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How we reached a mental health crisis

The state is short on resources, short on beds, and too often, families don't know where to turn in a moment of crisis.

DENVER — The number of kids showing up in emergency departments in Colorado more than doubled in a recent five-year span, from 2,002 in 2016 to 5,168 in 2021.

A similar number of kids went to emergency departments between 2021 to 2022, meaning that while the number was leveling off, it began to flatten at a highly elevated level of need. 

The state is short on resources, short on beds, and too often, families don't know where to turn in a moment of crisis.

Yet a look at history shows we've made the same mistakes over and over again when it comes to addressing mental health.

The current situation

In the more than four years that Kari Eckert has bravely shared her family's story, one thing has stayed the same -- suicide is still one of the leading causes of deaths for teenagers. 

"We can change that," said Eckert. 

Her son, Robbie, died in October 2018 by suicide. 

"I was an engaged mom, Robbie was a sophomore in high school. We didn't know Robbie was struggling," she shared. 

She has since worked to raise awareness and work with teens through the foundation her family started called Robbie's Hope


"Robbie was a great kid, super well liked, empathic and outgoing like myself," said Kari. "Robbie didn't know he was important on his own, and enough. I know Robbie was enough. I want kids who might be able to relate to how Robbie felt, that they are enough." 

Wednesday, she was at the Colorado State Capitol meeting with lawmakers, and urging them to take action as resources for kids dwindle, and more families are looking for help. 

"So much of this comes down to funding, we can't use that as an excuse anymore," she said. 

How did we get here? 

Vincent Atchity is the executive director for Mental Health Colorado. 

The turning point that sticks out to him dates back decades. 

"Deinstitutionalization started in the 1960s," he said. "The Kennedy family recognized how important mental health is and to appropriately meet the needs of people with mental health needs."

This is when the country started moving away from psychiatric institutions for good reasons. There were little standards for health care. People were hidden away, restrained and even experimented on. 

"Part of that movement led to the creation of community mental health centers," said Atchity. 

He said that was the right decision for better care, but it never materialized the right way, falling short on access and enough resources, while beds were vanishing. 

And so, Atchity said, many people were institutionalized in another way -- arrested and in jail. 

There were similar problems, according to Atchity, including a shortage of staff in the 1950s and a nurses strike in the '70s because they were so burned out and underpaid. 

As the population grew, the problem became more intense. 

In 2018, we saw a familiar situation play out again. 

"The Family First Prevention Services Act passed in 2018 at a federal level," said Zach Zaslow with Children's Hospital Colorado. "We supported that bill."

It's intended to get kids out of institutional settings and back into their homes and communities.

"In Colorado, we did the first part of that deal," said Zaslow. "We have not yet built those supports and services. We've lost 2,000 residential beds over the last decades, we have about 300 beds remaining, none of which will service kids under 13." 

Why do critical services keep falling through the cracks? 

"I think it's always been anemically funded," said Zaslow. "We always say as advocates for kids, unfortunately kids don't vote. So, when policy workers who are all adults are setting up systems, whether it's educational systems or other government programs, kids are sometime an afterthought, even if lawmakers are parents or grandparents, they are not always top of mind."

Atchity said what's needed is a long-term commitment to funding. This time around advocates say the energy is different.

"It's one of the mysteries of the way we do mental health in this country," said Atchity. "Our interest wanes, and then there are moments of enthusiastic commitment."

"We've got a moment where there's more awareness than ever before perhaps."

What was discussed at the Capitol? 

Parents like Kari were asking lawmakers to pay attention in the long run, not just now. 

She was glad to see legislation in the past gave assessment tools. She would like to see more education for educators. 

"Children need to be taught about their brain," Eckert said. "We aren't doing that in our state. There are a few state that are. I understand that requires mandates and requires money." 

Zaslow said there was a big infusion of COVID relief dollars, and what was important was the way the money was split. A third of the money went to kids, who make up a third of the state's population. 

He also said though one-time funding will run out soon. 

"There is a cohort of kids who will need extra help because of remote schooling, disruption and stress parents losing jobs," said Zaslow. "And kids losing parents and grandparents to COVID. We are going to need long-term investment."

Zaslow is talking to both state and federal lawmakers about this.

He also said changing reimbursements will make a huge difference. 

He said under Medicare, doctors get paid closer to the cost of providing services versus on Medicaid. It can be anywhere from 60 to 70 cents on the dollar of actual costs. 

"People who go into the business of pediatrics and serve low-income kids on Medicaid do it knowing they will lose money," Zaslow said.

But advocates said the energy is different this time and hopes that makes a lasting difference.

"We've got a moment where there's more awareness than ever before perhaps," said Atchity. "The volume of awareness can get to a place that it's unrelenting pressure on leadership to stay attentive to this need."

Data producer Zack Newman contributed to this report. 

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