The walk-in crisis center in Boulder cut its hours this year due to staffing shortages, leaving Boulder without a 24/7 option. Finding a bed is difficult at best, and for clients without private insurance, the options are even more reduced and waitlists can stretch months into the future. What is the responsibility of the city and county in ensuring access to mental health resources, and how can we work to improve access and availability of these services?

Saturday, September 10, 2022 

 
Ryan Bonick: Let’s change how we handle mental health crises

Fundamentally, mental health should be treated the same as all health issues, and be adequately funded at the federal level in a universal healthcare program. Full stop.

To the great ire and dismay of many people in America, it does not appear that this will happen anytime in the near future. In the absence of organized federal handling, then, how responsible is the city and county for providing stop gap measures to cover mental health? 

Mental health affects many of us: 21% of adults in the U.S. face mental health issues every year, and about 1 in 4 (5.6% of U.S. adults) of those issues are serious. These issues can lead to substance abuse — 6.7% of all U.S. adults have both substance use disorders and mental illness — and homelessness: 20.8% of Americans, across age ranges, experiencing homelessness have a serious mental health condition.

With mental health being a strong cofactor for many societal ills, it is imperative to provide support for people having mental health issues as quickly as possible – regardless of their insurance coverage, income or housing status. 

Denver’s STAR program, where mental health support staff are sent to people having crises instead of armed police, has seen tremendous success. Low-level crime for precincts served by STAR fell 34% when compared to non-STAR precincts. A Stanford University study estimated 1,400 fewer criminal offenses because of STAR. The same study also showed STAR cost a quarter of what arresting people does, even without factoring additional costs around substance treatments or incarceration.

We should provide proactive treatment, like better funding for MHP and other similar organizations, as well as support for people having mental health crises like Denver’s STAR program.

Ryan Bonick is a Boulder non-native renter who loves biking and bussing around town. More about Ryan.

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Doug Hamilton: To increase mental health access, lobby for insurance changes

The late Mark Fisher wrote an article over 10 years ago entitled “Why Mental Health is a Political Issue.” To summarize Mark’s thesis, broader societal issues such as class, race, working conditions, familial organization and gender are primary contributors to our mental health. These systematic features of our society inflict trauma on individuals, and that trauma manifests itself in mental health issues in each of us. 

For instance, a woman is denied an equal wage as compared to her male coworker. She struggles financially, leading to severe anxiety. Yet the deterioration of her mental health is seen as her own personal failing, for which she is solely responsible — financially and otherwise — to treat.  

What is the responsibility of the city and county in ensuring access to mental health resources? My answer is that the state, as the primary agent in our lives in creating markets, organizing people and distributing resources, has a responsibility in organizing itself and society as a whole such that all basic needs are cared for. People who are supported and cared for in their lives are more resilient to trauma.  

A local government declaring that people have a fundamental right to quality education, healthcare, food and a place to call home, and then acting accordingly (at least to the best of its ability) would be a great start. If we knew that, no matter what, our government was  looking out for us, we could likely eliminate a lot of mental health issues.  

As the unpaid business manager for the last 10 years of my wife’s private mental health practice here in Boulder, I have observed that lack of affordability is typically the primary reason people do not seek or continue therapy, especially when the service isn’t covered by a person’s insurance.    

Insurance therapist networks are terrible, some include dead people, and most providers are not accepting new patients. For therapists, insurance companies are even worse because it is too hard to join a network, and then they pay too little. In 2021, Anthem paid PhD level therapists $96 per hour, a rate that hasn’t increased for nearly a decade. Boulder therapists need about $145+ per hour to justify the cost of doing business. 

To increase access to mental health services in Boulder, the county should lobby the state to require insurance companies to pay a minimum hourly rate to therapists that is indexed to inflation (probably in the $150 range) and clean up and then open up their networks.

Doug Hamilton is a parent, lawyer, veteran, engineer and human who believes in free public spaces and a more participatory society. More about Doug.

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