PRISCILLA WAGGONER pwaggoner@alamosanews.com
ALAMOSA — With a statewide initiative drawing attention to youth mental health, the Valley Courier reached out to San Luis Vally Behavioral Health (SLVBH) where two members of the leadership team – Chief Program Officer Leova Mascareñas and Chief Clinical Officer Jennifer Silva – agreed to speak on available resources, ongoing challenges and unique strengths in how the mental health of people who are younger than 18 years old is addressed in the Valley.
The first issue to come up is funding, which has been cut across the entire state of Colorado, including at the federal level.
Not exactly a promising development in a state already ranking 41st in services.
“We used to have catchment areas,” Mascareñas explained, “but accessibility became an area of focus at the state level. So, now, there are more providers providing services. I would hope that would increase accessibility with giving money to other providers. But it also means there are fewer funds available to stretch as far as they are needed.”
A shortage of practitioners is also a major obstacle as those positions are challenging to fill all the time but especially so in a remote area like the San Luis Valley.
She provides a fitting – and unfortunately real – example.
One of their core programs connecting on a regular schedule with kids in school is made up of a team of six people – three clinicians and three case managers. “That team of six is soon going to be a team of five,” Mascareñas explains. One of the three clinicians has finished her advanced degree and will no longer be part of the program. “It will be very difficult to hire a qualified and experienced person to take her place.”
In their assessment, are kids and youth really struggling as described?
Silva chooses to answer. “I work on the crisis side. And I wouldn’t say that the numbers of kids we’re seeing has substantially increased. But what we see when we assess kiddos is that our acuity has really increased. The severity of the sickness is significantly greater. When a kiddo is sick, they are very sick. And that then involves other issues in Colorado with getting them to the right level of care.”
Both Mascareñas and Silva agreed that there were “lots of causes” responsible for the increased severity among youth but both acknowledged a spike that has increasingly gotten worse since Covid.
She doesn’t wait to be asked why that’s true. “Isolation. Not being with peers,” Silva says. “Not being in school. If kids are in abusive homes, they had to be at home all day… There also aren’t a whole lot of recreational options or things to do that are productive.” She pauses. “It’s just the rural nature of the community.”
Socioeconomic factors also play a large role with the price of gas and the rising cost of food, factors that are especially hard on families with limited income. And now, with families experiencing a reduction in SNAP benefits and Medicaid eligibility possibly being an issue, the pressure mounts even higher.
““I think about a family unit,” Mascareñas says, “and if they’re focused on paying rent and lights and gas at just phenomenal prices, they’re going to make those things a priority over other things like their physical or mental health or the mental health of their children. It’s just going to be that way.”
“I also think it’s going to be a volatile and scary time,” Silva says. “People are going to be more focused on taking care of those fundamental needs but not other needs that are just as important. I think the acuity is going to even be worse.”
That’s not to say that there aren’t some practices among providers that have been of benefit.
“We’re a comprehensive mental health provider,” Mascareñas says, “so we have to see and serve everybody. We have a lack of resources and all of us – SLV Health, Valley-Wide, us – are in a hole together. But we also collaborate with our competitors. I know I can call SLV Health who does this or Rio Grande who does this or Valley-Wide does this. It’s a way to stretch resources to serve people that you don’t find very many places.”
But level of care – such as finding inpatient treatment for a youth in crisis – remains a huge challenge.
“If cancer was treated in an equivalent way to mental health,” Silva says, “we’d have to say, sorry, you can’t get chemotherapy or radiation. You have to just stay home and take vitamins because we don’t have any place in the state to send you for treatment.
“So, when we have a person with high acuity, people are waiting in the Emergency Room for days. Days. And it’s more difficult to find a placement when a person has a really high acuity, especially with youth. No one would ever say, ‘You’re too sick to go to Parkland.’ But we have to face that all the time. So, if I had a chance to ask a candidate for something, I’d say ‘More care.’ Enough care to give a kiddo what he needs to get better.”