DENVER -- Two measures on the November ballot could affect how Colorado delivers behavioral and mental health care to residents across the state.
Amendment 72 would increase the tax on a pack of cigarettes by $1.75 statewide to fund health programs, research and training. And Larimer County voters will be asked to approve a 0.25 percent sales tax increase to build a detox and substance-abuse treatment center in the area.
Laurie Stolen, alternative sentencing department director with the county, said such a center could put a stop to expensive emergency-room visits for many.
"After decades of trying to put Bandaids on our gaps in behavioral health care in Larimer County, we've finally come up with what we feel is the most viable solution to fill these gaps,” Stolen said.
For every dollar invested in treatment, taxpayers save four dollars in criminal justice and hospital costs. And emergency room visits decline by more than 45 percent when patients can access behavioral health care.
Moe Keller, vice president of public policy and strategic initiates at Mental Health Colorado, said raising cigarette taxes would help Colorado invest in educating young people. She said Colorado ranks 48th in the nation in per-capita funding for behavioral health services, and near the bottom for the number of available beds.
"Currently 35 percent of prison inmates, for example, have a diagnosable mental illness,” Keller said. “And the prison system in Colorado is the largest provider of residential mental health services in the state."
Around 72 percent of people incarcerated in the state have a history of severe substance abuse, Keller said.
And when the only two options for addressing behavioral and mental health are hospitals and jails, Stolen said, taxpayers end up on the hook and problems are left unresolved.
"So many people have come forward and told their story of how they've been personally impacted by a family member - a brother, a mom, a dad - in some way,” Stolen said, "because of a substance abuse or a mental health issue."
According to a 2015 report by the League of Women Voters of Colorado, one in four people nationally has a mental-health or substance-use disorder.
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Alzheimer's disease is the eighth-leading cause of death in Pennsylvania.
A documentary on the topic debuts Saturday in Pittsburgh. "Remember Me: Dementia in the African American Community" features individuals and families who are dealing with memory loss.
C. Nathaniel Brown, founder and CEO of Expected End Entertainment and a former Pittsburgh resident, said his aunt lives with dementia, which sparked his interest in talking with others to find out more about the disease and how it affects communities of color.
"The first thing I found out was that there are over 100 types of dementia," Brown noted. "And the more I learned, the more I realized how much it was impacting the African American community disproportionately. We're twice as likely to be diagnosed with Alzheimer's disease or some other progressive type of dementia."
The film will be shown at the Carnegie Library in Homewood, from Noon to 3 p.m. ET. It is free, but registration is required. According to the Alzheimer's Association, more than half of Black Americans believe major declines in memory and cognitive function are simply a normal part of aging, rather than symptoms of Alzheimer's or dementia.
Brown added after the screening, there will be a question-and-answer session and community organizations will be there to provide resources.
"Allegheny County Health Department will be present, the University of Pittsburgh Alzheimer's disease Research Center will be there," Brown outlined. "The Dementia Friendly Pennsylvania organization will be there, as well as several people who were interviewed for the film, including counselors, professionals."
He mentioned the documentary features the late Academy Award-winning actor Louis Gossett, Jr. Brown said Gossett emphasized the importance of leaving a legacy by educating people about living with Alzheimer's, steps to take after diagnosis, and preventive measures.
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Boulder and Broomfield County residents can now access mental health services the same way they can access urgent medical care.
Dr. Nadia Haddad, medical director of mental health services with Mental Health Partners, said all too often, people can't get help unless they are already connected with an outpatient provider, and many have months-long waiting lists. She said if people have to wait for care, their situation can get worse, and what might have been a manageable issue can turn into a crisis.
"They are going to the emergency room or going to a psychiatric hospital. And so what we're trying to do is fill that gap so that people can get connected with services when they need it, on a walk-in basis," she said.
Mental Health Partners, a community mental health center serving Boulder and Broomfield counties for 60 years, recently launched UrgentPsych Mental Health and Substance Use Urgent Care. The walk-in program provides immediate, in-person support for urgent mental health and substance use needs for anyone, regardless of their ability to pay, whether or not they are an existing client, or speak English. For more information about the 24-hour facility in northeast Boulder, call 303-443-8500.
Mental Health Partners' new Intensive Family Services program provides in-home therapy for K through 12 youth with disruptive behaviors who are at risk of being placed in foster care or the juvenile justice system. The urgent care facility is also available to people of all ages.
"That's another really challenging part of seeking out services. Care for children and adolescents is often even more challenging to find. There are fewer child psychiatrists out there," she said.
Both new programs were created in part to get people the services they need to avoid hospitalization. But Haddad said when people do reach a point where they need 24/7 monitoring and daily visits from a medical provider, it is essential that people can access hospital-level care.
"The vast majority of people who are dealing with mental health-related issues do not require hospitalization. If we can change people's trajectories earlier, we can prevent mental suffering, and they may not have to go through the hospital," she explained.
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This is National Library Week, honoring the many roles that libraries play in their communities.
In central Texas, a pilot program is using the public library system to expand mental health services in rural areas.
Residents in four counties can get assistance at their local public library through the Libraries for Health program.
Trained mental health peer specialists evaluate clients and refer them to clinics for additional help if it's needed.
The program is funded through the St. David's Foundation, working to advance health equity in Central Texas.
The foundation's Senior Program Officer Abena Asante said the initiative works in tandem with the mental health community.
"It's in no way taking the place of clinical-directed psychologists," said Asante. "It's just one community response in addressing the lack of mental wellness resources in rural communities."
Asante said libraries are trusted and accessible gathering places for people living in rural areas. The libraries tailor programs to meet specific local needs based on feedback from the residents.
Data collected during the 3.5-year pilot program will be used to evaluate its success. The nonprofit Via Hope trains the peer specialists who work in the libraries.
Dr. Sandra Smith, vice president of Via Hope, said the staffers use their own life experiences to help them relate to the clients.
"They have to have had a mental health challenge at some point in their life," said Smith. "We don't ask them any specifics about that, we don't ask diagnoses - it's a self-disclosure."
The Libraries for Health program operates in eight libraries in Bastrop, Caldwell, Hays and Williamson counties. If successful, it could be implemented in other parts of the state.
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