Two facts about mental illness and behavioral disorders stand out: they’re complicated and they’re expensive to treat.  These facts are particularly pertinent, and poignant, when individuals experience symptoms from both simultaneously.  

Silos and bifurcation describe Colorado’s approach to mental health and developmental disability services. Mentally ill people go to mental health centers and developmentally disabled adults receive services through community centers.  Substance abusers have their own rehab facilities.  

People who need support for multiple mental health problems often land in the state’s other type of “care” facilities – jails and prisons. About 75 percent of prisoners suffer from drug or alcohol addiction.  Roughly 20 percent of prisoners experience severe mental illness.

Colorado spends almost $40,000/year for prison inmates.  Of those eligible for first-time parole, almost 70 percent get turned down because they haven’t received treatment for their mental illness or substance abuse, according to a state analysis. It’s straightforward to calculate savings based on more effective mental health care services.

Some bills introduced at the state capitol aim to find a bit of light at the end of the mental health tunnel. House Bill 1287, Expand Mental Health and Substance Use Treatment Capacity, aims to identify where mental health services are available for people in mental health crisis. It seeks to increase support in underserved areas of the state. Rural counties, where the opioid epidemic is particularly severe, lack substance abuse and mental health care facilities and support. But crisis beds are short everywhere and the bill should help the mentally ill find much needed services faster. The bill is on its way to House Appropriations, so it has a long way to go for passage.

For years, health insurance providers have treated mental illness as if the brain was disconnected from the rest of the body.  House Bill 1269 requires insurance coverage parity for mental illness, behavioral disorders, and substance abuse in relation to physical illness. The federal government requires health insurance providers to cover mental illness at the same level as broken bones or cancer treatment. Many insurers do not. The bill enforces federal rules. The legislation addresses private insurance and Medicaid. Its impact affects co-pays, length of treatment, types of treatment, and location of treatment. The bill is on its way to Senate Appropriations and has to clear the Senate chamber. Its prospects are good if it makes it through Appropriations.

A clutch of bills, collectively, address an array of problems for people with severe mental illness. Senate Bill 222 aims to prevent the mentally ill from ending up in jail or prison. It was introduced in March and is about to pass in the Senate but has to then move through the House.  

Senate Bill 223 puts guardrails on what happens to people who are in the process of mental competency assessments.  The bill requires more training for individuals involved in these assessments, such as district attorneys, public defenders, and alternate defense attorneys.  This bill is stuck in the Senate chamber, so it has a long way to go for passage.

Two more bills deserve attention. House Bill 1009, introduced in the first week of the session, attempts to get more resources for substance abuse treatment.  It hasn’t moved to House Appropriations yet. Unless someone faces a stick of dynamite to hurry up, this bill apparently isn’t going to pass this year.  House Bill 1044, which doesn’t cost money, passed.  It allows individuals with mental health problems to specify treatment options when they’re healthy to address treatment when they’re experiencing a mental health crisis. This bill was signed by the governor.

Altogether, this array of bills shows new interest and intelligence on mental and behavioral health issues.  Former State Sen. Moe Keller, advocacy director at Mental Health Colorado, has an observation about Colorado’s current state of mental affairs. When asked if she had a magic wand, what would she do to improve mental health care, she said, “I’d blow it all up and start over. The key is continuity of care from child to senior. We need to get out of our silos.”  We’re not there, but these bills can improve prospects.

Paula Noonan owns Colorado Capitol Watch, the state’s premier legislature tracking platform.