Mental Health Colorado’s new CEO talks legislative priorities, teen mental health, and how to go beyond how-are-yous at work
By: Faith Miller
October 16, 2019
Statewide nonprofit Mental Health Colorado’s leadership has shuffled around a bit in the past year, but its mission remains the same: “promoting mental health, ending stigma, and ensuring equitable access to mental health and substance use services.”
The shake-ups started when former CEO Andrew Romanoff resigned from his role at Mental Health Colorado early this year before entering the U.S. Senate race to challenge Republican Sen. Cory Gardner in 2020.
Nancy VanDeMark, now the nonprofit’s chief of planning and strategy, stepped in to replace Romanoff as interim CEO before handing the reins to Vincent Atchity in August. Atchity comes from the Equitas Project, a Colorado nonprofit focused on “disentangling mental health and criminal justice.”
Atchity took time to speak with the Independent on Oct. 10 — World Mental Health Day — about the state of mental health and substance use care in Colorado.
Indy: How does your background as executive director of the Equitas Project shape your approach to this new role?
Vincent Atchity: With the Equitas Project, my mental health advocacy work was focused very specifically on the intersection of mental health and criminal justice. … We have all kinds of different mental health concerns across the lifespan and in various sectors of our communities, but the intersection with criminal justice is one of the intersection points that is most painful for us as a community, because it’s where we systematically make mental health matters worse, rather than better.
… We don’t have adequate mental health care systems, or adequate systems of providing supportive housing for people who have serious and severe mental illness, and as a consequence we’ve got abundant homelessness, as everyone who lives in America is aware, and Colorado is no exception. We also have mass incarceration, with a higher rate of incarceration in this country than anywhere else in the world … and a lot of that is driven by unmet mental health needs and our defaulting to incarceration as a way of managing that population.
So it’s a really painful and important point, and so the way I’ve been approaching that in my previous role was … trying to correct that unfortunate state of affairs or tragic state of affairs [by working] with partners in law enforcement and the justice system, who are more acutely aware than people elsewhere in our community of the extent to which they are managing a mental health crisis with the tools of justice and law enforcement — and they are more acutely aware than most of the extent to which those tools are totally inappropriate and excessively costly with very poor outcomes.
But all along, and the reason why it’s exciting to be with Mental Health Colorado now, is that if what we’re doing as a community is waiting for law enforcement and the justice system to make corrections, that is far too little and far too late, and properly addressing mental health is something that needs to be done at every point in the lifespan — from prenatal contact with expectant parents to support for mental health for children in early childhood settings, in their homes, as well as for children as they go through their formalized education, and then of course we need mental health supports in terms of access to care throughout our lives. We need employment settings that are as supportive of mental health and as accommodating of mental health as they are of physical health needs.
It’s also Disability Employment Awareness Month. As employees, employers and policy makers, how can we better approach mental health disabilities and mental illness in the workplace?
I think that one of the key things that employers can do is ensure that when they are contracting with benefits packages with health insurers, employers can play a leading role in the community of holding those insurers accountable to the parity laws, which stipulate that mental health be covered on par with the way physical health is covered. The latest iteration of a parity law passed just this last legislative session, but I think that we are a ways from realizing actual parity in practice. So employers can play a key role there.
Employers can also be accommodating of people who may have different kinds of accommodation needs based on mental health conditions. The Americans with Disabilities Act has gone a long way to ensuring that people with physical disabilities are protected, but people with mental health disabilities don’t necessarily have the same level of protections, and employers can make sure that happens.
And employees and co-workers — we can do so much for each other’s mental health just by taking it seriously. You know, it’s sort of a commonplace in our culture that the way we greet one another is, we’re passing one another in the hallway as we say “Hey, how are you doing?” And the answer is, “Fine, how are you doing?” as people continue to walk on by. And every single one of those exchanges is an opportunity, and should be seen as an opportunity to actually stop and have a moment of contact with somebody where you disclose something that may be real about your own mental health state, and invite that similar kind of disclosure, and be there for one another — and find solidarity in, you know, stress, depression, anxiety, concern, having a hard day, having a good day.
These are things that everybody experiences, and when we share them a little bit more openly, we create bonds that ultimately support our mental health. And we can steer each other toward help, too, if there’s graver levels of concern, we can steer each other toward the Colorado Crisis Services Hotline [1-844-493-8255], or crisis text line [text “TALK” to 38255], or share tips about where to find good care.
As we head into a new legislative session, what are some of the key challenges ahead for the state, and what are some of your legislative priorities?
One of the key challenges ahead for the state, and one of the key accomplishments of parity laws, is really establishing that we can’t really have a second, inadequate system for managing substance use disorder care. The law has now established that substance use disorder care has to be accepted as a mental health issue and treated as such and across the board. Our behavioral health provider networks do not have network adequacy to provide adequate levels of care to address substance use disorders, which are a leading mental health condition in the state of Colorado, as they are in many other states around the country.
… One of the things we continue to be very much concerned with is … mental health needs assessment and access to care in early childhood and in school settings, and so we will continue to advocate for expanded access to care during that critical time of life. If we can intervene early with people and head off adverse childhood experiences at the pass, or get in shortly after an adverse childhood experience with appropriate care and intervention, then children’s resilience and recovery can be greatly enhanced, and if we provide those kinds of supports early in life, people are much better off, much better set up to have greater health outcomes as they age.
… Housing remains a critical issue in the state of Colorado as in most other places. … If you don’t have housing, that is an immediate mental health crisis for anybody, even someone who’s never experienced a mental health crisis — finding themselves un-homed initiates that kind of a crisis. And in the same vein, people with serious and severe mental illness have a very hard time maintaining stable housing, and the consequences for them are the very unfortunate consequences of homelessness and then of course the risk of arrest and incarceration, and so one of the things we need to continue to applaud and promote are the efforts that various Colorado communities have made over the course of the past several years to create permanent supportive housing for people with mental health needs. What we’ve done is substantial and worthy of note, and yet the need is vast, and we’re going to have to continue working on that.
… Decriminalizing mental health is a general theme for us. A lot of behaviors that are symptomatic behaviors from unmet health needs are treated by law enforcement response leading people into the justice system, and if we can meet people’s health needs then we are effectively decriminalizing mental health. A health condition should never be a criminal matter.
… We have one of the highest teen suicide rates in the country … and that is a truly major concern because the loss of teenagers to suicide is one of the saddest things that can happen to communities and families, and we’ve got a lot to examine and understand about what’s driving those behaviors. There’s a lot of isolation and hopelessness, and it results from bullying, and it can result from a variety of social determinants of health, like economic instability in families and housing instability and food insecurity — these can all be contributing factors to teen mental distress. And that may be worse, as we’ve begun to see in data, in some of the rural and frontier communities that are subject to these kinds of social determinants, and teens who are LGBTQ, teens in rural communities don’t have a strong network and can find themselves especially isolated, as can minority teens in those kinds of remoter settings.
We were really hard hit by that here in El Paso County.
We’re told that you’re supposed to, when you’ve got concerns about somebody who may be at risk of self-harm, that we’re not really supposed to beat around the bush. We’re supposed to go right at them, especially if we’re a trusted person, and ask direct questions — ‘Are you thinking about harming yourself?’ — and then remain with them, and make sure that they’re connected with some kind of appropriate level of care.
I think everybody needs to know that, and I wonder whether, rather than communities reeling from the blow of a suicide and getting together in the aftermath of that to try and heal themselves, whether communities need to be more consistently proactive and preventative in addressing the risk of suicide openly rather than treating it like some kind of a secret thing that we’re not going to discuss until it actually happens. It’s probably better to discuss it upfront, before there’s a risk of it happening, so that we create a forum for discussing how we manage overwhelming feelings, and try and equip young people with tools for self-management.
What can parents do to make sure their kids’ mental health is OK?
Parents have the best opportunity of all to support a growing person’s mental health, and I think that the real important thing there is everybody’s busy, parents are especially busy, but there’s no substitute for the gift of that time and attention. … Parents can take time to check in without an agenda, listen with an open mind, not be too quick to rush in with any kind of judgment or feedback or suggestions, but just taking the time to make sure that parents understand what matters to their kids, what is interesting to them, who their friends are — asking sort of open questions to invite dialogue and learning how to be somebody who is easy to talk to.
And then of course just observing a kid’s behaviors: Are they maintaining friendships? Are they attending school? Are they doing OK — is their performance more or less even? And keeping an eye out for changes that strike them as dramatic changes or turns in their children’s behavior, and then asking directly about them. And when there’s concern, reaching out for help … It’s really important for parents to take stuff like this very seriously, because I think too often parents of children who have died by suicide are taken by surprise, and that’s the most unfortunate thing of all.
As campaign season gets into full swing, what kind of questions should we be asking candidates when it comes to mental health?
I think the expectation on the part of the community and the media is that every candidate have some kind of an articulated platform regarding mental health. Mental health is the most important kind of health that we have. I could be a physically fit athlete in the prime of youth, and yet if I don’t have my mental health, I could be on the brink of total disaster. And in contrast, I could be living with some kind of serious cancer or other disease, and yet with mental health, I’m actually doing a whole lot better. Because we’re all going to suffer from physical infirmities, and our best hope is retaining some kind of mental health through those.
… If there’s a candidate that doesn’t have mental health on their radar, that’s a candidate to push hard against, and we should be expecting them to prioritize diversion away from the criminal justice system for people with mental health needs. They should be prioritizing housing. They should be prioritizing adequate access to care … especially in early childhood and through the school years.