Colo. Governor commends county's plan to address suicides

Eagle County, Colorado, is best known for the world-famous Vail Ski Resort, but the area also has a dark side that it's trying to combat.

The county of roughly 55,000 averages one suicide attempt per day, according to public health director Chris Lindley. One in four of its seventh and eighth graders seriously considered suicide last year, according to the most recent Healthy Kids Colorado Survey. Of that group, 16% have made a plan, some in pacts with others.

"It's unbelievable," Lindley said.

Colorado Gov. Jared Polis visited an Eagle County high school Friday morning to learn about an ambitious, collaborative effort to fix the area's urgent mental health challenges. Last week, Polis announced the creation of a state task force to address Colorado's behavioral health system.

The state spends about $1 billion annually on behavioral health—one-thirtieth of its budget, Polis said. He thinks the money would go further if it were integrated with community efforts like those in Eagle County, where 17 residents killed themselves last year.

"This work at the state very much aligns with what the county is doing around figuring out the 360-degree approach to needs and matching that to resources and having a data-driven approach to what works," he said.

Local not-for-profit health system, Vail Health, has pledged $60 million toward the effort over 10 years. Local leaders worked for more than a year before launching their new, not-for-profit organization called Eagle Valley Behavioral Health.

"In the last few months it has just exploded," said Jeanne McQueeney, chair of the county's Board of Commissioners. "We're in a really interesting place in time right now."

There are a number of components to the plan, including constructing an eight-bed crisis stabilization unit that will be open 24/7.

Will Cook, who took over as CEO of Vail Health in January, envisions it as an appropriate place for people in mental health crisis to spend a few days rather than holed up in the back of an emergency department. Visits to Vail Health's emergency department for anxiety and depression jumped 360%—from 63 to 290—between 2013 and 2018. And there isn't much the hospital can do for those patients. Many are transferred two and a half hours away to Denver or Grand Junction.

Law enforcement officers will also be encouraged to take some people to the crisis stabilization center in lieu of jail. The facility, which Cook hopes to open in about two years, will be staffed by licensed professionals and will also offer outpatient services.

Of the $60 million Vail Health has committed, $12 million will go toward opening that facility, which will be located in Edwards.

Cook wants roughly half of the $60 million to go toward hiring 50 behavioral health providers to serve the area, including a combination of psychiatrists, psychologists and therapists. They will be dispersed in churches, physicians' offices, jails and schools.

Currently, Eagle County has seven school-based counselors—more than ever before, Lindley said. The goal is to get a counselor in all 17 schools, and two in every middle school.

Saphira Klearman, a student at the high school Polis visited, formed a group dedicated to preventing suicides among its peers.

"We're crying out for help and finally, finally we have been confronted by something that will save lives," she told the audience before Polis took the stage. "This initiative, I promise you, is going to make a change, because we are running out of time."

Another component of the effort will be performing research to dig deeper and learn the root causes of the problem, Cook said.

"You come to Vail and it's beautiful mountains and god's country," he said. "Why, then, do people have a higher incidence of depression and suicide?"

Locals have ruminated on that for years. Cook and Lindley agree on some factors that likely contribute: Lots of people move to Eagle County without support systems, the cost of living is high and there's a dearth of behavioral health providers. Lindley thinks the screen-induced social isolation that plagues every community is taking a toll. But there's also a mentality that's unique to the Western U.S., the idea of pulling yourself up by your bootstraps and going it alone.

"People move to Vail and this area thinking they're going to paradise," Lindley said. "You hear it's the No. 1 ski resort in North America town and it's got all these great things to do outdoors and life is supposed to be perfect. Then they get here and they realize the cost of living is through the roof; they can't get housing. Everybody is working two or three jobs to survive and there is no real services behavioral health-wise."

Gov. Polis announced Colorado's Behavioral Health Task Force on April 8. The group will evaluate and set a roadmap to improve the state's behavioral health system. It plans to release a blueprint by June 2020 and anticipates implementing recommendations starting in July 2020.

Polis' announcement came a day after the Colorado Springs Gazette published a special report that described the state's mental health system as being in crisis and said its emergency departments have become the first stop for mental health crises. More often than not, the report said those who fall through the cracks wind up in the criminal justice system.

The real price tag for the array of services leaders have planned for Eagle County will be much higher than $60 million. The hope is that Vail Health's contribution will be a stimulus for investment from other organizations, including reimbursement for behavioral health services from commercial health insurers, Cook said. County funding, including from a local marijuana tax, is expected to contribute about $5.5 million over the next decade.

Vail Health, which includes one acute-care hospital in Vail and outpatient operations in eight surrounding communities, is well positioned financially to contribute to the effort. The system drew $49.6 million in excess revenue over expenses in its fiscal 2018, compared with $75.8 million in the prior year. It reported $318 million in operating revenue in fiscal 2018.

"In a world that's increasingly challenging what non-profits are doing to justify their non-profit status, I can't think of a more noble and worthy cause to direct some of the margins that have been made," Cook said.