Connecting state and local government leaders
Idyllic locales sometimes stigmatize mental illness the most.
EAGLE-VAIL, Colo. — Andrew Romanoff served in the Colorado legislature for eight years and was speaker of the House for four of those years, but now that he’s president and CEO of Mental Health Colorado, the former Democratic lawmaker is turning to local governments to find and fund solutions to a growing mental health crisis in the state’s rural communities.
“It’s been my experience that people trust local government more than the state or federal government,” Romanoff said. “The county commissioners are closest to the people they’re serving, and folks are more inclined to believe that if they vote yes on a local measure, the dollars will stay closer to home.”
Romanoff is hoping voters in Eagle County agree and pass Ballot Issue 1A on Nov. 7, approving a 2.5 percent sales tax on recreational marijuana to fund up to $1.2 million a year in mental health and substance abuse services in a county of 53,000 that’s home to two of the nation’s busiest ski areas: Vail and Beaver Creek. The tax would be capped at 5 percent in five years.
Eagle County currently has no in-patient beds for crisis mental health issues, with residents required to travel two hours or more to Grand Junction, Denver or Pueblo. The county has already seen 10 suicides so far in 2017, surpassing the total for all of 2016, and has one of the highest per capita suicide rates in the state. Neighboring Summit County, home to four world-class ski areas, has also seen a record-breaking spike in suicides in recent years.
Chris Lindley, director of Eagle County Public Health and Environment, said he was stunned by the lack of mental-health services in a ski county that’s a global destination where the population swells by tens of thousands of people during peak winter visitation months. In such an idyllic locale, he said mental illness runs counter to marketing messages and can be stigmatized.
“If you’re depressed and having a difficult time and you’re living in this beautiful environment and all your friends and family who come and visit you say, ‘You live in paradise, and you’re the luckiest person in the world,’ it’s kind of hard to then turn around and say, ‘Yeah, but I don’t like my life,’” said Lindley, an epidemiologist and Iraq War veteran.
Lindley says a severe shortage of affordable housing, one of the highest costs of living in the state, runaway health-insurance rates and a hard-partying, tourist-town culture are all contributing factors. “It wears on you; it breaks you down,” Lindley said.
Romanoff, whose own cousin shot herself to death in the backyard at a family New Year’s Day celebration in 2015, says mental illness and substance abuse touches people in every walk of life, making funding in any form a matter of utmost urgency: “It’s local, it’s targeted and it’s a matter of life and death,” he said of the Eagle County effort.
“The mission or our organization is to make Colorado a national leader in the prevention and treatment of mental health and substance abuse disorders, and we’re obviously not there yet,” Romanoff said. “In many ways, rural Colorado is suffering more than urban areas.”
Romanoff recently met with Eagle County health officials to offer his group’s support for 1A, which also has the backing of local health care providers, law enforcement agencies and the region’s largest employer, Vail Resorts. He was asked by one county commissioner if local governments should wait for Washington to sort out its roiling health care debate.
“Two days later [President Trump] issued an executive order that jeopardizes coverage for, among other services, mental health and substance abuse care, Americans with preexisting conditions and could take us back to the point where people could be denied coverage on account of a mental illness and the days in which mental health and substance abuse were not considered essential benefits,” Romanoff said, referring to recent executive orders to end federal subsidies.
“Her question and his executive order, for me at least, underscored the importance of not waiting for Washington,” Romanoff added. “We’re hoping that the feds do no harm in trying to protect the gains that we’ve made there, on the one hand, but we’re also moving forward as a state.”
Colorado Gov. John Hickenlooper made mental health funding a top priority in the wake of yet another horrific mass shooting at an Aurora theater in 2012, and he’s also been a bipartisan proponent with Ohio Gov. John Kasich of health care reform that fixes the Affordable Care Act and continues its Medicaid expansion—a plan that would target insurance gaps in rural areas like the Colorado’s Western Slope. The 10 governors also back the Alexander-Murray bill.
But given the inability of Congress to pass anything either replacing or reforming the ACA, Romanoff urges counties, cities and states to do all they can now. Eagle County Commissioner Jill Ryan, an epidemiologist and public health planner who formerly headed the county’s public health department, fully agrees, spearheading the ballot issue.
The $1.2 million in annual funding expected to be raised by the pot tax will only fund services, not facilities. Local health care providers and governments are then trying to find funds for a combined low-income health clinic and mental health facility, but Ryan says those efforts—spearheaded by Mountain Family Health Centers—are in flux due to the federal debate.
“In Eagle County we are lucky enough to have a federally qualified health center. They serve everyone, and they’re the safety net. They really rely on Medicaid, especially the expanded Medicaid, to make their numbers work, and if you go to their clinic today, they don’t have any space available,” Ryan said of ACA repeal. “They will be stuck in the same facility they have, unable to meet the needs of the most vulnerable populations in our community.”
Vail Resorts, the largest ski-area operator in the nation, on Thursday officially endorsed 1A, sending a letter to local papers saying, in part, “From our youth to our adult peers, mental health and substance abuse has become an increasingly serious issue in many resort communities, including Eagle County, yet there are limited facilities to address it.”
The tax would also provide mental health service in a tiny wedge of Eagle County that extends into the Roaring Fork Valley, where the four Aspen ski resorts are located.
“Yes, we support this and feel this issue needs more of a concerted effort by everyone in our mountain communities,” Aspen Skiing Company spokesman Jeff Hanle said Wednesday. “We do not yet know at what level we will support, but it's certainly something we will help to push.”
Vail Police Chief Dwight Henninger supports more beds for the treatment of mental health issues possibly coming online in nearby Summit County but prefers beds closer to home in Eagle County.
“Currently, anybody who has a mental health issue, we have them assessed here in Eagle County and then it’s a game of trying to find a bed for them somewhere and it’s very hard to do,” said Henninger, who adds officers are sometimes required to drive patients up to three hours to the state’s Front Range, confined in a police vehicle that whole time.
“We’ve been working for a year now to try to have better detox and mental health treatment opportunities for people who are in crisis, and we’re working with all the different stakeholders to try and find better solutions and have had very little success,” Henninger said.
Deputy District Attorney Dylan Roberts says the lack of in-patient treatment beds for mental health issues is seen on a weekly basis in the Eagle County Justice Center where he now works but also is a big problem in his hometown of Steamboat Spring, another iconic Colorado ski resort town. Creative funding methods are key since state and federal funds are tight, he says.
“Looking for innovative ways to fund more mental health service programs is an important step, for instance what Eagle County is doing this November—taxing marijuana that goes specifically to mental health services,” Roberts said. “I’m in support of that and applaud the commissioners for putting it on the ballot and hope that it passes this November.”
For his part, Romanoff recognizes that taxing pot sales may not be for every community. But he urges every city and county in the state to recognize and try to tackle mental health issues the way Eagle County is.
“We’re keen on helping communities identify needs and break through barriers to care, and that is exactly what Eagle County is doing,” Romanoff said. “I would be surprised if every county wound up with exactly the same kind of proposal. But most people get it because they’ve lived it, and want to know what to do about it.”
David O. Williams is a journalist based in Avon, Colorado.