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New mental health legislation aims to improve patient outcomes

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By Jeanne Souldern

Sopris Sun Correspondent

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Mental Health Colorado (MHC) President and CEO Dr. Vincent Atchity declared, “2022 may be the biggest year in Colorado history in terms of the significance for mental health legislation passed.”

What began in March 2021, with Congress passing the American Rescue Plan Act (ARPA), would result in Colorado being awarded $450 million to address the state’s behavioral healthcare needs.

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Before the legislative session convened, Gov. Jared Polis established the Behavioral Health Transformation Task Force interim subpanel, composed of 25 members with expertise in various aspects of behavioral healthcare and tasked with making recommendations for allocating funds earmarked for mental health efforts.

After months of work, Atchity, who chaired the subpanel, said, “pretty much all of the recommendations materialized as bills during this legislative session.” 

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Bringing M1 hold laws into the 21st century

The Modifications to Civil Involuntary Commitment (HB22-1256) bill, the result of about a year’s worth of work ahead of the legislative session, updates our civil commitment laws.

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In Colorado, police officers, licensed professional counselors, licensed social workers, doctors and nurses are legally able to place a person on an “M1 hold” for 72 hours if they are deemed to be in imminent danger of harming themselves or others.

Atchity said those individuals are often discharged quickly, picked up again and placed on hold repeatedly, which is “a poor use of resources and leaves those individuals with poor mental health outcomes.” He added, “this bill is key to instituting expectations that when people are discharged, they must have follow-up continuity of care.”

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Atchity shared that many states have outdated civil commitment laws on the books, which “date back to understandings of mental illness from the 18th century and are based on fear rather than understanding or any kind of health science,” leading to an archaic and arguably draconian system of enforcement and detention.

Currently, a workgroup of mental health legal experts across the country has drafted recommended statutory language for revising state civil commitment laws. Endorsed by State Supreme Court justices, they hope to amplify the national dialogue on quality mental health care support and services and “not continuing to rely upon our, in effect, de facto mental health system, which is our jails and prisons,” Atchity shared.

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BHA formation and safety net urgency

The formation of the Colorado Behavioral Health Administration (BHA) (HB22-1278) was formalized in “a bill that encodes all of the different structural elements of how the BHA is going to be cobbled together as a result of various agency funding streams coming together,” Atchity declared.

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While he remains hopeful of what the BHA will accomplish, Atchity admits, “I’ve got questions, so we’ll be carefully watching the implementation over the coming years.”

He elaborated, “Some of the questions we have are who will be impacted by this because Medicaid and private payers don’t come under the BHA umbrella. Even though our Medicaid enrollees are some of the most vulnerable populations, we hear weekly from consumers with private payer sources or private insurance who have difficulty accessing the care they need. The BHA doesn’t touch either of those.”

BHA has until July 1, 2024, to meet agency-wide benchmarks. However, “in the meantime, the MHC, as an advocacy organization, can’t lose sight of urgency because we are in a desperate situation — as a state and a nation — with a lot of mental health distress, and our pathways to support are scarce.”

In the meantime, “We’re gonna have to wait and see,” a seemingly frustrated Atchity shared. He then reflected, “It’s a weird thing, because I know that on the one hand, with these policy folks, we’re playing a long game in the big picture. But as [mental healthcare] consumer advocates, it’s painful because we hear stories of people’s pain every day.”

Increases in workforce and residential beds

The Behavioral Health-care Workforce (SB22-181) bill acknowledges the severe workforce shortage by dedicating $72 million in ARPA funding to cultivate a mental health workforce.

An ARPA-funded and MHC-priority bill — Increase Residential Health Beds (HB22-1303) — will significantly increase the recommended number of adult inpatient beds in Colorado.

Atchity clarified that while increases won’t reach the recommended level of residential beds, he said, “it’s a good step in the right direction.” However, he said, time is needed to build increased capacity, so “it’s not just a matter of building the infrastructure itself, but we also need staffing, and we’ve got a workforce shortage, so there are a lot of question marks there.”

Distressed? It’s a sign of the times

Atchity explained that other external factors could impact someone’s mental well-being.

“People are distressed — by climate change, gun violence, the country’s inability to have a peaceful transition of power, political polarization, the economy, the war in Ukraine, the lack of affordable housing and the scarcity of a living wage and the lack of accessibility to affordable health care,” he said.

Atchity added, “We’re distressed at the prospects of aging into isolation and loneliness. It’s distressing, and we don’t have a society that is thoughtful about coordinating resources to support human health and well-being from one end of life to the other.”

However, all is not lost. Atchity shared a way each of us can help, saying, “We can offer human kindness to others with a simple shift in the way we think about mental health, by emphasizing human health and well-being as the whole purpose for being in community with one another.”

For more information about MHC and its 2022 Legislative Report and Scorecard, go to www.mentalhealthcolorado.org/

People can use the recently-activated 988 dialing code if they have thoughts of suicide, mental health or substance use crises, or any other kind of emotional distress. You can also dial 988 if you are worried about a loved one who may need crisis support.

Tags: #Colorado behavioral health #Jeanne Souldern #Mental Health #Mental Health Colorado
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