Opinion: Rep. Amabile: 4 things the Behavioral Health Administration can do to improve Colorado’s mental health

Colorado’s Behavioral Health Administration was created by Gov. Polis two years ago and announced with great optimism. The idea was to create an organization that could coordinate the various mental health programs run by our state agencies. The hope was to get these disparate programs working together to drastically improve Colorado’s mental health landscape. 

That landscape is now more desperate than ever. More Coloradans with untreated mental illness are suffering in our jails and on our streets. Children’s Hospital declared a “state of emergency” in youth mental health two years ago, but record numbers of young people continue to need emergency room care for mental health needs and self-harm. Homelessness linked to intractable addictions is growing and impacting every Colorado community.  

Unfortunately, the effort to stand up the Behavioral Health Administration has struggled. Many dedicated administration team members have worked tirelessly to move the organization forward, but poor communications, missed deadlines, and misunderstandings have resulted in insufficient progress on problems we urgently need to address. 

A month ago, we learned that the appointed leader of the Behavioral Health Administration was no longer in her position. Sometimes even the best-vetted people just don’t work out and the reasons are always complicated. The more difficult reality is that we are yet another two years into neglecting our mental health crisis.

But there is reason to hope. On April 17, the governor appointed Michelle Barnes as interim commissioner of the Behavioral Health Administration. Michelle is a turnaround expert. She chaired the task force that led to the creation of the Behavioral Health Administration, and is well-positioned to take the reins until a permanent leader is appointed. 

This change offers opportunities to refocus the Behavioral Health Administration, and these are some of the things I hope will be prioritized:

The Behavioral Health Administration must lead to bring a profound change in the way our state approaches mental health care. Most Colorado communities deal with serious mental illness through the least effective, most expensive ways: in hospital emergency departments and the criminal justice system. Families watch their loved ones cycle from emergency rooms to jails to homelessness and worse, while trying everything — for years, in vain — to get appropriate medical care for their loved ones with serious mental illnesses. Imagine if we treated cancer patients this way. It has to change.  

The Behavioral Health Administration needs to provide a mechanism for prioritizing care to those who need it the most. Colorado’s mental health care resources are extremely limited. Prioritizing people with the highest needs across Colorado’s limited treatment resources is a crucial leadership function the administration should provide. 

The Behavioral Health Administration must lean into early care. Mental illness does not begin when a crime is committed, and yet we have no meaningful interventions for people with serious mental illness other than arrest. Crimes by mentally ill people are a manifestation of untreated psychosis and addiction disorders. We can’t solve our enormous competency backlog without a robust civil mental health system that gets people into care before they get involved in the justice system. This is a public safety issue. 

Our safety net system is not working, and the Behavioral Health Administration must address this. A family in my Boulder district has an adopted teenage son with attachment and substance misuse disorders, who has repeatedly tried to commit suicide. These parents have done everything in their power to get Medicaid-supported care for this young man. He is finally in a Colorado facility, but getting him there has been an epic struggle that cost the state far more than it should have. During more than a year of delays, his condition worsened and the family experienced anguish that was extreme and unnecessary. The Behavioral Health Administration has to institute payment policies based on the proven wisdom of proactive care. Being reactive is costing us so much more down the line. 

The Behavioral Health Administration will be successful if, over the next five years, Colorado figures out how to effectively help people before their mental illnesses do so much harm, both personal and societal. That is what the Behavioral Health Administration is supposed to do. We need concrete steps to get there. I am hopeful and ready to help.

Judy Amabile, of Boulder, represents District 49 in the Colorado House Representatives.