Five years after declaring a “state of emergency” on youth mental health, leaders of Children’s Hospital Colorado are continuing to draw attention to what the nonprofit system still labels as a “crisis.”
Anxiety, which, if left untreated, can lead to depression and mood disorders, is prevalent among teens, as are eating disorders, various addictions, and more serious mental afflictions such as bipolarism, professionals say.
Also, a simultaneous ongoing shortage of beds, particularly for inpatient and residential treatment, as well as the number of providers and funding, is stymying comprehensive treatment and care, they say.
“The crisis is quite urgent and acute,” said Dr. K. Ron-Li Liaw, mental health in-chief at Children’s Hospital Colorado. “There are more than 1 in 7 young Coloradans who report poor mental health most days.”
One-quarter of adolescents statewide indicated in last year’s Colorado Mental Health Access study that they persistently feel sad or hopeless for weeks at a time, Liaw said, which impairs their ability to participate in school, extracurricular activities, friendships and relationships with families.
Colorado also has a historical trend of elevated teen suicides – in general, two to three times higher across age ranges than national averages, she said, though the state’s numbers have been falling in recent years.
As a result, the hospital network, which operates a location in Briargate in Colorado Springs, launched a “policy playbook” on Wednesday in collaboration with lobbyist Healthier Colorado. The two organizations formed a coalition earlier this year, Mind Our Future Colorado, under which the work is being done.
The report, compiled from 14 roundtables held around the state with input from some 70 groups and organizations, lays out policy options and top recommendations for state-level changes that organizers say are needed to improve the pediatric mental health system.
“The question is how can we take the best of what we’ve learned from task forces and reports and programs implemented in the past and look at how other states have solved youth mental health crises, and build solid systems of care,” Liaw said.
The Mind Our Future Colorado coalition also is hosting a gubernatorial forum on May 28.
The event will call on frontrunner candidates to prioritize pediatric mental health for whoever becomes the state’s next leader. It will be livestreamed for free; check the Mind Our Future Colorado website for a link. The session will also be recorded.
“The current system at the state level is too bureaucratic, too fragmented,” said Josh Ewing, executive director of Healthier Colorado. “We need to empower local communities to do more, particularly when it comes to upstream interventions, such as afterschool programs, which has evidence base to improve social connections and well-being of young people.”
Obtaining treatment can seem like an unending quest, Liaw said. Families across Colorado Springs, Pueblo and southern Colorado pinpoint the cost of care and appointment availability as key barriers, according to Children’s Hospital Colorado.
“Access is still quite a big issue,” Liaw said. “Whether routine, specialty care, hospital-based or intensive community services, it’s tough for families to actually get help for their kids in a timely way.”
If the dire messages sound familiar, it’s because they are.
To reverse dismal standings by Mental Health America, which now ranks Colorado 31st out of 50 states for youth mental health and 41st worst for the state’s overall mental health status, Gov. Jared Polis began in 2019 a study of the problem.
In July 2022, state lawmakers launched a new cabinet-level Behavioral Health Administration.
The agency, though, has encountered difficulties in rolling out its model of regional care coordination. A third commissioner is now in charge amid allegations of a “toxic culture” in the workplace. A bevy of legislation, some that was never realized, and state budget constraints have further eroded efforts to make progress.
The future of the administration appears uncertain under a new governor, who will be inaugurated Jan. 12, as Polis is term-limited.
The policy playbook is different, its creators say, in that the forward-looking, solutions-oriented document presents a roadmap for the new governor to use from the first day in office.
After a massive undertaking to solicit feedback, Ewing said five main recommendations emerged. First up: for the new governor to appoint a chief children’s mental health officer, who would report directly to the governor and coordinate plans across state agencies and with public and private entities.
That person would “identify opportunities for streamlining, reducing duplication and creating efficiencies,” Ewing said. “We have to do something to break down the silos for delivering mental health care to young people.”
The report also advises issuing an annual children’s report card measuring the well-being of youth, to identify gaps and chart progress.
There’s a recommendation for a “youth trust fund” for community interventions to prevent mental health crises from developing, along with new funding based on fees from digital platforms such as application downloads.
The fifth suggestion is to build programs to help youth integrate from high-acuity settings back into the community with ongoing outpatient care and for private insurance to cover such services like Medicaid does.
“This is not a partisan issue, unlike just about everything else we deal with,” Ewing said. “I think you’ll see broad agreement and a desire from leading candidates for governor that we absolutely have to do more and do better for young people.”
A poll that Mind Our Future Colorado commissioned earlier this year showed 90% of voters who responded agreed that addressing youth mental health is a priority, he said.
Katie Blickenderfer, chief clinical officer at Diversus Health, a large nonprofit community mental health provider based in Colorado Springs, was a professional advisor on the project.
Social media and online presence are driving higher rates of mental instability and imbalance, she said, and prevention is important to continue reducing suicides. One positive development, she said, is that children age 12 and older can receive behavioral health therapy at school, without parental consent.
“We know the budget is very tight in Colorado, but the challenge is if you cut off things that are more proactive, you start to make decisions that are more reactive,” she said. “It’s important if we can get ahead of access to care and prevention.”
Seventeen-year-old Akshaya Mandhapati, who graduated from Pine Creek High School on May 12, was one of several teens to address the governor and other state leaders at the Capitol in Denver a few months ago.
Basketball and other sports had been a healthy outlet for her, but Akshaya found herself overwhelmed with academics and had to quit athletics, which in turn hurt her mental health. Reducing or otherwise addressing academic pressure and competition would benefit youth mental health, she believes.
“In my school, there was so much competition of who has the highest grades and will go to good schools,” she said. “There was so much stress, so I had to quit something I really liked, but that affected me negatively.”
Akshaya also mentions how the unrealistic, seemingly “perfect” lives portrayed on social media, along with cyberbullying, can be poisonous to adolescents.
Her friends, teachers and family helped Akshaya get through the rough patch. As she learned she wasn’t alone in facing such adversity, she said the journey got easier.
“The stigma that mental health is not real or not as big as it seems has to change,” she said. “Everyone should understand it is a problem affecting our youth.”