental health care in the state finally believed that we had moved beyond the study, the sub-committee, the working group and the endless discussions on the problem. resolution phase of our broken mental health system. It felt like we finally hired a badass to fix things, finally had some skin in the game, and entered the phase of real people solving real problems.

Boy, it certainly didn’t last long.

The agency has been marked by controversy since its birth. More recently, a report by The Gazette’s investigative editor Chris Osher revealed that the bureau had spent $61 million to improve clinical staffing at the state’s two psychiatric hospitals, resulting in no hiring only four nurses. Most of the money went for other purposes, including “grants to improve the workforce of community providers, repay loans for behavioral health care providers, expand peer support programs and other initiatives”.

The survey also found that with nearly half of the nursing positions vacant at the two hospitals in Pueblo and Fort Logan, “more people than ever are languishing in Colorado jail cells awaiting health care treatment. mentally ordered by the court to restore their skills. they can be judged.”

Last week, according to Osher, “449 people incarcerated in state prisons needed restorative treatment. The waiting list hit an all-time high last month, despite state officials who have promised three years ago that no one should have to wait in jail for more than 28 days for sanity recovery if they were found incompetent for trial.”

The BHA was supposed to fix all that. It was intended to provide leadership, coordination, and standardization for nearly 100 existing mental health programs housed across a multitude of state agencies. However, these programs remained housed in their home agencies and partially overseen by those agencies, leading to concerns among Legislative Joint Budget Committee staff in 2021 that the BHA was little more than another tier of bureaucracy.

This lack of clarity as to who exactly is in charge of fighting this out-of-control fire is why Medlock leaves.

“I had a great relationship with the former chief of staff and things have changed in recent months,” Medlock told The Sun. “In the context of an administrative dispute…I was put in a light where I was asked to essentially cede control of the BHA to another person. I didn’t feel like I could continue to serve with integrity in light of that.

Prior to the establishment of the BHA, behavioral health surveillance was primarily the responsibility of the Colorado Department of Human Services, led by Michelle Barnes. It’s funny, but Barnes is the person who took over oversight of the BHA as a nationwide search for a new commissioner takes place.

When he appointed Medlock to his cabinet, Polis called him “transformational change” in the state’s behavioral health system.

The new agency was recommended by a working group that met for an entire year before recommending the new structure. Even this process was slow and bureaucratic, and working group members complained to me on occasion that they didn’t feel like they were doing anything practical.

What’s even more heartbreaking is that the Behavioral Health Administration was created at the same time Colorado was pouring $450 million in federal COVID relief funds into mental health services. Here is a unique injection of vital resources that could make an extraordinary difference for our children.

So far, the BHA has invested $150 million in services, the governor’s office said, including $61 million for four nurses. But much of that emergency money still needs to be spent. It just sits there in the state coffers like a fire truck idling in front of a fire with its hoses still hidden.

And yet the fire at our neighbor’s house is raging.

Someone please grab a pipe.

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