League of Women Voters of Colorado
Behavioral Health Study 2015
STUDY GUIDE
Behavioral Health Study Guide
This guide accompanies the 2015
Behavioral Health Study materials and is
provided by the Behavioral Health Study
Committee.
Members of the Committee are available to
present this Study Guide.
To schedule a presenter, please contact Barbara
Mattison, Chair, LWVCO Behavioral Health Task
Force
303/322-4878 or mattisonleague@gmail.com
Brain Disorders
• Mental illness is a wide spectrum of brain
disorders, from mild to severe; those with
mental illnesses/brain disorders should not be
grouped into one category. For those reasons,
say “people with mental illness”.
• In substance use disorder, addiction means a
brain change – a brain disorder.
Access to Care
“Mental Health is the only physical illness where
we wait until stage four to do anything.”
Moe Keller, Mental Health America of Colorado
Parity and Integrated Care
• People are more likely to start and complete
behavioral health therapy offered in the same
place as their primary physical health care.
• “Behavioral health stigma is real. Everybody in a
small town recognizes your car or truck. When
you’re parked in front of a clinic that provides
integrated care, no one knows whether you are
there for physical or behavioral health services.”
Dorothy Perry, CEO, Spanish Peaks Behavioral Health System
Parity and Integrated Care
NEW Colorado SIM Project
Goal: access to integrated primary care and
behavioral health services in coordinated
community systems for 80% of state residents
by 2019
Federal Parity Act
• With ACA and federal Parity Act implementation, some
health insurance plans will have the same benefits for
physical and mental health – this is parity. Lifetime caps
and exclusions for pre-existing conditions will be gone.
• However, health insurance plans are falling short in
coverage of mental health and substance abuse
conditions according to a report issued April 1, 2015 by
the National Alliance on Mental Illness (NAMI), based
on a survey of 2,720 consumers and an analysis of 84
insurance plans in fifteen states.
Accessibilty
• 17 Community Behavioral Health Centers
provide a range of core services at almost 200
locations
• Care beyond core services is dependent on
local fund raising
• Behavioral health services are paid for
through many sources of funding. With
implementation of the Affordable Care Act
(ACA), Colorado’s uninsured rate has fallen
from 17% to 11%.
Accessibility: Colorado’s NEW Behavioral
Health Crisis Centers
A community place to ensure that people are
treated appropriately rather than being taken to
the Emergency Room or Jail
Accessibility in Colorado
• Colorado needs more behavioral health
providers.
• Providers are concentrated in Front Range
cities with some in mountain areas, Grand
Junction and southwest communities.
• Residents of eastern and northwest Colorado
have few, or no, provider options.
Accessibility in Colorado
• Colorado is 52nd (including U.S. territories) in the
number of hospital beds available for mental
health.
• Each state government department and division
(Department of Corrections, Division of Child
Welfare, etc.) and each educational institution,
etc. has its own specific silos, i.e. how its specific
funds will cover individuals; when an individual
leaves that entity, his or her health benefits go
away.
Children’s Behavioral Health
Over 50% of life-long mental health conditions
are present by age 14
Early identification is an important part of a
continuum of services
Children’s Behavioral Health
Challenges:
• Families in Poverty have barriers to quality
care
• Stigma influences whether parents will seek
and accept mental health care for their
children
• Child data collection in Colorado is segmented
with state departments, offices and agencies
collecting different data; information is not
uniform.
Children’s Behavioral Health
Challenges:
Comprehensive early childhood services, homeand school-based services, evidence-based
and trauma-informed assessment and
treatment, and integrated primary and
behavioral health care in pediatric settings are
not consistently
available across Colorado
Child and Adolescent Behavioral
Health
Youth and young adults with mental health
challenges between the ages of 14 to 25 have
unique needs and strengths that often
transcend services provided in traditional youth
and adult service systems.
These are ages when brain disorders
may become apparent.
Services are not consistent.
Children’s Behavioral Health:
Family and Community Support
• Family involvement is primary in a child’s
treatment and recovery.
• Families face a complex, fragmented
behavioral health system
• Office of Early Childhood focuses on adults in
children’s lives and support for their
behavioral health
• Colorado programs like Nurse Family
Partnership focus on first-time moms
Case Management: Homelessness
• People can’t work on their mental health
issues unless they have daily requirements
covered (food, housing and other
fundamental needs)
• MHCD’s High-Intensity Program: most clients have
spent time homeless or in hospitals or in the criminal
justice system
(typically for crimes relating
to homelessness such as
urinating publicly)
Case Management: Homelessness
• CO Coalition for the Homeless:
“Residential instability increases risk for serious
mental and physical health problems,
exacerbates existing illness, and complicates
treatment… preoccupation with securing food
and shelter leaves little time for medical
appointments. Pain and discomfort associated
with illness and treatment side effects are
compounded by lack of privacy, risk of abuse,
and theft of medications. Clients frequently
explain that they have ‘no place to lie down
during the day’ to rest and heal.”
Case Management: Re-Entry
“It is critical to keep people with mental illness
out of jail – the system can eat them alive.
Jails are the new repository for people
dealing with mental illness – there is hardly
any place to take people other than the jail.”
Nicky Marone, Executive Director, FOCUS Reentry
Case Management: Re-Entry
“It is not known whether people who leave
prison homeless have a higher failure rate on
parole, but it is known that people face
enormous challenges, including finding
housing, when they are released. Based on
our own research and interviews with
parolees, CCJRC believes that paroling or
discharging from prison homeless is a barrier
to successful re-entry and should be avoided
to the greatest extent possible.”
Colorado Criminal Justice Reform Coalition
Case Management: Re-Entry
People come to cities upon discharge from prison or jail
rather than going back to smaller communities
where they would be known
Re-Entry Work:
• Identify critical barriers to successful re-entry
• Identify internal strengths/external resources
• Build a multi-faceted plan/carry it out
• Focus Re-entry in Boulder provides a Mentor
Case Management: Problem Solving Courts
• Problem solving courts: “You can’t punish
someone out of addiction”
• Problem Solving Courts work – money is
saved; recidivism is reduced
• Non-adversarial model
• Integrates treatment
and judicial systems
Education
Early childhood mental health is the capacity of
children from birth to five years to form close
and secure adult and peer relationships,
experience, manage, and express a full range of
emotions, and explore the environment and
learn—all in the context
of family, community,
and culture
Education
NAMI provides family education to help parents
gain understanding, support, and access to
resources as their children begin and continue
to receive behavioral health services
Colorado Mental Wellness Network
works in wellness and recovery
education
CO Dept. of Public Health’s programs
focus on education for healthy
social & emotional growth
Decreasing Stigma/Normalizing Behavioral
Health Problems and Care
• Stigma is prejudice - society
“candy-coats” it as stigma
• Treating people like “a diagnosis” is
depersonalizing (“He’s Bipolar”)
• Individuals “self Stigmatize” and
create ways to deal with mental
illness including denial,
not talking about it, isolating
from others, and not making small talk
Decreasing Stigma/Normalizing
Behavioral Health Problems and Care
Needed:
• Education about mental illnesses
as brain disorders
• Recognition in law and
insurance that mental illness &
substance abuse are chronic
illnesses
• “Coming out” by Persons in Recovery and
their families, friends, and caregivers.