An Interview with Catherine Strode
Democrat Rhonda Fields and Republican Lois Landgraf are each sponsoring the same bill, in the State Senate and in the House, to fight the rising youth suicide rate in Colorado. Senate Bill 19-195, Child and Youth Behavioral Health System Enhancements, creates a policy office and a commission to direct, coordinate, and implement children’s behavioral health services across various state agencies.
The bill also provides for standardized behavioral health screening tools for children and wraparound services. Both legislators say wraparound services will reduce the need for facility-based care and out-of-home placements. In addition to addressing the youth mental health crisis, they agree that the bill will result in significant cost savings to the state. Moreover, it will save lives.
How do you characterize the state of mental health for children in Colorado?
Senator Fields (Senate Sponsor):
Colorado is experiencing a mental health crisis as it relates to our children and youth. The indicators for that would be the increased number of teen suicides. For kids between the ages of 10 and 24, the highest rate of death for them is suicide. That is a Colorado statistic. The health survey that kids take says, ‘Kids are feeling sad for more than two weeks in the past 12 months.’ We have a tremendous number of kids who are feeling sad while in school. What is causing that sadness? We don’t know. Kids are dealing with all kinds of gender identification issues and bullying. We know kids at risk have issues of income insecurity and food insecurity. It has a lot to do with poverty. If you are living in a neighborhood, where there are concentrated areas of crime, violence, and poverty all of that is going to impact a child’s behavioral health.
Why is the bill necessary?
Our youth, our kids, our families need a system of care coordination. Our kids are falling through the cracks because they are not identified early if they have a behavioral health issue. Typically, what might happen is a kid might be defiant or acting out in school, they get expelled or suspended and their families later find out that they had a behavioral health issue. If we could start identifying kids who are experiencing issues, like depression, early on, we could start coordinating wrap around services. We could save lives. Far too many kids are committing suicide and/or are experiencing issues of addiction. What happens in our state agencies is we have pockets of different departments doing a variety of different things. If we can have one-person work across the state within our state organizations to find ways to be much more efficient in our delivery of care for kids, we can save lives.
How will this bill specifically impact the youth mental health crisis?
Right now, our coordination of care is disjointed. You have people operating as independent departments. You have a criminal justice system that is working with juveniles. You have a welfare system that is dealing with youth. You have school systems dealing with kids and the trauma they bring into the classroom every day. You have hospitals dealing with an increased number of kids with attempted suicides. We need to have more of a coordinated approach when dealing with behavioral health and our kids. One part of the bill is to have a Commission that looks at all the different delivery resources available for behavioral health. Where is there duplication? What are the trends they’re seeing? What kinds of resolution can be tied to problems? It is an action orientated Commission. If we have someone looking at this on a larger strategic scale, I think we would see that crisis number go down.
How important is the bill’s implementation of wraparound services?
Representative Landgraf (House Sponsor):
Colorado taxpayers are spending hundreds of millions of dollars across a range of intensive services. These include: Medicaid inpatient stays in hospitals, emergency department visits, residential treatment, expensive psychotropic medication, child welfare, juvenile justice and supports in the K through 12 school system. With these kids, it’s often a multiple number of entities that are involved from schools to inpatient treatment and everything in between. Kids are not getting proper treatment but we are paying for it. Or, they are languishing because there’s no place for the child to go. Wraparound services should reduce the need for residential treatment. If you can figure out what the problem is, you can avoid some of these things. This bill saves money by providing the proper treatment instead of a shotgun approach.
How much is the fiscal note?
It’s about 1.3 million. A large part of that amount is coming from the federal government. It is not all coming from the General Fund. About $500,000 of that will come from the state. You can’t put a price on a kid. When you think about the number of children who have problems, if you divide 1.3 million among all those kids, it’s nothing. Colorado right now is one of the worse states in the nation for kids with mental health issues. We’re at the bottom, because of lack of mental health services, lack of wraparound services, lack of recognition. We have to make a change so kids get the right diagnosis and the right treatment. When they don’t get that treatment early, by the time they do get it, they are too far gone. This bill can take Colorado from being one of the lowest states in helping children with behavioral health issues to being one of the best states in the country.
Is the high youth suicide rate the reason you have thrown your support behind this bill?
Suicide is the startling point of the whole conversation, but suicide is not the only point of the conversation. We’re trying to help kids who maybe will never be suicidal but have behavioral health problems. Maybe they don’t want to kill themselves but they want to kill somebody else. They will end up in jail. We want to avoid all of that. I think Colorado should be the state that does not fail its kids. We are a beautiful state and we have a lot to offer. We need to have this to offer too.
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.