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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As Children's Mental Health Awareness Week kicks off in Arkansas, an expert said parents can help their children have a healthy brain to thrive.

Charles Fay, child psychologist and president of the Love and Logic Institute, said national data show roughly 42% of adolescents aged 12-17 in Arkansas, mirroring national trends, receive services for severe depression.

He argued a healthy brain is the foundation of good parenting and Arkansas parents could foster children's ability to become mentally strong, responsible and successful.

"Parents creating a home where kids are really expected to take good care of themselves and show them how to do it, with the eating, the diet, with sleep," Fay outlined. "We're seeing more young people getting hardly any sleep and one of the biggest reasons is they have their phones or other devices in their bedrooms."

For children struggling with depression, anxiety or adjusting to challenging situations, the state program ARKids provides mental health resources online.

Fay stressed it is important for parents to identify signs of mental health struggles in their children. One indicator he suggested is a child's lack of interest in activities they normally enjoy. He added it is important for parents to consistently be firm and caring with their children.

"Firm means healthy limits and accountability," Fay emphasized. "There's been a number of studies recently that show that when kids do not have consistent limits, when they are not held accountable, they are far more likely to suffer from anxiety, depression, and a whole host of other mental health disorders."

Fay noted the importance of guiding children to translate their natural talents into fulfilling careers. He believes the path leads to greater happiness. His book, "Raising Mentally Strong Kids," features a strategy combining brain science with practical tools to cultivate resilient minds in children.

Studies show suicide is a serious public health problem, claiming more than 48,000 lives each year in the nation.

A new initiative from the Zero Suicide Institute aims to change it and demonstrate how a diverse group of hospitals in South Carolina and elsewhere can improve their suicide prevention practices.

Allyson Sipes, director of clinical initiatives at G. Werber Bryan Psychiatric Hospital in Columbia, said the Institute worked with her staff to develop best practices.

"The Zero Suicide Institute brought in a group of individuals that we could learn from," Sipes recounted. "Then having an expert faculty with a change package that we used to set our facility and what to look at and address."

Sipes explained the program was developed by the Pew Charitable Trusts to test evidence-informed methods to detect suicide risk and connect patients to treatment.

Nearly 27% of U.S. hospitals do not practice recommended suicide prevention practices, including safety planning, warm handoffs to outpatient care, patient follow-up and lethal-means counseling.

Laurin Jozlin, senior project associate for the institute, said studies show half the people who die by suicide saw a health care professional in the month before their death but were never referred to a mental health professional.

"We know that there's an opportunity in health and behavioral health care systems to intervene," Jozlin acknowledged. "They are being seen by health and behavioral health care professionals but they're often not identified as someone who is at risk of suicide."

Sara Voelker, improvement adviser for the Education Development Center, said they take ideas proven successful elsewhere and develop them into best practices.

"We put it together into a change package," Voelker noted. "Then teams pulled out ideas that had worked in other places and then, essentially, figured out a way of, 'How do I adapt this to make it work in my organization?'"

If you are struggling with mental health, help is available by calling or texting 988, the Suicide and Crisis Lifeline.

Support for this reporting was provided by The Pew Charitable Trusts.


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More than 1,000 family members of firefighters who died in the line of duty, including some from Texas, will gather in Emmitsburg, Maryland, starting this Friday, to honor their loved ones.

The occasion is the National Fallen Firefighters Memorial Weekend and 13 of the firefighters being honored are from Texas.

Victor Stagnaro, CEO of the National Firefighters Foundation, said their names will be added to a memorial wall.

"Every firefighter that's died in the line of duty since 1981 has their name inscribed on a bronze plaque that's mounted on a marble wall," Stagnaro explained. "The monument itself at the center is a marble sphere, I would say, and there's a flame that never goes out."

Fire chiefs from around the country will present the families with a rose, a badge and an American flag flown at the U.S. Capitol and the memorial site. Anyone who would like to honor the firefighters can participate in "Light the Night for Fallen Firefighters," this Wednesday through Sunday night, by lighting their homes, businesses and other landmarks with red lights, or by signing a virtual remembrance banner on the foundation's website.

The Foundation was formed in 1992 to not only honor those firefighters who pass away but provide support for their relatives. Through a "Fire Hero Family Network," survivors are matched with others who have similar experiences and circumstances. Stagnaro pointed out assistance is available for however long it's needed.

"We continue to support those families -- through scholarships, through wellness conferences, we have kid's camps -- all other types of activities to help support those families throughout the year," Stagnaro outlined.

He added relatives of people honored in previous years will be in attendance this weekend to offer support to those who are just beginning their journey. This year's tribute is for 226 fallen firefighters nationwide.


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