In a perfect world, every state in America would have a dedicated leader focused on mental health.

Dr. Benjamin F. Miller

Unfortunately, this often amounts to nothing more than wishful thinking. In the eyes of state leaders, such a role is just too unfamiliar, or too much to ask for. Sure, we have people who oversee mental-health programs in states – typically focused on Medicaid – but we don’t usually see these people in positions of authority.

However, back in April, Colorado began the hard work of transforming wishful thinking into concrete reality. In October, that work was taken one step further, when Colorado announced an opening for the role of Commissioner of its brand new Behavioral Health Administration.

It is worth taking a moment to note just how significant this development is. Under Colorado’s new Behavioral Health Administration, a scattered assemblage of resources and stakeholders will be brought under one roof to more effectively coordinate and integrate efforts to provide affordable services to those who need them. This is a one-of-a-kind development. 

Even more importantly, the Behavioral Health Administration will have a seat at Gov. Jared Polis’ table. For the first time ever, a mental-health professional — the Commissioner of the BHA — will have a position in a governor’s cabinet, for the explicit purpose of guiding better mental-health policy in the state. Not only does this development mean that Colorado is symbolically elevating the importance of mental health in the state (which is a victory for mental health in and of itself); it also means that mental health and addiction concerns will be actively raised across a range of policy issues.

From housing policy, to COVID responses in schools, to poverty and health-care access, to the use of federal resources, mental health shapes and is shaped by just about every kind of public initiative. By placing the Behavioral Health Administration Commissioner in the governor’s cabinet,  the likelihood that mental health needs will be incorporated into less traditional policy avenues dramatically improves.

This represents an opportunity for victories large and small across the policy spectrum. Mental health may be better integrated throughout the state rather than just be another siloed program that doles out dollars into struggling systems and structures.

However, the creation of the administration does not guarantee improvements in mental-health policy. Colorado has a major opportunity for sweeping mental-health reform — not just how state and federal dollars are spent on care, but how oversight is conducted and mental health-related policies are crafted and implemented.

But it is an opportunity that could just as easily be squandered. Without strong leadership – leadership with a vision and the courage to challenge the status quo – we will have a wonderful position, but no meaningful results.  

Mental health policy is complex and often frustrating, which means that there is just as much of a chance not to move the needle as there is to do so. Leaders should be vigilant against such an outcome. Despite robust evidence and decades of data showing people are not getting what they need for mental health care, we continue to build programs using outdated, ineffective policies. This means our new commissioner will be in the culture-change business as much as they will be in the health-policy business. 

Now, there are plenty of signs that Colorado will end up with a commissioner who takes an active and assertive role in the development of policy, so that mental-health considerations are kept front of mind. The fact that this office has been created is perhaps the most important of those signs. But sometimes, a little encouragement is necessary.

Whoever ends up in this role should be heartened by the fact that there is a clear path being laid for dynamic and meaningful change. The creation of the Behavioral Health Administration represents a roadmap for the path of change, both in Colorado and across the U.S., and the future commissioner should feel empowered to entrench herself or himself in substantial structural reform.

Colorado faces no shortage of mental-health challenges, from a youth mental health crisis to reports indicating that the state ranks worst in the nation for adult mental health care. A pessimist might look at this data with despair, but we should all be encouraged that Colorado is taking direct action to address these problems. 

Through the creation of the Behavioral Health Administration, Colorado has given the rest of the country a model to follow, and it has started to form a clear path out of the mire of its own mental-health challenges. This is an enormous opportunity, and one we should all hope Colorado takes full advantage of. 

Dr. Benjamin F. Miller, of Denver, is the President of Well Being Trust and the advisory board chair of Inseparable, two of the nation’s leading mental health organizations.

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