A host of barriers that make it harder for people suffering from poor mental health to access preventive care has led to an increase in care delivered through emergency departments, according to a new report.

Rick Doucet is the CEO of Community Reach Center, which provides mental-health care in Adams County. He said lack of adequate insurance coverage can cause people to put off getting help, which can lead to deteriorating conditions.

"It's hard for people that don't have insurance or Medicaid to make that decision to be seen," said Doucet. "That's why a lot of people end up in the ERs, or they end up being picked up by law enforcement."

Numerous efforts are underway in Colorado to improve diagnosis and treatment of mental-health conditions, reduce stigma, and expand coverage and access to services.

But according to new analysis by the Center for Improving Value in Health Care, the number of patients seen by Emergency Departments across Colorado continues to rise.

Emergency rooms have become the most accessible option for many suffering from potentially preventable mental-health crises.

From 2016 to 2021, the number of children seeking mental-health or potential self-harm care at emergency departments increased by 158%. In 2021, youths accounted for one in five of these visits.

Doucet noted that emergency rooms are not set up to provide mental-health services, and the services they can provide come at significantly higher costs.

"I mean, you walk into the ER, the dollars start adding up," said Doucet. "So it is going to increase the costs to the community, to the insurance companies, to the individual if they don't have insurance."

Anxiety, panic and major depressive disorders account for 44% of all mental health-related diagnoses in Colorado.

Doucet said the state is currently looking at the possibility of funding community mental-health centers at a higher rate to help cover the potentially crippling costs of uncompensated care.

"Because if you don't cover the costs for people that don't have insurance," said Doucet, "or their insurance companies don't pay enough for the services, you can't keep your doors open, you can't serve them."




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The growing crisis in Ohio's child welfare system is drawing attention, particularly for its impact on children's mental health.

Across the state, children with complex behavioral needs are struggling as placement options shrink and demand for specialized care reaches an all-time high.

Lindsay Sparks, protective services administrator for the South Central Ohio Job and Family Services, Children's Division & Adult Protective Services, noted that despite efforts with mental-health providers, many agencies lack the resources to handle severe cases.

"We have had a young child, under the age of 10, who we have about 45 denials across the state, they feel that they cannot meet that child's needs," she said. "Children have had to spend the night at our agency. That is not ideal for our children, for our staff, for anyone - but it has happened."

In some cases, Sparks added, agencies are forced to seek out-of-state placements - which can further complicate care for children already facing significant challenges. Recruitment efforts for foster families are ongoing, but the gap remains wide.

The crisis extends beyond placement shortages to escalating mental health concerns. Jody Walker, executive director of South Central Ohio Job and Family Services, highlighted how these issues have worsened over the past decade.

"The types of children that we're seeing coming into care, that have more severe behavioral mental health issues, and our system really hasn't been able to keep up with types of placements that benefit these kids the most," he said. "The cost for those placements went up, at the tune of 300% in the last 10 years."

As Ohio faces rising costs and limited resources, the County Commissioners Association has made child welfare a top priority in the upcoming biennial budget. The association is applauding Governor Mike DeWine's commitment to children, and stresses that counties play a vital role in protecting them.

As mental health challenges continue to rise among young people, advocates across North Carolina are pushing for increased access to mental health services in schools.

They are watching the upcoming election for North Carolina Superintendent of Public Instruction closely.

Kathleen Daughety, vice president of campaigns and engagement for the mental health advocacy organization Inseparable, said the outcome could significantly help fill gaps in access to mental health services for children across the state.

"Increasing access to mental health care is our focus because half of people in the US who need mental health care are not getting it today," Daughety pointed out. "That number is even worse for children; 70% of children who need mental health care aren't able to access it."

A recent poll by Inseparable showed it is an issue resonating with voters. About 88% believe expanding mental health care access should be a top priority for elected officials.

Graham Palmer, director of systems innovation and policy for the nonprofit Rural Opportunity Institute, explained barriers like broadband and workforce shortages and limited funding make it difficult to provide the necessary services, especially in rural areas. He believes schools can make a life-changing difference for kids.

"Sometimes schools are the only access point that systems of care can get to for kids, because there's transportation challenges," Palmer explained. "There may be time challenges, if the student has a job or they just don't have extra time to be driving an hour to see a therapist."

The Superintendent of Public Instruction would play a key role in shaping school policies, funding, and resources directly affecting whether schools can provide mental health services. The Democratic candidate, Maurice "Mo" Green recently signed Inseparable's "Mental Health Now" statement of support. He worked as the superintendent of North Carolina's third-largest school district and pointed out addressing the workforce is going to be crucial to giving students the support they need.

"The school psychologist's major association would recommend a ratio of about one school psychologist," Green noted. "For every 500 students, in North Carolina that ratio is almost 1 to 1,800."

Green is facing off against Republican nominee Michelle Morrow, who is a nurse and homeschool educator in Wake County. Her campaign website shows she supports school choice and increasing school resource officers.

Advocates are also calling for state policymakers to invest in expanded school-based mental health programs and improve crisis response efforts.


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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.