Mental health is a top issue for voters, and candidates running for office across Colorado are pledging to make it a priority if elected.
Kathleen Daughety, vice president of campaigns and civic engagement with Inseparable, said if people can get treatment, they can thrive. But if they can't, the situation can get much, much worse.
She pointed to a recent survey showing that half of all Americans who need mental health care aren't able to get it, and said one of the biggest barriers is that health insurance companies aren't doing their part.
"People are buying insurance policies expecting to get care when they need it. And then when they are sick, insurance companies are denying the care that their doctors are prescribing," she explained.
Nearly nine in ten voters say expanding access to mental health care should be a priority, ranking it just as high as lowering the cost of living. So far, 80 Colorado candidates have signed a Mental Health Now statement of support, more than any other state. The statement calls for policies that increase access to mental health care, improve crisis response, and expand youth mental health services, especially in schools.
Colorado is one of many states that lack facilities to place people experiencing severe mental illness. In 1955, there were nearly 6,000 psychiatric beds in the state. In 2023 the number dropped to 482.
Dusty Johnson, R-Fort Morgan, is running unopposed for House District 63 and signed the Mental Health Now statement of support.
"We shouldn't be using jail as a place to get mental health resources. But when you have nowhere to take them, they end up in our prisons, or back on the street, and then they go and hurt themselves worse, or hurt somebody else. It would be nice if we had places that would take them on the spot," Johnson said.
Since 2015, one out of five people killed by police were experiencing a mental health emergency. Daughety said the goal for politicians should be to make law enforcement involvement in crises the exception, not the rule.
"If someone is having a mental health emergency, they need a mental health specific response, they don't need a law enforcement response. Law enforcement says these calls are really stressful. They're not trained for them," Daughety contended.
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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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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.
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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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