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Opinion: Colorado’s “mental-health hold” rules don’t hold on tight enough

A reform bill in the General Assembly would help prevent premature discharge from the ER

Anyone who has found themselves caring for a loved one with mental illness knows that it can be next to impossible to access the care someone needs to be healthy and safe. That was, unfortunately, the case for my brother, who ultimately died after he was unable to get the care and support he needed. 

Cristina Azzam

I always knew my brother had faced some unique struggles in his life, but it wasn’t until my mother became critically ill that I came to truly understand the severity of his situation. He’d always lived with my mother who cared for him, but when she got sick and eventually died, I assumed the role of his primary caregiver. He had schizophrenia, and I stayed with him for a while, but ultimately decided it was best for our family to find him housing of his own. 

We were able to get help from our community mental health center, which assisted in finding housing and getting treatment. But he resisted treatment and wouldn’t take his medication, and eventually, he decided he was better off homeless in the middle of winter.

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Shortly after he ended up on the streets, I got a call from the hospital: He was in the ICU with a severe case of pneumonia. Fortunately, they were able to get him back on his medication, keeping his mental illness at bay. But they couldn’t get his oxygen levels where they needed to be, and even though he was homeless and still needed supplemental oxygen, they released him.  

I begged them to keep him there and keep him safe, explaining that my brother had serious mental health needs. He was gravely disabled and should have been placed on an emergency mental health hold. I told them that my brother wouldn’t take his oxygen or his medication, that he needed ongoing care, and that if he were released, he would die.

The hospital refused to place him on a mental health hold, despite his dire need for mental health care.

Unfortunately, I was right. Just 10 days later, a jogger found him unconscious, lying frozen on a sidewalk in the middle of winter. He was rushed to the hospital, where he eventually passed away. 

What happened to my brother is just plain wrong. The system failed him, and he paid the ultimate price for that failure.

It is imperative that we create a system that properly cares for Coloradans with mental health needs, and House Bill 1256 is a critical step. Although my brother wasn’t on an emergency mental health hold, he should have been. This bill could have saved his life. 

House Bill 1256 makes major changes to our state’s involuntary mental health commitment system to ensure a better system of care for Coloradans in need.

In Colorado, anyone who is deemed to be gravely disabled or a threat to themselves or others as a result of their mental illness can be held in an ER or other designated facility for up to 72 hours to be kept safe and evaluated for further treatment. Ideally, these mental health holds should keep Coloradans safe in their time of need, but the system doesn’t always work like it should.

House Bill 1256 sets clearer guidelines for evaluating patients, ensuring follow-up care, and discharging patients. I know all too well what happens when patients are prematurely discharged. The reforms laid out in House Bill 1256 could save lives.  

I tell my family’s story to give a voice to those who can’t speak for themselves, and I hope that it will inspire changes to our mental health system so that people like my brother don’t keep slipping through the cracks.

We must do everything we can to support the mental health of Coloradans and work toward a system where all Coloradans get the high-quality, compassionate care they need. Colorado lawmakers, please pass House Bill 1256.  


Cristina Azzam lives in Aurora. 


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