By John Ingold | and Noelle Phillips | | The Denver Post

DOUGLAS COUNTY – For the man who killed a Douglas County sheriff’s deputy and wounded six other people, the warning signs were abundant.

At various points over the past three years, Matthew Riehl’s parentsfriends who served with him in the Wyoming National Guard, professors at his former law school and law enforcement officers in two states all expressed concern about his mental health, according to official documents and interviews. His mother told police last year that he had stopped taking medication for bipolar and post-traumatic stress disorders. A sheriff’s deputy and a mental health professional went to his apartment last month and had the door slammed in their faces.

But, despite those concerns, Riehl was not placed on an emergency mental health hold in recent years and was not apparently receiving treatment of any kind when deputies arrived at his doorstep on New Year’s Eve morning. The last attempt to intervene came from the sheriff’s deputy he killed that day, Zackari Parrish, who said, “Let me help you. Please,” just before Riehl began shooting, according to the Douglas County sheriff.

“With this guy, nothing I saw or heard on YouTube made this guy eligible for (a mental health) hold,” said George Brauchler, the district attorney for Douglas County.

The reason has a little bit to do with the language of Colorado’s mental health hold law, which — despite recent enhancements — can still make it difficult to define exactly when someone qualifies for a hold, one expert said. But the situation mostly points to a larger problem for mental health services in Colorado, which are overwhelmed by patients in need.

“At some point,” said Andrew Romanoff, the president and CEO of the advocacy group Mental Health Colorado, “we should say, ‘What can we do to prevent a condition from becoming a crisis?’ ”

Riehl’s condition was well documented.

In 2014, four years after serving as a medic in the Wyoming National Guard during a deployment to Kuwait, Riehl was hospitalized at a veterans mental health facility in Wyoming. He escaped and was brought back on a 72-hour involuntary hold. Veterans Affairs records contain other references to attempts at mental health treatment in the following years.

So, too, do law enforcement records. During a welfare check last year, Riehl’s mother told a Lone Tree officer that her son stopped taking his psychiatric medications in February, according to a Douglas County investigative document obtained by The Denver Post through a records request. Specially trained crisis-intervention officers attempted to reach out to him. A retired behavioral health officer who knew Riehl from the Wyoming National Guard told The Post that he, also, tried to connect Riehl with help last year, only to receive in reply a string of bizarre text messages.

“To the extent that Matthew is both willing and able to accept Mental Health assistance, again, one can only guess,” Douglas County sheriff’s Detective Phil Domenico wrote in a report in November.

Colorado, along with most other states, sets a high bar for when someone can be held involuntarily for mental health reasons. To be eligible, a person must be an imminent danger to themselves or others or so gravely disabled by mental illness that they cannot feed or care for themselves. Only a law enforcement officer or a licensed medical or mental health professional can make the decision to place someone on a hold. A family member cannot.

Recent changes to the law have created better definitions around the risk to others — the law requires “evidence of recent homicidal or other violent behavior by the person in question” or a concern that people might be harmed, “as evidenced by a recent overt act, attempt, or threat to do serious physical harm by the person in question.” The law in Wyoming, where Riehl lived for a time, uses similar language.

But Moe Keller, the vice president of public policy and strategic initiatives at Mental Health Colorado, said the definition of “imminent” is still up to interpretation in Colorado. Does it require someone to say they plan to shoot someone? To actually have a gun? To be holding that gun?

“As a result, every law enforcement agency around makes their best judgment call on what is imminent,” she said.

Last fiscal year, 37,771 people were placed on mental health holds in Colorado, said Camille Harding, the head of Community Behavioral Health at Colorado’s Department of Human Services. Some people were placed on more than one, meaning there were a total of 52,661 involuntary 72-hour holds, and that may actually understate the true count.

Harding said those numbers are only from facilities designated to accept someone experiencing a mental health emergency — mostly large hospitals and mental health clinics. But new reporting requirements aim to get a broader picture by including currently unreported people who are taken to freestanding emergency rooms or other such facilities.

In the 2016 fiscal year, 34,948 people were placed on a total of 39,271 involuntary holds.

The vast majority of people placed on a hold are not violent toward others, but are instead suicidal, Harding said.

And mental health holds are really a last resort. Both mental health advocates and those concerned about civil liberties have cautioned against expanding them.

“Having a mental illness is not against the law,” Keller said. “It’s not a crime. So the great majority of people who have a mental illness do not deserve to be picked up by the police.”

The real cure for the problem, say both mental health workers and law enforcement, is greater access to early treatment.

Chris Johnson, the former sheriff of Otero County who is now the executive director of the County Sheriffs of Colorado association, said the state in recent years has been 2,500 beds short of where it needs to be in order to treat the mentally ill in facilities across the state. A recent report by Mental Health America ranked Colorado 43rd in the nation for treating mental illness.

A law passed last year made millions of dollars available to expand access in rural areas. Millions more were provided to expand training for law enforcement and pair up mental health responders with beat cops.

Johnson said he is optimistic those changes will help. But the overall challenge still remains enormous.

“The mental health hold system had nothing to do with that,” he said of the shooting. “I think what we suffer from in this state and across the rest of the country is the severe lack of the resources for people with mental health crises.”

This article originally appeared in the Denver Post.