2005 to 2011

The Advancing Colorado's Mental Health Care project was a joint effort of The Trust, Caring for Colorado Foundation, The Denver Foundation and the Colorado Health Foundation. The project provided support to human services agencies, mental health care providers and others to improve the integration and coordination of mental health services in Colorado communities.

Based on the 2003 comprehensive study of Colorado's mental health system, the funding partners created the Advancing Colorado's Mental Health Care project to help improve the system of care for Coloradans with severe mental health needs. The 2003 study The Status of Mental Health Care in Colorado detailed the crisis situation of Colorado's mental health care systems, noting that only one-third of those who need treatment received it, that costs continued to rise as state expenditures decreased, and that care was often inaccessible and inadequate. The study also found that the mental health care system was unduly fragmented, which further prevented many people from receiving the care they need.

In 2011, researchers at TriWest Group developed a follow-up report, The Status of Behavioral Health Care in Colorado. This comprehensive assessment details the strengths and weaknesses of Colorado's mental health and substance use disorder (SUD) care systems. TriWest interviewed 89 key informants actively involved in mental health and SUD treatment delivery and policy development; expanded the 2003 data to include information on SUD services and current data on mental health care across state agencies; examined the overall findings and lessons learned from the six ACMHC grantee projects; and completed an extensive literature review of key issues identified through ACMHC's work. A few of the key findings of The Status of Behavioral Health Care in Colorado include:

  • There are too few providers with specialized skills willing to serve Coloradans with the most complex behavioral health needs, given current reimbursement rates and gaps in specialized training. As a result, these individuals are accessing services through multiple systems, too often receiving ineffective, uncoordinated care, and driving up costs.
  • There is a critical shortage of providers in rural and frontier areas of the state. Eighty-two percent of practicing psychiatrists, 86 percent of child psychiatrists and essentially all psychiatrists specializing in SUD treatment are located in the Denver and Colorado Springs metro areas.
  • Specific populations continue to struggle to access mental health/SUD care. Sexual minority groups have a two to three times higher risk of suicide than the general population. Veterans are returning from Iraq and Afghanistan with elevated rates of trauma-related disorders and depression, or untreated traumatic brain injuries. In addition, when they do receive care, Coloradans of color are disproportionately served in correctional settings.
  • Colorado is a national leader in promoting integrated behavioral health care, and 50 percent of mental health/SUD care is now delivered in primary care settings.

The report offers a number of recommendations for those striving to improve behavioral health care in Colorado:

  • Continue to promote consolidation and coordination efforts among state and county agencies. These efforts are key to aligning benefits and maximizing access to federal funds, reducing overall costs, and minimizing the adverse impacts of unmet behavioral health care needs. Target provider workforce-expansion efforts to two areas: access in communities outside the metro Denver and Colorado Springs areas, and in specialized areas of need, including providers with advanced training, specialists to care for older adults and children, and culturally competent providers.
  • As available funds allow, increase overall investment in mental health service delivery, and substantially more (on a percentage basis) in SUD treatment and prevention services.
  • Expand availability and access to person-centered medical homes that integrate behavioral health and primary care.

Evaluation
Heartland Network for Social Research conducted an independent evaluation of the Advancing Colorado's Mental Health Care Project. The evaluation assessed the improvements in the coordination and integration of mental health services for adults with serious mental illness and children with serious emotional disturbance. Each of the six grantees was part of the evaluation. Lessons for agencies pursuing integration work, as well as lessons for funders and policymakers are described in the final evaluation report.

GRANT AMOUNT: $4.1 million