Colorado Behavioral Health & Wellness Summit 2019
so good evening everyone welcome I’m delighted to see all of you here this evening thank you for joining us to open the Colorado behavior health and wellness summit I’m grateful to each of you for the contribution you were making to improve the well-being of Colorado and cenar State I’ve been incredibly lucky to work with some amazing people over the past year to bring this to life including my fellow steering committee members dr. Nancy Lawrence on dr. Walter inna de France before somewhere back there Kim Lao from the University of Denver jerry cunningham and jazz Fitzgerald from envision you and then Karen Chrystia from the mental health center of Denver so really grateful for all of their work I also want to thank dr. Clark Rick dirty Jeanne Ritter Darcy Cunningham and Amy Sarah’s on from the mental health center of Denver for their unwavering support of our work finally we are grateful to each of our individual donors and sponsors as a result of their financial commitment we are able to offer all of the programming this week at no cost and so the entire summit is open to the community so my passion for this work is built upon personal experience I grew up in a home impacted by mental illness and addiction as an adult sighs s substance use disorder and debilitating depression when I felt the flicker of hope go dark I attempted suicide I’m proof that recovery happens when supported by knowledgeable and affirming providers I love this quote by nito qbn your present circumstances don’t determine where you go they merely determine where you start by nearly every metric suicide rate the prevalence of mental illness substance use disorders vaping and death from drug overdoses our state is in crisis it’s estimated at about 20% of our adult population as a mental illness which is about eight hundred and thirty-two thousand people and sadly according to a 2009 teen report from Mental Health America more than 600,000 of them are not getting the services they need additionally 67,000 Coloradoans have a substance use disorder and in the past 12 12 months have also been unable to access services and the help they need and we learned recently that youth suicide is up in the state 58% from 2016 it’s the greatest spike of any state in the nation and it’s the leading cause of death for Colorado’s young people and youth stigma fear and lack of understanding compound the suffering of those affected and prevent the bold action that is so desperately needed historically Colorado’s efforts to make mental health services effective accessible and affordable have been inconsistent at best thankfully under the leadership of lieutenant governor Diane Primavera Michelle Barnes the direct executive director of the Colorado Department of Human Services the Poulos administration along with many leaders in the state capital including Leslie Herod have an ambitious plan to remake the delivery of mental health care services in the state with the determination of all of us we can work to impact meaningful change hopefully through the workshops and trainings offered this week each of us will have a renewed sense of purpose and determination to help those suffering and to encourage family friends and neighbors along with colleagues and the people we serve to discover a life worth living through better mental health I’ll leave you with one last quote by the author susan Sadler never give up on someone with a mental illness when I is replaced by we illness becomes wellness so thank you again for joining us it’s really grateful to see all of you I know we have some just amazing workshops this week and so I hope in addition to join us tonight you will join us for one of the 37 amazing workshops that we have so I’m pleased to introduce you the co-chair of the Colorado behavioral health and wellness summit dr. Nancy Lawrence um Thank You Steven I’m just so happy for the turnout that’s here tonight and the turnout that all the of all the registrants that have shown interest in all the different workshops throughout the rest of the week it really shows the incredible interest need and concern for the health and well-being of all of Colorado tonight we are joined by clinicians educators students policymakers and community members to address some really critical concerns mental health issues and substance use continue to challenge good health and well-being in the state of Colorado and in the United States I’m a teaching professor in biological sciences and director of pre-health advising at the University of Denver my interests and passions are health education and health equity I mention this to begin to explain how this summit came about I wanted to better educate the student body and d-u community about some of the current issues related to substance use and the intersection of mental health and physical health in January just as past January 2019 I was incredibly fortunate to be introduced to see Steven Hayden at the mental health center of Denver Steven told me about a new initiative that he and Jerry Cunningham had founded envision you an initiative to address the intersection of the lgbtq+ community mental health and substance use disorder if you know Steven you know he sets huge goals and gets things done from this meeting in January the summit was born the University of Denver the mental health center of Denver and envision you joined forces to create the summit as we share a common collective commitment to encourage neighbors friends family and colleagues from around Colorado to learn more about behavioral health issues and substance use disorder we know we have a long way to go in terms of making mental health and substance use treatment available and accessible to all of Colorado in the next several days we’re going to engage our community to break down silos statewide and to bridge gaps in communication and collaboration we hope to discover new tools and resources discover practical discuss practical strategies for change and connect with colleagues and experts we hope this community collaboration will foster an increased focus on tackling these difficult issues the behavioral health concerns in Colorado and nationwide have been recognized by community health care providers institutions and also policymakers who better to make opening remarks and ignite a call to action but a steadfast patient advocate lieutenant governor Diane Primavera a little bit about the lieutenant governor diana diane primavera is a leading patient advocate who has spent three decades fighting for every Coloradoans as access to quality affordable health care as a young mom in 1988 diane was diagnosed with breast cancer her doctor told her that she had at most 5 years to live since her first diagnosis Diana’s fought cancer four times and survived her personal battle with cancer expire in spired her to make it her life’s work to ensure that every Coloradoan has access to the health care they need when they need it in 1990 diane joined the Rocky Mountain Regional Brain Injury Center where her work focused on helping individuals dealing with serious injuries to recovery to recover and resume dignified fulfilling lives since their since then she has held many prominent positions throughout the public and nonprofit sectors devoted to furthering life-saving medical research and connecting Coloradoans who experience illness with the treatment they need to recover in 2006 Diane was elected to the first of four terms in the state legislature representing Broomfield superior and parts of Erie throughout her service Diane was highly regarded for her success working across the aisle to promote Colorado’s small businesses lower prescription drug costs and expand access to affordable health care most recently Diane served as the CEO of the Susan G Coleman Colorado one of the largest organizations in the country dedicated to breast cancer prevention treatment research and education Diane is a lifelong Coloradoan and a Broomfield resident she has two adult daughters and a two-year-old granddaughter Diane is also an avid ballroom Country and Latin dancer taking after her dad who has dedicated a dedicated ballroom dancer throughout his life even on his 95th birthday so amazing health there it is now my pleasure to introduce to you the lieutenant governor Diane Primavera [Applause] I’m a little vertically challenged so anyway thank you a doctor for the introduction inviting me to join you this evening I’m glad you’re all here at this summit to collaborate and discuss practical strategies for change and connect with colleagues and experts alike I want to thank you all clinicians educators researchers policymakers and leaders in the field of behavioral health for your commitment to our family our friends our neighbors all who are working through substance use and/or mental health challenges tell you a little bit more about myself personally I started off my career my professional career is a vocational rehabilitation counselor I worked with people who were physically and/or had physical disabilities and/or mental illness to try and help find them jobs I found it easier to find people with physical disabilities jobs and I did to find people with mental illness jobs and so I learned first hand how strong the stigma is against people with mental illness and unfortunately behavioral health struggles struggles are something that I’m personally all too familiar with my favorite brother an accomplished attorney faced mental health challenges in his later life he was diagnosed with bipolar disorder but he continued to resist help leading him to withdraw from his family gamble away his retirement savings and ultimately lose his job in his career he lost his will to live and ultimately succumbed to his struggles and unfortunately this story is far too common in Colorado according to Mental Health America about 20% of the state’s adult population around 832 thousand adults is living with mental health condition worse yet nearly half of them aren’t being treated for that illness the results are daunting our national suicide rate climbed by 33 percent from 1999 to 2017 and simply put we need to do a better job serving those Coloradans struggling with behavioral health challenges many national rankings plays Colorado in the bottom quarter of states when evaluating the quality of behavioral health care provided to residents Colorado ranked 43rd out of 50 states for the prevalence of mental illness and access to care and Colorado also has among the highest suicide rates in the country we can and we must do better to transform our system for Colorado’s living with the behavioral health condition so if they can access affordable high quality and patient centric treatment improving mental health and preventing suicide is a complex and delicate issue it requires a holistic approach through upstream prevention early intervention and treatment and post intervention measures for starters we need to improve access to mental and behavioral health care a major barrier to accessing mental health care of course is cost which is why our administration’s efforts to reduce health care costs are absolutely critical we’re proud to have delivered a slate of proposals in conjunction with our legislative partners that will lower the cost of health care short and long-term and I’ll go through a few of those with you with the legislature we us are establishing a reinsurance program that will lower premiums an average of 20 percent across the state for people who buy their insurance on the individual market we capped insulin prices at a hundred dollars a month we passed legislation to lower the cost of prescription drugs by importing medication from Canada so Coloradans can get the same quality medication for much lower costs we’re also reducing out-of-pocket costs by bolstering consumer protections like prohibitions on surprise out of network billing and the governor signed a bill to increase Hospital price transparency so that we can pull to pull back the curtain and identify and address the causes of outrageously high hospital bills we’re working across many medical fields in order to increase the scope of care for qualified medical professionals to drive down costs and improve access to high-quality care for individuals and the governor signed legislation creating the framework for a state-based insurance option this will give Coloradoans more health care choices and will bring down costs by injecting competition into the healthcare market but as you know cost isn’t everything another major barrier to mental and behavioral healthcare as I mentioned before is stigma we must continue to do more to activate community networks and encourage those at risk to seek help within those networks and do all that we can to reduce stigmas associated with seeking treatment this requires collaboration between state and local governments and nonprofits to promote treatment options along with specific strategies focused on at-risk populations like LGBTQ youth Native Americans farmers ranchers and Coloradans living in rural areas well these are complex challenges it is one of one that we must take head-on to save the lives of our loved ones our friends and our neighbors so Governor Poulos and I take this charge seriously and have laid the foundation to evaluate our state’s current behavioral health system and to develop a statewide strategic plan to reform our system through the formation of the Colorado behavioral health task force and I think Michelle Barnes is in the audience tonight right down here and I just wanted to command a Michelle for tackling this head-on and putting a great staff around the effort so thank you Michelle so our goal with this is to ensure that every Colorado and experiencing behavioral health needs can receive timely high quality and cost effective services in their communities too often individuals living with behavioral health challenges experience homelessness and trauma and sadly all too often they find themselves in involved in are costly criminal justice system or expensive emergency care system receiving services much too late and not appropriate and at taxpayers expense so we need to streamline access to quality services that enable Coloradans experiencing behavioral health needs to obtain an education enjoy their childhood find and hold gainful employment and live productive happy lives and we know that providing upstream care and services through community behavioral health programs promotes the health and well-being of our citizens and also ensures that we’re using state resources effectively this task force will build on the good work of local and state agencies service providers and stakeholders from across the spectrum and embrace a holistic approach to the challenges that our state faces while exploring creative and innovative solutions also the task force includes members who represent diverse and balanced perspectives on these issues such as consumers and families who are dealing with mental health issues key executive agencies representing state and local government criminal justice experts advocacy groups and behavioral health experts the behavioral health blueprint which will be completed by June 2020 will outline detailed steps and implement implementation timelines for desired changes that will improve the efficacy and efficiency of our behavioral health system so governor Poulos and I are proud of the work that we’ve done this far to address our behavioral health crisis but know that there are still Coloradoans in our community who are struggling fortunately we’re not alone in this we have dedicated partners in you all and would not be able to make an impact without you so thank you all for the work that you are doing here today to collaborate break down silos and bridge the gaps in communication to address our behavioral health needs I hope you have a wonderful summit and we look forward to working with you in the future [Applause] all right so the deck speakers name is on my paycheck so I better get this right floor dr. Clark is the president and CEO of the mental health center of Denver and inspires a culture of innovation and well-being that motivates employees to deliver evidence-based practices that are strengths based person-centered culturally proficient and trauma-informed he has dedicated his career to improving the well-being of the Denver community and Beyond through a focus on health promotion wellness resilience and recovery across the lifespan dr. Clark has extensive involvement at the local state and international levels working with leaders to elevate the importance of behavior health care under his leadership the mental health center of Denver has recently limit recently been named one of the top workplaces by the Denver Post seven years in a row and just last year we won the 2018 excellence in behavioral health care management award from the National National Council for behavioral health please join me in welcoming dr. Karl Clark [Applause] mom would like that imagination is what makes us uniquely human we imagine things that never existed in the world before and together we can create those things in a way that’s never been so this summit really gives an opportunity to think about how we would really like things to be so I’m going to talk a little bit about where we are in mental health and what imagination can do and accomplish so that’s me at our organization the first thing we do is focus on what people are naturally good at so we have people take strengths finder so that they can know what they’re pretty good at and be great at it here’s some of the things we’ve done I’m dr. Carl Clark I’m the president and CEO of the mental health center of Denver our mission is enriching lives and minds by focusing on strengths and well-being so in 2017 we opened the Sanderson apartments this was a sixty unit apartment building that was for people that have been on the streets and homeless it’s been a great success not only did we get people into the apartments people have gone from not working and not being engaged in school to almost everybody doing one of those activities we’ve also been recognized nationally for a couple of things one is our Co responder program that’s a program where we send social workers with police officers on calls where there might be a behavioral health issue either mental illness or addiction it’s been remarkable what’s happened with that program our Co responders have seen almost a thousand people and 99 percent of those people have gotten what they needed as opposed to being arrested our our Dahlia campus for health and well-being was recognized by the National Council for behavioral health and we won the 2018 excellence and behavioral health care management award we were recognized for a model that engages the community to create the types of services that can help a community thrive so our vision is that everyone who lives in Denver who needs access to any type of behavioral health care whether that’s for mental illness or for addiction that people get access to the care that they need Denver did a really great thing this year they passed the caring for Denver ordinance which was a 0.25 percent sales tax for money dedicated to meeting people’s behavioral health needs Denver voters are saying we want something to happen here in Denver here’s an interesting thing the better your well-being is the better it is for everyone around you so I’m inviting you to take the science of well-being course it’s offered for free by Yale University so that’s imagination it’s your gift to the world so we’ve talked some about the numbers we heard from the lieutenant governor it really is about one out of five people that are dealing with the mental illness or an addiction problem and of that group only two out of five are getting access to care so three out of five are not getting access to what they need now that group is interesting it’s for a lot of different reasons the most common reason is people don’t know where to go they don’t know how to connect with services and we need to think of ways imagine ways that that could be different there are a group of people in that group that don’t think they need help and that’s interesting too because it’s actually two different types of folks one is the group of folks who they know they do need help but they’re just not ready for it yet and then there’s another group that it’s actually a symptom of their illness that they have the inability to know that they’re ill it’s called a nose Ignazio and these are often the folks that we see out on the streets we have an outreach program for people that are homeless and there are folks in our community that a layperson could say something is not right here but that person themselves doesn’t experience their life that way it’s a very difficult group of people to connect with now what we do in treatment is basically three things somatic treatment is really about doing something with the body and that might be a medication it might be transcranial magnetic stimulation it might be helping people eat right to sleep better to get exercise all those things that happen to a body that helps the mind be healthy the second thing we do is psychotherapy and we do all types of psychotherapy and it’s the evidence the evidence is there that changing the way people are thinking about things feeling about things and their behavior can be done through psychotherapy our psychotherapy goes beyond just the psycho therapies for illness it includes the psycho therapies for positive psychology so how do you move somebody from being doing just fine to actually thriving in the community one more thing there social determinants is the third thing that we do and those are all the things that actually have a bigger impact on your overall health then even anything any clinician can do in any discipline so those are things like having a safe place to live so we do affordable housing helping people go back to school helping people go back to work those has a tremendous impact on people’s overall health now we’re all and this is what Leslie Herod was saying earlier we’re all somewhere on this continuum so when I say mental health people think mental illness it’s interesting isn’t it because we all have mental health you know and we’re all somewhere on a continuum most of us are doing just fine there’s probably folks right here they’re actually thriving and then there’s those things that happen the ups and downs of life where things happen and impact your mental health sometimes that can result in an illness and then some and most people who develop an illness will recover from that there are some folks through genetics and circumstances developed very difficult illnesses and that group of folks needs our respect they need our protection and they certainly need access to care so mental health has evolved over time in our country in the 1800’s if you were not acting right you went to a place that pretty much looked like a jail in fact right now today you can visit places where there are two buildings side-by-side they’re built exactly the same way if you were a criminal you went into the one building if you were mentally ill you went into the other building Dorothea Dix through kind of civil rights advocacy said putting people in jail for being sick is wrong and that’s actually what started our state hospital systems across the country and the state hospital systems were a place where people were protected but the treatment was not very advanced and we wound up warehousing many people in those institutions advent of medications and a variety other things we were able to move people out of the state hospitals and into the community which has started the community mental health movement in the beginning it was more the approach was illness management it wasn’t about like really even getting the illness could go away it was just taking care of somebody with an illness then the treatments got better then people got on to the idea that health is much more than the absence of illness and what are those things that we can do to help somebody do well in their life and that started the recovery movement which was buying into the idea and knowing the data that people can and do recover from mental illness we’re now shifting again adding in positive psychology to look at how do you take somebody from doing okay to actually thriving in the world the science has not been around that long it’s only been around for about 20 years so Martin Seligman is a psychologist he’s at Penn and he was the head of the American Psychological Association and he had studied very interesting things difficult things like genocide learned helplessness those sorts of things and when he became the head of the American Psychological Association he said we study what goes wrong with the brain why aren’t we studying what goes right with the brain and this is really the starting of the movement of positive psychology his first book is authentic happiness it has a smiley face on it he hates that cover but his his publisher said that will make it sell and what’s happened over time is a construct looking at what are the elements that contribute to somebody’s well-being it’s called the perma model and I’ll talk a little bit about these so the first thing is having positive emotions the more positive emotions you have the better your well-being and there’s even a ratio that people talk about that if you’re if you have three positive emotions to everyone negative you’re actually thriving in the world if it’s one to one you’re just kind of doing okay and if it’s the opposite you’re likely not doing well at all now positive emotions are an interesting thing because you know whether you’re having one or not it’s subjective so I will give you an example I have friends that jump out of airplanes and they like it right I would not so that’s an example of you can’t just take the situation and say that will cause a positive emotion it depends on the person’s response the more positive emotions you have in your life the more you will have in your life and there are things that you can do to increase positive emotion the second thing is engagement an engagement is when we’re so involved with things that time sort of like disappears and it can happen in a variety of settings and the more times you have where you’re deeply engaged the better it is for your well-being again this is subjective sometimes you don’t know you were engaged until after it’s over sometimes you know it while you’re in it so when I’m playing the piano I know I’m engaged right then at that moment the third thing is positive relationships this is actually more objective you can look at people’s relationships and determine whether they’re positive or negative the more positive relationships you have in your life the better it is for your well-being the M stands for doing something meaningful we all want to do something meaningful with our lives and when you engage in meaningful activities it contributes your well-being the last one is achieving things accomplishing things it can be little things it can be big things it can be starting a family it can be I got the garage cleaned so being engaged in stuff and getting things done contributes to your overall well-being now there are different types of well-being and these are actually in order of the most impact on your life your career has the biggest impact on your overall well-being and most likely because your career is where you’re doing something meaningful with your life relationships are the second most impactful the third is actually your financial well-being and we live in a country where we have great disparities when it comes to finances and if people don’t have the basics it does contribute to their well-being not being good the last one our physical well-being of course is important but the last ones community well-being and the science here is really fascinating so it is true the better your well-being is the better it is for everybody around you this is what the science shows us if you have a friend whose well-being is good they have a 15% influence on your well-being to the positive if you have a friend who has a friend whose well-being is good and you don’t even know them they have a 6% influence on your well-being and then it goes the opposite direction to if you have a friend whose well-being is not good the percentage isn’t the same but it’s a 6% influence on your well-being to the negative so as it turns out we are all very connected the Gallup group looks at well-being by cities and they look at well-being by States and Denver of the top 50 cities we’re actually number 18 and well-being so we live in a pretty good environment you know we’re not number one but we’re not number 50 I would like us to be number one when we look at Colorado as a state we’re actually number seven in well-being so we live in a really healthy state and the thing about living in a healthy state you can move to even a healthier place so let’s talk about some of the challenges that we have in behavioral health access to care is the big one you know if three out of five aren’t getting it we’ve got to do something about that we’ve had parity laws which means that mental health behavioral health needs to be paid in the same manner that we do physical health care those have been on the books for 11 years it’s still not happening it’s kind of hard to prove it’s hard to make a case fortunately we have an attorney general in Colorado that’s relat if he can find cases the issue that we find in health plans is that they have a provider list that looked pretty robust if you call the provider list though the answering machine will tell you they’re not taking new patients so there’s a question about whether those are really adequate networks or not we definitely have a mal distribution of therapists in our state so and even with the mal distribution every single County except one which is Larimer County is a health provider shortage area when it comes to behavioral health including Denver so and then we need to talk about how do we actually access care now I can tell you and I’ve got some resources for you here at the end I can tell you that if you have a friend or a family member that’s not doing well we have a walk-in clinic that’s open 24/7 at Claire Mountain Colfax it’s easy to get to you don’t need an appointment somebody’s not doing well you just go there now if your friend or family members really ill and they need to go to the hospital take them to the hospital but if they’re just like needs to get things checked out go there that works great right except I think most of you probably didn’t even know that so how do we get word out about people accessing care and then the other thing is is that if you have to go somewhere to access care maybe that’s a barrier in itself and when are we going to have the day where we have a digital front door to what we need for behavioral health that’s what we imagine happening in the near future our workforce is shrinking the past 10 years the people doing behavioral health has gone down 14% so the number of folks that do this work is this big and yet the need is this big so how do we help that small workforce meet the needs of the whole community we’re going to have to use our imagination leverage technology think about all the things that can be done outside of that face-to-face relationship can help people in their care and then the funding challenges are pretty straightforward it doesn’t matter where you look on the whole planet the need is this big the resources are this big so when it comes to behavioral health every country on our planet is a developing nation nobody has solved this issue so we’ve heard about the crisis that’s here in Colorado a brief note on that in 2017 we had over a thousand people died of overdoses in the opioid epidemic and a part of that was the opioids being laced with fentanyl you know eighty one of those folks died because they took a substance that they didn’t know had fentanyl and it commit contributing to their demise now when you go somewhere it doesn’t matter where you go you hope there are people that look like you when you get to that door right you want that connection we put a big emphasis on having is a diverse a workforce as we can there’s lots of things that you can do that creates an environment where people want to work within a facility we have employee resource groups for folks of sort of different backgrounds to connect with one another and to do their work and certainly safe space is important to us you heard what Leslie said I’ll just said do on that one and the last thing that I have here is about the most popular course at Yale ever in its entire history it’s the science of well-being it’s taught by Professor Laurie Santos who recognized that Yale students were not thriving not doing well it comes from the field of positive psychology it’s online it’s for free anybody can take it I learned recently from somebody that if you if there’s something that’s good for you your resistance goes up about doing it so I have offered this course to lots of people and it’s like a third do it and they always thanked me for taking the course you know a third set I signed up but I haven’t done it yet and the other third said oh yeah I should sign up for that so all of my board has taken this course all of my executive management team we encourage all of our staff to do to do this course it really gets down to sometimes what our brains think will make us happy actually doesn’t make us happy at all and what are those elements that truly do it’s a 10-week course there are no assignments there re wireman you watch a video of her teaching this course in front of Yale students that ask really good questions and then you learn about what can go right with the brain and that week you do that thing so I think we have these handouts up there so it’s both about the science of well-being that I just talked about also other resources that we think are helpful for folks and how to connect with the crisis services so that’s it [Applause] thank you very much dr. Clark so there’s lots of great opportunities to engage in conversation about what are some of the ways in which we can make a difference so right now I would like to shake things up a little bit and I would like to invite you to hear a little bit from people in different people in our community who work in different sectors that are engaged in mental health substance use disorder and other aspects of some of the challenges that we’re seeing in Colorado so I’d like to introduce first our moderator Don stator he’s the associate medical director an emergency physician at Swedish Medical Center and care port healthcare and he’ll be moderating some of the discussion tonight also our panelists are michelle barnes who we’ve heard as the executive director of the Colorado Department of Human Services dr. Michael laughs our executive director of health and counselling at the University of Denver dr. Jennifer tippet director of the substance use disorders specialty program at the University of Denver’s Graduate School of Professional Psychology so I’d like for them to come join us on stage [Applause] thank you so much Nancy okay well good evening how are you guys doing wow that was rousing thank you how are you guys doing whoo right so I have the great pleasure of moderating this panel of people who are far smarter than me so I’m gonna try to do a good job of asking questions and then keeping my mouth shut so you know I’ve always been fascinated by how people got into their roles and each one of you have a different journey to the position that you’re now in and a different reason for why you’re passionate about it so we’re gonna start at the end with Michael and we’ll come across and I just love to hear about what got you into the role that you’re in and why you’re so passionate about it thank you for that question I think I’m a clinical psychologist by training and I think many of us in the helping field come to this experience of this profession and from sort of influences from some of our past experiences I moved here three years ago from Boston and had an experience where I was two o’clock on a Saturday afternoon on my way for a massage taking care of my health and wellness and and I was brittle II attacked by a gang and suffered with PTSD and it was through this experience of both that day in the folks from the police officers to the ER Doc’s to the folks who I’m sure it was you know quite startling for the passers-by who saw my sort of damaged body and and what was there how did people respond I think as you make your way through these major life experiences you’re touched by a lot of people and I went to the trauma center some of you know the trauma center in Boston one of been doing some cutting-edge work for a long time and engaged and it was in the care of dr. Marla Zucker a wonderful psychologist and through that experience I would say that I was able to reclaim my life and go from not being able to leave home and the terror and fear and the flashbacks that were part of my life to leading a full and productive life and I thought after that experience you know I was 35 years old you know I was well into a career I was working at Harvard I’ve had at all and my life changed at that moment and I wanted to do what she did I wanted to help to figure out how to help a person in me for my experience she helped me reclaim my life from living in terror and I wanted to do that and so I went back to school earned my doctorate in clinical psychology and have had the gift of working with people no matter what their journey or how they got to be with me and it’s been one of these talking about positive experiences about being able to join people in there as they’re trying to make their way through their issues and lead a more positive life I think it really was turning something that was so tragic for me and it I wanted to use it in a different way and I think that that life experience really helped impact and change the way that I was sort of living my life and and yeah it was that experience you know that’s amazing and it’s amazing how you’ve taken something that first some people would be so detrimental and so destructive and make it into something that now is so meaningful and allows you to help others so thank you for being on the stage um Jennifer how about your story how about now yeah okay I think you know like Michael mentioned a lot of us in the helping profession come in all sorts of ways but for me with substance use disorder specifically it was seeing all of these really well-meaning programs that didn’t work and were actually hurting people and then a lot of disparity in what people could access based on how much they made so even you know as a graduate student there was this this program in Colorado or they took individuals with drug-related offenses and put them in an inpatient treatment program in a halfway house and just sort of scooped them up and put them there and I’ll never forget we had one client who they put there and they didn’t send his psych meds with him and then he was labeled as resistant because he couldn’t sit through the six hours a day of treatment that he needed to do and it was just very punitive and that client later went out and overdosed on heroin and died in downtown Denver unfortunately so watching how we stigmatize even within these places where we say we’re not going to but we do anyway and then I was living in LA and I worked in community mental health and also at a rehab in Malibu so I would go from my clients who had access to clinical psychologists who were completely trained and they had all of these luxury pieces to my clients in Ventura County who had nothing they had no idea where they were gonna sleep at night and because they didn’t make enough to pay 60 grand a month out of pocket for rehab they were not going to get the services that they needed so I really became passionate about training clinicians to do a better job of treating substance use disorders and being able to create better programs that actually respond to what people need instead of what we think that they need so that is why we’ve created the program that we have thank you okay hi Michelle and I took a little bit different path to running Human Services in the state I worked in for-profit business for a long time I worked in the nonprofit sector but I always felt like you know I bled for the world like like I had the heart of the world and I could in her situation without feeling compassion and empathy and love for what I was interacting with which made it pretty interesting because I worked at Facebook for a few years so you kind of mix like what my career was and and kind of who I was as a person and I recently when Poulos got elected I got an opportunity to interview for this job and and I was able to explain that I had a good overview of Human Services but I was really a business person which is exactly what he wanted he wanted somebody to come in and think pragmatically as well as heart and be able to blend both of them so I’m in charge of the behavioral health task force for Colorado which we’re trying to reform the system and the first couple weeks I was in my position you’d have these series of discussions with the governor and he’d say here’s what I want you to prioritize and you’d say here’s what I want to prioritize and you know give and take back and forth and I went in you know think I’m going to be foster care or you know I had all these ideas of what is gonna prioritize based on just personal passions and where I’d worked and he had his ideas but I said you know I’ve worked here a week and everybody I’ve talked to his old me behavior health is an issue in Colorado I’ve been here two weeks and all I hear about is substance abuse and now in my third week and mental health underlines everything we do and and so we settled on taking the bold move of putting someone with no mental health background and the only non doctor sitting up here in charge of system reform and I couldn’t be happier about it because I do have outside eyes so I’m looking at a little bit differently but I’m also not bringing my own bias I’m able to hear people’s stories and hear what’s going on and really figure out what’s the best thing we can do for all Coloradans so this is like the most bizarre series of coincidental things that ended up making me here but as I was just telling telomer earlier I feel like I’m getting a master’s degree without having had the benefit of getting the undergrad degree so I’m learning very quickly and I’m appreciative of so many people sharing their wisdom so you mentioned one word and you talked with me a little bit about it before we got on stage versus bolt the governor told you to be bold in terms of reforming health care especially mental health care with your task force how are you guys planning to be bold or what are some of the policy ideas that you’ve been kicking around yeah that’s a good question it would be really easy just to come and say well we need to do another PSA campaign a public service campaign on stigma or we need to pass this one bill or we need to ask for more money to do this but that’s not really bold that’s just incremental thinking and it’s at the margin and what we’re really trying to do is say what would change the system and I think the fact that most of you are here I’m sure you know that our system is not working for a lot of Coloradans in spite of some amazing people in the system and some amazing programs that are working very well but the system itself isn’t working it’s access it’s affordability it’s it’s a lot of different things aren’t working so we’re looking to really say not being bound by where we are today five years from now where could Colorado be and then let’s back out and say what do we do in year one what are we doing here – what do we do in year three but not be held back by the realities of you know tight state budgets and not enough providers which is a huge issue and rural communities not having the resources they need and an opioid epidemic and having one of the worst suicide rates in the country and Colorado’s rated on the mental health index I think were 44th in the country so while we’re a very we have a lot of things to be proud of as a state mental health is not one of them and so trying to really bold and say how could we be in that top five up States how could we do things significantly better which means we need to really push each other and the first round of kind of recommendation on the task force were pretty incremental and now we’re trying to get to things that with what would really a difference so great so Jennifer and Michael you both are deep in the mental health world you have right here the task force leader of the governor what would you tell what would you tell her with being bold what would you advise her to how to improve our mental health system make-a-wish sister you know I think one of the I was thinking about this this idea of bold and doing things differently and one of the things some ways a university is a microcosm of sort of a city or a community and I’m reflecting both on the bold question now how do we address and do things differently because as you said it’s not working and one of the things that we have done here is we’ve said okay you know individual psychotherapy is a wonderful beautiful thing but some people may not be ready for that may not have access for that how can you what are some of these other ways that you can be doing it is supporting people and one of the things that we’ve just initiated here is telemental health for students and we’ve given it to everyone without a cost and I think we’re going to see over the long term that there’s going to be quite a return on that it’s been the institution of thought okay we can’t keep up with this folks are online there are Oliver so I think you know one of the questions that I think about is are there things that we haven’t used historically like perhaps telemental help that we can make accessible to some of our Coloradans in rural communities for example folks who are underinsured so I I it’s just an idea I don’t know I guess I’m just floating is are there things like telemental health that we could provide for all Coloradans that would help a stop-gap in some way I guess that was a rhetorical question but I’m just thinking about are there things like that that would that we should be considering when a lot of our providers are bringing up but we need to think differently other than just one person face-to-face especially when you start talking about the vast number of people that need mental health services and the shortage of workers and then the fact that if you live in a rural County there may not be more than one or two mental health providers in your community and they may be your sister and your you know ex-boyfriend so you don’t have the same options you might have in Denver well even within Denver I mean if you say miss your bus or the bus is late and I missed your appointment at an MHC D and now you’re back you don’t see your psychiatrist for a month now and so even within an urban population it can be really difficult for people to access so I think tell mental health is such a great idea such a great way to sort of overcome some of those barriers so here’s a bold thing that you hear batted around and that’s an absolute lightning rod for the addressing the opioid epidemic is supervised injection centers okay that’s a very bold idea that’s been advanced by some different proponents around the states what are your thoughts and we’ll start with Jennifer because you’re big into harm reduction is what are your thoughts about a policy a policy like that a supervised injection facility yeah thank you for that um I really tend to look at addiction as an issue of disenfranchisement and by and large and so when we take people and we marginalize them and then we marginalize them further when we push them and push them and push them it becomes a really ugly cycle and which they don’t have any pathways back into society I really think that safe injection sites would provide people a way back into society so it is not handing someone a needle and saying here go shoot up we don’t care what you do it really is come in let’s talk let’s be in a safe place here’s some access to a mental health worker while you’re at it just in case you want a chat right it provides avenues for people to start talking and looking at their addiction instead of sitting in a street corner or an alley someplace where they have access to no one and they other thoughts from the panel I’m very interested to hear your thoughts Michelle I’m not sure I’m an expert on this but I can tell you one of the things we’ve been experimenting with and we’re doing a lot more this coming year is making sure we’re getting Matt or medically assisted treatment to people where they are and trying to help them a deal with their addictions with prevent with with the right medication at the right time and we’re even rolling out later this year bands it’ll be gone out to world communities to administer this and finding ways we can administer it so I think the more we can get treatment to the people in a way that they can receive it we can distinct an help them not continue down I’m completely in favor of so you know we’re starting to transition I have another question and one that’s actually a personal one for this community you know a few years ago there’s a very high profile overdose that happened unto use campus where a young man by the name of Jonathan went afield who is the son of a former vice chair of the the Joint Chiefs of Staff overdose right here on this campus let me ask you what has been done since that time to make sure that we’re looking out for the warning signs of mental health and substance use disorder within the collegiate ranks and assuring that there’s never another Jonathan afield yeah thank you for that this community was deeply impacted by the loss of Jonathan Jonathan Jonathan’s dad as you said is a form of Admiral of the Navy so he has been on TV and and talked a lot about the loss of Jonathan as he was here in his first few days in orientation I think it was a shock for this community I think like many communities we sort of saw the opioid issue as an issue that was impacting other communities and I think that’s probably true across the country why this has taken so long for us to address it is that I think particularly with heroin I think we really saw that there were a lot of marginalize it was an it was an issue impacting marginalized populations and it wasn’t I think until it started impacting more mainstream America that we started really taking this seriously and I I think in some ways there was some parallel processes that were going Jonathan died on September 7th two years ago and the community was rattled and what do you do out of that and and we I think that with Marian sandy multiple times they really were looking for services and and looking for us to sort of step up out of that came the collegiate recovery community here is were in our first year we have over 30 members we have a director and I was searching for a coordinator now our director is extraordinary we’ve have flirty members and you know as compared to other collegiate recovery communities around the country some are in year 3 and 4 and just building that so there was a need here I think many folks didn’t recognize it and sand and we’ve got a great relationship with Sandy he flies out every few months and he’s on the phone with Walter ena who’s the director of our community on regular basis so I think out of that we’ve said we’ve got a responsibility to the community and we had to address the stigma because for a lot of our communities they a lot of members of the community was sort of like well oh my gosh that issue is here what are you doing about it and there was a lot of fear but I think what people are seeing now is that supporting people to thrive in their recovery is the biggest gift that we can get I think there are lots of ideas is this a impatient you know just an inpatient treatment center what what’s happening over there and what they’re seeing is it’s a supportive community that’s helping eat one another in maintaining their sobriety and they’re thriving and I’m really proud of what’s been able to be to have been built in come out of that tragic loss so how do we protect more young men and women from I guess are coming to a mental illness how do we build a system that better cares for and identifies young men and women like Jonathan and gives them the support that they need open-ended question I’ve been with one thing we’re doing Colorado is a state is embracing this new federal legislation called family first prevention Services Act it passed about a year and a half ago and states are opting in and it basically kind of closes the door to one set of funding streams but opens the door to a different one and the new one you’re opening is prevention services so Colorado’s moving to be on the forefront of jumping in on that and really trying to move the money in our child welfare system to be preventative so an example would be if you take a child away from their parents and put them in foster care that is unbelievably traumatic and there’s a lot of downstream implications of that which if any of you have been removed from your families or had your children removed you know it impacts the whole family so we’re moving all kinds of funding streams to support keeping kids and families and working with the whole family and the issues going on in the family as opposed to creating them as two separate entities the parents that did something bad and the kid that needs to be removed for their own safety and that’s a very different approach to to what we’re trying to do another thing we’re doing is I also have the responsibility for our youth correction system in the state and we find that about 80 percent of the kids who end up doing time so these are kids under 20 have moderate to severe mental health issues so it’s another thing we’re doing is really treating kids and adults when they get in the justice system not just as perps or people that did something wrong but again seeing them as victims or people that have had trauma in their life and so we’re trying to address the trauma as well as trying to get them in a place where they aren’t doing things that are illegal anymore but you have to start from that in perspective and really meet people where they are and understand most people don’t wake up saying I want to commit a lot of crimes you know lots of things have happened to them to impact their mental health that result in them being in the criminal justice system or these justice system so it’s a lot of it’s about prevention I hope you’ll hear a lot about it in the next couple of years is shutting the valve off on one set and moving to prevention you know so much of this is I feel like there’s a lot of systemic errors that we’ve created in our current system right now and something that you mentioned Jennifer is that you you’ve encountered a system that sometimes does more harm than good can you give me some examples of things that you see in our current system that are wrongs that need to be righted or policies that just need to be changed done away with sure I think you know as I sort of mentioned when we first started out looking at programs that treat people the way that we think they should be treated rather than listening and observing and treating what people actually need so people don’t need punitive you know you missed your UA and so now you go back to jail we’ve we’ve got to stop making that the answer for when people are using or in the throes of addiction or mental illness we create programs that have incentives and then if you are not behaviorally compliant now you go back to wherever you came from or you are now punished somehow and it can be really traumatic even an inpatient psych wards I’ve worked in a lot of public health hospitals and in psychiatric hospitals and that becomes very scary and traumatic for individuals who end up and say padded rooms as they call them or the turtle suits as a way of punishment solitary confinement is one that we love in the criminal justice system and that we now know actually causes mental illness and we’ve got to start addressing some of these things one of the things you brought up with early childhood care foster care system I mean that’s a soapbox all on its own but also educating teachers to recognize that kid in the back of your classroom who can’t sit still isn’t just there to make your life miserable maybe he’s got XYZ trauma but you can’t expect someone to recognize that if they’ve never been trained in that way we don’t we don’t allow their resources for some of these systems to function in a way that would be better and would be more beneficial and we could do it I think it’s just wanting to do the prevention piece rather than answer to everything on the back end which I think we’ve been really reactionary in this space and it’s maybe time to do something different Michael it looks like you had something that yeah I was thinking about the the program that was highlighted here talking about one of the programs about sending social workers along with the police officers I think that that kind of thinking is exactly what we need instead of treating folks struggling with mental illness as criminals to actually acknowledge their humanity and their dignity and I’d love that stat of 99 percent of the folks that there was a different outcome other than you know sending a person to jail I think that we can’t expect police officers to you know know absolutely everything and using the expertise of a social worker in that example I think we need to be just changing the way that we’ve done taking care of folks who are struggling and that’s a great example of a really innovative program so let me ask you know I’m an ER doc and of course in the ER we see a lot of patients who are struggling with mental health crises people who are struggling with addiction people who are there because they’re homicidal or suicidal and things have reached to a point of crisis where they’ve come in on a 72-hour hold one of the great frustrations I think that er Docs and other physicians have is that we seem like we’ve built two parallel and non-communicative systems a mental health system where we send patients to and often time I never speak with the psychiatrist I never speak with the mental health specialists and by their own evaluators and then a medical system that’s really just right now a cat hold and then when they get placement release is that the right system how we are we well served by serving privacy needs and siloing or is there a system where we could have much more open communication between those two medical and psychiatric systems yeah here at DUI I oversee the health services and counseling services one of the things that we’ve seen from we’ve heard great things about from the patient’s is that as we do their health questionnaire when they check in we have a social worker that’s reading the screenings and looking for things around signs of depression anxiety substance abuse and what she’ll do is before the doc goes in if they’re here for a stomachache or whatever it might be the social worker will go in and introduce herself say that she’s seen that they’re experiencing a lot of stress here’s my name if you’d like to talk to me so it’s a soft kind of entry and it’s been really a wonderful way for us to bridge that mental health as they’re waiting for the doc to come in anyway they’re getting a contact they’ve got a name now and a person and we’ve found that students are really really appreciative of that and it’s giving them permission to sort of reach out and get that support yeah I think one of the things that we’re really pushing to do at the Graduate School of Professional Psychology is to create these embedded psychologists positions out in the community in medical settings so that there is already somebody available in in the sort of situation that you’re talking about because I don’t think siloing is helping what we’re seeing is what we call frequent fliers right they go from your IDI to my jail and then to X community mental health and then they balance because no one talks to each other and nobody knows what’s going on with this person and so trying to create more systems where we’re talking to each other social work comes in if you’re there for a stomachache or you already have an embedded psychologist I think that that really starts to address some of what and not only that I’d say that because of the protections put around mental health which have been long-standing and in many cases before the era of HIPAA which protects all your all your rights in terms of your medical care it was really important that we had these these protections like 42cfr but now that we have HIPAA we still have these old rules that now create two medical systems and in my and my you know in my estimation by having these two mental health has been siloed and is kind of the ugly stepchild of medicine when it comes to so many of these things and be reason why it’s so stigmatized in the medical community as I think is because it’s hidden away and you hid away in you hide away things that you’re ashamed of okay so is there a way to create a better more communicative system it’s interesting that you say that because when you said two systems I’m like I would loved onei have two systems today i sat with a white board with some colleagues and we came up with 63 different doors that you can enter the mental health system through and the challenge I’m seeing is depending on which door you come through we’re not patient centric or door centric so if you come in through a certain door in order to go through another door that may be more perfect you have to go all the way back up to the front stoop and come in a different door and start over so an example would be using the example dr. Clark mentioned earlier about the behavioral health specialists and the police officer going out together if rather than bringing them to you or to jail they brought them to a walk-in clinic where they can that’s one outcome sending them to use a different outcome sending them to jail is a completely different outcome because let’s say when they did that the the person got a little nervous is you can get nervous if you’re living on the street or have mental health illnesses are challenges and you might have spit on the cop well that’s a felony that’s assault so now you’re not just in jail but you’re in jail with an assault and you may not be competent to stand trial because you have mental illness so now you have to be restored to competency usually in the state mental institution where there’s a waitlist if you aren’t competent you need to be restored that’s another weight they may be able to stabilize you on your prescriptions if that’s part of your challenge but as soon as you exit it your Medicaid stops and so you have to wait six weeks till Medicaid kicks back in by which point you’re unstable again and it goes back to spitting on a cop and and so the system works if you just think that your sliver in it but if you think from a patient perspective our system has way too many doors and the service you get depends on which door you come in and god help the person that has idd or just intellectual or developmental disabilities or no money or is underinsured or it’s the system doesn’t work if you’re thinking from a patient perspective I’ve never heard that door analogy but it is you know something that we see all the time and so true and for so long the only way that you can get a good m80 program is to go through the criminal justice system right and be put in a drug court where they mandated it for you then it actually get paid for you know so so it is kind of a bizarre world in some senses okay so you know I want to be respectful of everyone’s time and I also know that there’s a lot of audience members who probably have better questions than I do so I’m gonna ask one last question and then two of these microphones are gonna journey into the audience and you guys can ask the questions that you want and then we’ll come back and we’ll maybe do a one last wrap-up okay so here’s my last question for you in the news recently there’s been a lot of news about opioid settlements right and you know and speaking with people in – no it sounds like most of these opioid cases will be mostly resolved before the end of the year right so we potentially have the opportunity for a large sum of cash to be coming into Colorado to address you know opioid use disorders and mental mental health disorders in our state let’s say you had fifty billion dollars let’s talk about a big number how would you implement different policies or how would you spend the money to change the behavioral landscape in Colorado and we’ll start Michael with you at the end and we’ll bring it this way sorry to put you on the hot seat so I’ve got fifty billion dollars you know one of the things I’m thinking about is we talk about upstream work I think how I would develop a program a prevention program so that we are working with families and folks who are struggling early before the addiction starts so I’m thinking more little little kids how are we helping support those family units that are struggling how are we intervening before we get to that that perspective so I guess I would really be wanting to think about preschool family support I’ll think more about that but I really I guess I would be thinking about not necessarily how can we help prevent the issue to happen I guess is my is my biggest question and you caught me off guard with them no worries and we can come back to you so answer answer prevention is a pound of cure is kind of the perspective you’re finding though Jennifer yeah I really echo a lot of what Michael said that that really little you know early childhood intervention because I think that substance use also is born of attachment disorders and trauma and so if we can start to address that in a way that’s really helpful for the tiniest humans in our society that would that would really do a lot of preventative work I also think providing the same type of treatment to individuals who can’t afford luxury rehab in Malibu you know sort of taking what works and what we know works and being able to do it if I could but what fifty billion dollars yeah I would just create a little luxury rehabs all over downtown Denver right and and provide that kind of holistic care so acupuncture somatic therapy things that we know really do work in this population that we just don’t have the fund for I think that’s where I would start Oh training training really competent clinicians kind of one of my passions helping people really understand addiction and mental health in a way that is a little more nuanced and not so behavioral all the time it’s a good question the state currently spends about 1.2 billion a year on mental health behavioral health services and if we got a big influx of money I think what I’d want is to see one big door and so people don’t have to pick a door to come into the system they can just walk up to the front door and have concierge service to direct them to where they need to go with clean assessments and the ability to be flexible and then behind that door I’d make sure there’s a wellness room with workout equipment and cakes and all that stuff for everybody who’s chosen to make this their field so they really know how important they are and that we have a strong workforce and then love to be able to have enough people in the field that we could open the front door and go find people before they ever need to come to us and so it’s a prevention so one door and lots of people in the front yard helping people not ever having to come to the door and then supporting those people in the yard right because we burn out like crazy in this field that’s why there’s cake okay I’m just gonna add one one more point I think that there is in terms of prevention right now I think you need amazing insurance and I think leveling the playing field of who can get preventative preventive care would be a big part of that because if you’re poor in this country you don’t have access to the prevention or if you’re a marginal in marginalized populations I would say that’s true so I would say that’s how I’d be using its level the playing field a little bit and also sending some of that money towards I mean we have a lot of money going towards addressing the opioid crisis and in this country we don’t have as much still going towards meth and heroin some of the things that are still really ravaging especially Colorado and so like you said sort of leveling that playing field your ports not so likely that your downing oxy you’re probably shooting up heroin or meth and so your choice your chances to get treatment because there aren’t these big huge fancy grants for that and become much less so I’ve heard people talk sorry I lied to you that was my last question I’ve got one more so I apologize hopefully you forgive me so you know one thing that was said in our opening which was just so eloquent I really loved that quote and it’s gonna stick with me for a long time so thank you is that when we replace I with we we replace illness with wellness and I’ve heard people talk about how the opioid epidemic is really just a symptom of a much deeper epidemic that we have of isolation and of mental of you know in lacking that interconnectedness that really we need to thrive upon so what are your thoughts about is the opiate epidemic really just a manifestation of a greater mental health epidemic that we have in this country I mean I think a lot of almost all addiction is not just opioid when I look at people who use opioids or meth or sex or porn the common denominator is attachment issues and difficulty relating to others feeling belonging feeling accepted feeling part of so my answer be yes cross the board I’m not sure this answers the question specifically about the opioid piece but I would say Generation Z just arrived on our campus they have had access to technology one of my answers was telemental health so I’m not anti technology but I think it’s meant that these folks have created relationships in different ways so my lens of course working with college students today in and day out is that I think that there is a the irony is as connected that they are there is also a loneliness and isolation with the population so I think we’re talking about mental health in general not just addiction there is a disconnection these computers that were walking around with has created some unintended communication issues and leaving a lot of folks feeling awfully isolated and disconnected with maybe not as many communication skills how do you work through some of the issues that were facilitated face to face before I think that’s completely changed and our society is trying to keep catch up to the ways in which we have modified and changed the way folks communicate with one another but I think a symptom of loneliness and disconnection is one of them a devil’s advocate to that as the only non-medical professional here plus a Facebook er yeah X yeah opioids are different it fundamentally changes your brain chemistry and a lot of people may be addicted to opioids not because they have isolation or other things happen in their life but because a doctor wrote him a prescription and they got addicted to it because they trusted their medical professional and found themself in a situation that they could never imagined and whether it’s opioids or benzos I think we also have to look at the system not doing right by a lot of people who got walked into this crisis and didn’t have pre-existing conditions that walked them through it and so I think as a system we need to take as well for us failing a lot of patients as well as well as societal issues that may make someone opt in couldn’t agree as a medical provider and in prescriber of opioids I couldn’t agree more so okay great so let’s go ahead and give two microphones to the audience we’ll go ahead and steal great yours and yours thank you very much my name is rob Hernandez I earned my graduate degree here from University College in healthcare leadership and right now the pressing issue that’s being discussed by the governor’s Health Commission as well as a lot of medical providers whether it’s integrated health or not is regarding interoperability and that is in regards to the health information exchanges is that and especially with this population that you’re talking about with a behavioral health care is that you’re gonna see fragmented care so you might have them go into one agency for health and then you never see them again but then they pop up somewhere else and then somewhere else and some because it’s a mobile population so I would like to take that 50 billion dollars and solve the the interoperability issue because right now healthcare policy and finance says well we can’t do anything about it well yeah they can but or when you talk to the leadership at that department they’ll say well we’ve been working on this for years well let’s get to it and solve it because fragmented care means expenses it means cost and it means people aren’t getting the care that they deserve so what can folks do to really try to make sure that interoperability succeeds and not only that but director Barnes you touched on people with intellectual developmental disabilities thank you for mentioning that because that is one population that always gets marginalized no matter what the discussion is so thank you very much for that thank you if I can just comment on that thank you for your words I actually attend a lot of the eHealth commission meetings they’ve been meeting for about five years something like that for trying to move forward on this it is a huge initiative but it’s one that we can’t do any of this without any technology platform I worked in the IT sector for a while and so I can tell you a lot of the answer is new technology and new ways of interoperating between whether it’s being able to legally share data or just being able to functionally share data we are not there now and it’s causing harm for people and if you take the idd population they may not even be in a database and then they walk into emergency room or a provider and there’s no way to let them know that this is a comorbidity or an issue they’ve been dealing with or a natural response to some of their disabilities so thank you for that one thing that people can do and I mean this seriously is please talk to your legislators a lot of these changes like the interoperability is a budget issue and a priority issue and I can’t tell you how powerful your legislators are in terms of setting those priorities and so if it’s important to you tell your legislator and ask for their help to get it on on the budget document and legislation hello my name is Maureen Welch I live in a rap Hill County and I have a 12 year old son who has Down syndrome so he has an intellectual disability so thank you again for mentioning the idd I am a little bit wondering where hick puff is tonight because we hear all about how the regional accountability entities are supposed to be coordinating and uniting care between physical health and behavioral health and my son and I just made a recent foray into mental health and I had a little bit of a reaction when I saw the PowerPoint earlier because um the mental health centers are not inclusive of my son they do not serve people with intellectual and developmental disabilities and I think it’s actually complete completely illegal they push it all over into the CCB’s the community center boards to serve and that’s a real concern for us and then also I would like to know how we might be able to access director Barnes because I do have a few questions is about Adult Protective Services and I’ve attempted to email you and call you and I just don’t know how to get in to speak to you so maybe you could share how public can follow up that’d be wonderful but thank you again for mentioning the intellectual and developmental disabilities because we are always tenth class citizens including in the mental health arena and I hope that changes in the future yeah thank you for that question miss Welch I also have a beloved niece with ID pretty extreme intellectual and developmental disabilities and so I keep her for thought you know her for in my poor front in my mind when working on this you’re right we don’t have good systems for people with i/dd and mental health it’s a it’s a definite gap in our system in terms of pick puff the woman who runs at Kym BIM said her and I don’t go a day without speaking she’s a co-chair of the behavioral task force and I will say I feel like I’m bold I think she’s twice as bold as I am and so I expect some of our recommendations to come out to be extremely bold in terms of system reform so suspend any thoughts on it until you see what we come out with I have a lot of confidence and hikmah being a leader and doing some things differently regarding and reaching me Yamma but I just declared email bankruptcy because I have like 8,000 emails I don’t even think I’ve read so go ahead and email me again at Michelle dot Barnes at state code IQs I’m relieving myself a feeling guilty about the other 8,000 and just starting fresh with the new inbox doctoring ng Patroni I’m the head of higher education for the state and I mentioned this a little bit earlier but as I speak with all the presidents of the institutions and I asked them what’s the number-one concern they have on campus and to a person to a person they said mental health issues the number of students who have attempted or committed suicide over the last just last year would probably astound you if you knew and so what’s what what do we do on campuses I like your idea of having that the campus recovery piece but what are some other things that that we can do on our colleges to help our students with this issue yeah I think we are we just got back the American College Health assessment looks at mental health domains as well as other physical domains and I think the surveys are echoing exactly what you’re talking about 20% of the students have seriously considered suicide in the last 12 months 20% of our entire student population that’s amazing I think we do have to certainly individual psychotherapy as a therapist I think that that’s a very powerful tool but it can’t be our only tool so helping people to student to thrive Kimmel our director of health promotion is here today she spends a lot of time in prevention how are you training folks to connect to talk what how are you connecting people into the resources these early interventions one thing that the university started last couple years the behavioral intervention team says looking at faculty reports so students who are not have a change in baseline who are not doing well connect the dots much earlier I think we in higher ed have been done a great job when a crisis happens but what can we be doing how we need to change those issues that someone who’s feeling disconnected not doing well how can we know about that earlier on and so we’re creating we are using technology to connect faculty to the advisors developing the CRC is another example the telemental health program has been another I think the alarm bells are there and we all have to be working together I think faculty have been terrified about what’s happening in this classroom and they haven’t known what to do so how are we training faculty on early signs of identifying what these issues are they’ve sort of said I think historically not felt comfortable or competent in that area so identify those people who are have regular contact with the students get them tied into the system earlier before crisis arises it’s what we’re doing here and I think you’ll see more of that nationally hello my name is Edward kan and I’m an associate professor at the University of Colorado Denver in the MA counseling program personally I believe that safe affordable housing is a human right and I think here in Denver we obviously have a housing crisis and we’re criminalizing homelessness so my bold idea would be to have safe affordable and on-demand housing for folks but obviously that’s pie in the sky so what do you see as the biggest barriers to safe and affordable housing for Denverites thank you I’m not going to address the and if I had an answer to that I would be in a different job but it’s a huge it’s a huge issue particularly for marginalized populations and that’s where we’re trying to put some focus right now if you’re exiting the foster care system and emancipating you don’t have a family to move back in you’re probably homeless if you’re exiting the criminal justice system and you have mental health issues or substance abuse you’re probably going to be homeless if your youth exiting Youth Corrections and you have the same thing and it hasn’t been you haven’t been given an opportunity to rehabilitate the same is going to happen to you so that’s where our focus is really right now in some of these marginalized populations we’re doing a project and this is just a drop in the bucket but we’re taking a quality in with Colorado Coalition for the homeless and turning it into apartments rooms that people exiting veterans exiting the state mental hospitals would have a place to go so they have a chance to reenter society and not end up homeless so what we’re finding is Colorado Coalition for the homeless is clearly one of the leaders in the state for this and so we’re trying to partner with them and everywhere we can to support them within the communities is where we’re doing the more support for foster kids and in disenfranchised youth but it’s a huge it’s absolutely part of the the problem it’s assume it’s the social determinants of health right just didn’t want to get that wrong and it’s one that as a state we need to be doing a lot more and as a community and I think this is your question is a really is one that I think as a that we need to look at in the city because I think as the city has exploded so quickly further gentrification of I point to five points in particular I think this issue is only you know on the ballot last year was what to do with the the tent communities I think the issue is going to get bigger and bigger and I’m fearful if we don’t head it off and solve some of this issue that we’re going to have them far more complex problems in in the very near future I just think it’s untenable what’s happening okay looking at the time I think we have time for probably one more question and then we’re going to try to get people out on time right around 8:30 ish great so I’m gonna leave this panel and we’ll start at the end with maybe a just a last thought to end the evening on to send our send our attendees home one so Michael we’ll start with you I’ve really picked on you I’m Paul I apologize but I think you know in in wrap up I think I’d like to tell some positive positive news I think gen Z the students who are coming here have as you look at the whole picture that there are some loneliness and isolation issues but I think that we’re seeing some really positive things there’s lower substance use amongst this population fewer have reporting less early sexual experience so I think that it is a group that’s deeply dedicated to the planet dedicated to one another we’re seeing it’s a compassionate group and I’m very hopeful for our youth actually I’m seeing just a lot of positive things that are coming that they’re coming to campus with so I just wanted to add that part that there is there are some of those liabilities that we talked about earlier but I’m really hopeful for our youth and seeing a lot of care and compassion for one another and deep commitment to social issues including our planet and poverty so I’m very very hopeful that this generation is going to be able to do things better than mine they also seem to be a lot more open about mental health right they are there’s not the same kind of stigma or discomfort around it um I was you know as I’m listening to all of us talk I’ve just struck by how multi-layered and systemic these issues really are and even you know professionally we have our siloed conferences and so I think summits like this that bring so many people from so many disciplines with interests that are you know multifaceted together really will start to create some answers to these questions rather than all of us just hanging out in our professional wheel houses and not not speaking to each other so I’m just really grateful that we are we’re having these types of conversations I think I’ll leave on a final note is stigma is real and it’s another thing we’re learning as we’re going around the state is how important it is to reduce the stigma associated with mental illness and substance abuse and I congratulate you Stephen for starting us by being so honest about your own situation and if in as you notice the Lieutenant Governor mentioned her brother and his struggles with mental health and ultimate we taking his own life and I think it’s really important that particularly people in power and people with influence are brave enough to talk about their situation and try and make normalize it like if I have the flu every one of you is going to know because I’m going to tell you 10 times but what I but it wouldn’t be great if I could say the same thing I’m feeling a little down today and I could use some support we did a project this year which I have to admit I wasn’t too thrilled about my we had some opioid money to do a project called recovery card project which we got a bunch of people who are in recovery to design greeting cards and gifts and limping so you would it would help people if you knew someone in recovery or someone struggling with addiction or somebody whose family member loved one was it was to give them the words to support them because you don’t say hey you’re doing better with that opioid problem you have or you know sorry you’re signed in it’s like we don’t have the words to do that and I wasn’t actually thrilled I thought it was kind of a silly project until the first day we give the cards away in 10,000 cards disappeared for our website people ordering them and now we’ve got hundreds of thousands more so you can order them for free but what it told me was that a lot of us don’t know how to deal with stigma and we don’t have the word so we avoid it and we run away as opposed to saying you know that was a beautiful thing you did to start us we need to run into into the the concern and not run away from it and so that’s one of my big messages is every one of us can do something about stigma even if it’s just looking at your own biases in your own insecurities and just ask that follow-up question and support people who need us so my final thought is one of uh you know we started off talking about isolation and I and how I should be.we and I think I’m gonna turn that around and say you know we’re facing right now one of the greatest public health epidemics threats whatever you want to call it in our nation’s history with the opioid epidemic in the mental health epidemic that we have in the country and instead of looking at the stage and looking out these experts and saying oh it’s great what they’re doing I want each one of you to ask what am i doing to really help our country and help my community solve these issues am I being a good neighbor or friend my patient is struggling I might oughta buy it to my you know classmate or my roommate who’s struggling am i checking in with them if I have someone who I know and love who has an opioid use disorder do I have narcan with me so that if they do overdose I’m able to reverse them right am i being an open door that people can feel like they can speak with and then on the other hand if you do struggle with one of these issues know that you’re not alone know that there’s so many people like you who are struggling and have really it is the bravery to go out and seek help when you need it it’s nothing to be ashamed about it’s something that we all and by you stepping for it and saying I need help at this time I’m having a bad day and having these thoughts I think it makes you stronger and it also models for other people that look for help is okay so maybe I will leave by I guess you’re gonna have the final word here right so I just wanted to thank everyone so much for joining us tonight this has been a really amazing conversation thank you dr. Clark for your contribution thank you to each of the panelists really appreciate your insights and the good news is as this is just the start of the next three days so we hope each of you in the room will find a workshop or two or three or four to join us because we’ve got some amazing content we’ve got speakers flying in from around the country so please take advantage of it so hopefully I’ll get to see you throughout the week and if you have questions afterwards please stop down and see us so thanks again and get home safely [Applause]
The intersection of substance use and mental health continues to be a challenge in the State of Colorado. It’s estimated that about 20 percent of the state’s adult population —about 832,000 people— is living with a mental health condition, according to a 2019 report from Mental Health America, and nearly 450,000 of them aren’t being treated for that illness. What’s clear to community leaders, policymakers and providers alike, Colorado’s behavioral health care system is struggling to keep up with the increased need.
Speakers and presenters engaged our community to break down silos statewide and to bridge the gaps in communication and collaboration. Specifically, the Summit provided various audiences with approaches to:
awareness and education;
training and clinical practice; and,
policy advocacy and action.
This free event was a collaboration between the Mental Health Center of Denver, the University of Denver, and Envision: You—an initiative focused on LGBTQ+ behavioral health concerns. Participants were able to discover new tools and resources, discuss practical strategies for change, and connect with colleagues and experts alike.
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