Nearly a quarter of Ruth and Moffat counties use the local community health center, so he tried to include mental health checkups for anyone who came for a checkup – or even a toothache.
Northwest Colorado Health, with offices in Steamboat Springs and Craig, began integrating mental health care a decade ago, trying to catch early signs of depression and send patients to therapy meetings, either on site or at the community mental health center. in the region. He added mental health reviews to dental meetings in 2017.
Yet, like many of Colorado’s 20 public health centers across the state, Northwest can’t hire enough counselors and social workers to maintain full staff and is constantly struggling to keep up with its behavioral goals. health. Patients who are unable to have a face-to-face meeting are connected by telehealth to a therapist who does not live in northwestern Colorado.
“The star is that when we have full staff, we are fully integrated,” said Stephanie Einfeld, CEO of Northwest Colorado Health. “It really was a big barrier for us.”
Colorado has been talking about truly integrating mental and physical health care for years, if not decades, into what many experts see as key to tackling the state’s suicide and mental health crisis. Now the influx of federal funds to alleviate the coronavirus will intensify the work.
A law passed by lawmakers in Colorado this year provides $ 35 million for public health centers, doctors’ offices and clinics to add mental health proposals – whether they start from scratch or have ambitious plans to increase services. Another new law sets $ 11 million to add more mental health care to school health clinics and pediatricians. Two other bills focus on recruiting and retaining therapists, psychologists and substance abuse counselors.
“We will never see this kind of funding again,” said Senator Sonia Jacques Lewis, who was the main sponsor of the House’s Bill 1302, which invested $ 35 million in “full-face care.”
What many clinics need are technological incentives to improve telehealth opportunities, as well as funding to hire more therapists, she said. Colorado has lost too many behavioral health providers due to retirement and burnout in recent years, and then the coronavirus pandemic sent depressions and anxiety to new heights. “It’s always balancing with the care of the whole person that you need to have suppliers available and on hand,” said the senator, a Boulder Democrat and pharmacist.
Clinics can apply for dollars in grants to extend working hours to offer behavioral health care at night and on weekends for working parents struggling. They could use it to guide staff through advanced training so they can check for mental health problems or provide therapy.
According to an accompanying bill aimed at increasing the workforce, municipal colleges can seek funding to expand night and weekend programs for health workers who want to enter mental health or advance in their careers but do not want to quit their jobs. Also included: funding to expand a program in which robots are sent to remote parts of the state to teach health professionals how to perform certain procedures. In training courses, the robot is the patient.
Over the next five years, Jacques Lewis predicts that colleges will offer free training to those interested in working in health and mental health. And patients – no matter where they go for health care – will receive preventive behavioral health care without being noticed.
“This is done so smoothly as part of the regular issues that the patient doesn’t even know what’s going on,” the senator said. It’s not like, “We’re going to look at you now to see if you have a mental health problem.”
“We are finally trying to prepare things for reality.”
The $ 35 million bill is a continuation of an already dead federal grant program called the U.S. Innovation Model. Under the program, from 2015-19, 344 primary care practitioners received funding to integrate mental health care. A federal assessment showed that the program led to fewer behavioral visits to hospital emergency departments, but then funds stopped.
Efforts to better integrate mental health care into medical offices came at a time when Colorado was trying to revamp the state’s mental health system, which includes 17 centers across the state. New rules will open non-bidding centers to care for Medicaid or uninsured patients to competition – including potentially from some of the state’s 20 health clinics that offer medical and dental care.
Public health clinics, ranging from the Tepeyac and STRIDE centers on the Denver subway to the Uncompahgre Medical Center in Norwood, began offering mental health care as early as 2006 or 2007, according to the Colorado Health Network. But these services have expanded to the point that today, centers often have a mental health professional who sits in medical meetings or, at the very least, asks a health care professional to ask questions about whether he or she feels depressed or thinks he or she wants to die. .
The reason community health centers need to include mental health care is that 1 in 7 Colorado residents receive first aid from a community clinic, said Taylor Miranda Thompson, senior manager of online quality initiatives. That’s 847,000 patients in 230 clinics in 45 of Colorado’s 64 counties.
“The focus of health centers is prevention, and that could mean identifying a patient with symptoms of depression … or chronic stress or difficulty sleeping, or even screening for suicidal thoughts,” she said.
Each of Colorado’s 20 public health centers has contacted the local mental health center to refer patients who have more severe mental health problems.
In general, the centers need more staff and funding to modernize technology. When the pandemic struck, many quickly switched to telehealth. Now that the sense of urgency has diminished and funding is available, health centers are seeking to upgrade their platforms, said Stephanie Brooks, director of public health network policy.
And in rural areas, health centers hope that legislative reforms will lead to better broadband services so that patients have more reliable video connections during virtual meetings, she said.
“All health centers have a very fast-paced telehealth platform, but because they had to set it up so quickly, they still have a long way to go,” Brooks said. “You can do it fast, cheap or really good. I think they are working on doing it really well. “