More than one million Coloradans experience a mental health or substance-use disorder each year. Only 40 percent receive treatment.

What stops so many Coloradans from getting the mental health care they need? And what can we do about it?

Mental Health Colorado – the state’s leading advocate for the prevention and treatment of mental illness – is taking those questions on the road. As part of our statewide listening tour – “A Conversation with Colorado” – we convened public forums in Pueblo on March 30 and Greeley on May 24. (We head to Fort Collins on June 28; details are available at mentalhealthcolorado.org).

Here are some of the findings we’ve gathered so far:

1) Cost poses one of the biggest barriers to mental health care. More than 60 percent of the respondents in Pueblo and Greeley – and nearly as many in the statewide Colorado Health Access Survey – cited “concern about the cost of treatment” as the reason they (or someone they knew) didn’t get the care they needed.

2) A lack of insurance remains a significant barrier to care. While the percentage of uninsured Coloradans has fallen dramatically in recent years, two-thirds of the respondents in the statewide survey, as well as a majority of the participants at our Pueblo forum, listed a lack of insurance among the obstacles to mental health care.

3) Stigma continues to stop many Coloradans from getting the mental health care they need. Fully 40 percent of the statewide respondents, and similar percentages in Pueblo and Greeley, said they (or someone they knew) “did not feel comfortable talking about personal problems with a health professional.”

4) An even larger share of the respondents in Pueblo (54 percent) and Greeley (48 percent) said they (or someone they knew) didn’t get mental health care because they were “concerned about what would happen if someone found out.” The corresponding figure in the statewide survey was considerably smaller (28 percent).

5) Waiting lists and scheduling difficulties impede access to mental health care. One-third of the respondents in the statewide survey said they had found it hard to get an appointment. That problem seemed more pressing among our Pueblo participants (46 percent) than among their counterparts in Greeley (27 percent).

A caveat: The participants in our listening tour are self-selected; they may not mirror Colorado’s population as a whole. But they do bring a broad range of perspectives. One-third of the Pueblo and Greeley respondents, taken together, said they had provided mental health care. The same percentage had experienced a mental health or substance use disorder. And more than two-thirds had family members with such disorders.

Few of the participants (only 7 percent in Pueblo and 14 percent in Greeley) pronounced themselves “very satisfied” with the mental health services in their community. Dissatisfaction was far more pronounced in Pueblo (59 percent) than in Greeley (29 percent). The remaining participants (34 percent in Pueblo, 57 percent in Greeley) described themselves as “somewhat satisfied.”

Participants offered no shortage of suggestions for improving mental health services. Among the most common: engage the news media, educating the public about existing resources; increase the number of psychiatric beds; recruit more qualified providers; and expand school-based programs.

The need for more information formed the most frequent refrain throughout our discussions. Asked why children in their community didn’t get the mental care they needed, for example, roughly 70 percent of the participants in both Pueblo and Greeley said parents didn’t know where to go. Nearly as many respondents also said the children’s symptoms had not been identified.

We’ll report more findings from our listening tour in the months ahead. You can take part – and share your stories and suggestions – by visiting mentalhealthcolorado.org.

Andrew Romanoff is the president and CEO of Mental Health Colorado. He served as speaker of the Colorado House of Representatives.