Two years after the National 988 Suicide and Crisis Lifeline was introduced, a new report by the group Inseparable says Colorado and other states have work to do in order to fully staff call centers and connect people with the care they need when they need it most.

Colorado is answering just 75% of 988 calls, and lacks critical resources including care providers, beds and other facilities.

Vincent Atchity - CEO of Mental Health Colorado - said like many other states, Colorado is experiencing a workforce shortage.

"Those people don't grow on trees," said Atchity. "So it is difficult to create a system that has got a really high response rate, and a really high connectivity rate."

Colorado got props in the report for its 988 wireless phone surcharge and other funding streams.

To ensure people in crisis get the help they need, Inseparable's report offers policy templates already at work in other states - that add mobile response units, crisis stabilization centers, and expanded call center capacity.

Angela Kimball, chief advocacy officer with Inseparable, said she hopes the report will spark conversations among local communities and policymakers.

She said not getting it right means people will go without help, or end up in emergency rooms, jail, turned onto the streets, or worse.

"There are enough states that have introduced mobile crisis response teams, and crisis stabilization services - in addition to the call centers," said Kimball, "that we know that with the right approach, people can get on the path to recovery."

The new 988 lifeline has helped divert people in crisis away from potentially deadly encounters with law enforcement.

Atchity said he encourages people to call 988 instead of 911 for mental health crises. He said if you're concerned about yourself or someone else, make the call, and a professional will evaluate the situation.

"And far better to place a crisis call," said Atchity, "and have everything de-escalated successfully in no time at all over a call, than to hesitate and experience worse outcomes."

Nebraska mental health professionals worry the Trump administration's proposed $880 billion in Medicaid funding cuts would threaten progress the state has made in providing help to those who need it.

The reductions could have a dramatic impact on the 345,000 Nebraskans who rely on Medicaid as their only source of health insurance.

Aileen Brady, president and CEO of Omaha-based Community Alliance, said Nebraska has had recent success in getting higher Medicaid reimbursement rates for providers, and has expanded services.

She added that cuts would hurt people who need help the most - those struggling with mental health problems, people with disabilities, and kids.

"Nearly half of Medicaid enrollees in Nebraska are under the age of 20," said Brady, "and I think people need to understand that impact it'll have on our children in Nebraska - and that means our future in Nebraska."

A recent survey by the Centers for Disease Control and Prevention says at least 50% of American adults will need treatment for a mental health issue during their lifetime.

Brady said such steep cuts at the federal level would require dramatic cuts in services to Nebraskans, especially when considering the degree to which the state relies on the federal money.

"Fifty-eight percent of every dollar is a federal dollar, 42% of those dollars are state dollars," said Brady. "If those cuts would come into play, that $880 billion over a period of time, that's going to create a fundamental shift in how services are delivered - the shift of cost to the states - or it's going to result in a significant cut."

The Trump administration is following through on a campaign promise to cut federal spending across the board.

Diagnoses of mental health conditions in children and teens are on the rise, including in Indiana. But getting kids the help they need can be a challenge.

About one-third of Indiana high school students reported "experiencing poor mental health, most of the time" in a 2023 survey.

But Jeff Reiter - a psychologist with Whole Team, a group that provides technical assistance to primary care clinics - said many parents have trouble accessing both medication and talk therapy for their kids.

He said he thinks what is most needed is more support for primary care providers - which is where mental health problems often are first identified.

"So they're getting those medications from a primary care provider," said Reiter, "a pediatrician, a family medicine, family doctor or something like that. And these are providers who don't have a lot of time in their visits, maybe 15 minutes. They're not specialists - they don't get a ton of training in how to work with psychiatric issues in kids."

Reiter advocated for placing mental health professionals in primary care clinics, to make them more easily accessible to patients and their parents.

He said he also supports what's known as parent management training as a non-medication option for youth with mental health concerns.

Advancements in mental health treatment programs and medications have been helpful. However, these services can be out of reach for a patient with limited or no insurance coverage.

Reiter said he agrees the traditional psychotherapy treatment model can be costly - a factor he said he sees as part of the access problem. But he maintained there's a more relevant issue.

"The point is, there are much more flexible and accessible ways that mental health professionals can practice," said Reiter, "and that's really what we need to be encouraging if we're going to have any chance of reaching more kids."

A study published in 2023 found in Indiana, in one recent year, untreated mental illness was associated with more than $4 billion a year in costs to society.





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The U.S. had more than 500 mass shootings last year, and a new program launched in Denver hopes to prevent targeted violence before it happens.

AllHealth Network is a nonprofit behavioral health center that serves all patients regardless of their ability to pay. Its Chief Clinical Officer Jen Bock said her team can intervene the moment that direct threats of violence, or violent behaviors are witnessed and reported.

"We can step in and work with community providers to identify and decrease that risk," said Bock. "The goal is to get people support, so we can increase overall community safety."

Just 5% of mass shootings are related to severe mental illness, according to researchers at Columbia University.

Other factors play a bigger role, such as a history of financial and legal problems, challenges coping with anger and stress, nihilism, and a desire for notoriety especially among young men.

Those wishing to request a targeted violence prevention training can send an email to tvp@allhealthnetwork.org.

AllHealth's Rebecca Rickard was certified as a targeted violence and prevention co-responder through the Department of Homeland Security's National Threat, Evaluation and Reporting Program Office.

She said people closest to individuals often don't believe they could harm others, and overlook threats. But she said it's important to take signs of potential violence seriously.

"If you see a sudden change in how your child is dressing that might seem really unusual for them, ask them what's going on," said Rickard. "What's fueled the change? And basically just getting as much detail as possible."

Bock said she believes education is key to reducing targeted violence.

She pointed to the success achieved by national and state campaigns that helped raise awareness about the signs and symptoms of potential suicide.

"This training helps with signs and symptoms of possible violence," said Bock, "and so, getting the word out can really help overall for early intervention and increasing community safety."



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