“The hope that kills you” is a phrase reflective of how it is best not to raise expectations because if the endeavor fails, the disappointment is less crushing. I have felt that devastating blow many times in my life, and yet I still hope for so many things, including that Colorado will continue to focus on reforming our behavioral health system.
The recommendations put forth by Colorado’s governor-initiated Behavioral Health Task Force cannot be forgotten. The need for high-quality, accessible and timely behavioral health services existed when the task force was established in 2019, and the need has not diminished.
Almost all of us are impacted by mental health or substance use needs, either directly or with a loved one. The demand for services increased exponentially during COVID. And post-COVID, substantial supports are still needed. It is challenging to seek professional help when our workforce is limited, waitlists are long, and insurance is rarely accepted by providers.
In 2020, the task force released the Blueprint for Behavioral Health Reform with more than 150 recommendations spanning accessibility, accountability and affordability, among others. Some of the recommendations — like establishing a Behavioral Health Administration, or BHA, to serve as the entity responsible for all behavioral health in Colorado — are very much in progress and moving forward.
The blueprint was meant to be a guide over the course of several years to reform our behavioral health system. We knew that it would take a long time — a decade, if not more — for the full vision of the task force to come to fruition. We anticipated that the initial focus of the reform work would be to reach and serve some of our most vulnerable populations.
Eventually, though, the outcomes of reform efforts must serve all people in Colorado. We are far from meeting our first goal to serve our most vulnerable — and not for lack of effort and trying.
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When first established, there was so much excitement about and hope for the new BHA that it was deluged with a myriad of statutory requirements and challenging timelines. This includes but is not limited to an overhaul of the state’s behavioral health rules to set new standards of care and expectations of providers, the development of a statewide care coordination structure, and establishing a grievance system — all of which is outlined in House Bill 1278, which established the BHA in 2022. There have been leadership transitions and staff turnover. And yet, despite the slow march toward change and the challenges necessary to overcome, we must continue to believe what our behavioral health system can still, and will, be.
There is good work happening. In July 2025, the new Behavioral Health Administrative Service Organizations will offer coordinated care across Colorado, and will address the bifurcation between mental health and substance use services. The BHA’s performance hub gives us some insight into if our system is working as we need it to. We are continuing to cultivate and strengthen our workforce by promoting the online Learning Management System.
I’m grateful for the initiatives underway, and I’m hopeful that more will continue.
However, there is less coverage of behavioral health reform by the media and fewer pieces of proposed legislation this session. I have not heard as much discussion about it among communities as I’ve traveled across the state. There are, and always will be, competing priorities.
Housing, gun violence prevention, education and health care are hot topics in 2025, as they should be. Behavioral health, which is an important part of health care, must remain a priority, too.
We cannot overlook the fact that there are so many people who are trying to navigate depression, anxiety, addiction and many other conditions every single day.
On a personal level, this impedes our ability to live healthy, happy lives. On an economic level, the burden can be upward of millions, if not billions of dollars, due to less productivity and missed work. (In 2017, the Mental Health Commission of Canada found that the economic burden of mental health conditions in their country was upward of $50 billion per year.)
Colorado is facing a severe budgeting challenge. We can, and must, continue to embrace the recommendations for behavioral health reform. Even in these difficult budget times, the blueprint offers opportunities to improve our system that require little, if any, funding. Legislators who are considering public policy changes to behavioral health can look to the blueprint as a guide.
Hope is trusting or believing that something good will happen or a positive outcome will occur. On behalf of the hundreds of people across Colorado who shared their behavioral health stories and the millions of people who still need help, we must not give up hope — and we should continue to invest in behavioral health reform efforts in big and small ways.
Summer Gathercole, of Conifer, is the managing director of SHG Advisors and is the former deputy commissioner of the Colorado Behavioral Health Administration.
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