Every year, an estimated 1.5 million people in the United States are diagnosed with a traumatic brain injury (TBI). For some, they may experience a mild concussion. For others, the impacts of brain injuries can be long-term or even deadly.

For those in the age group 65 years or older, the impacts of brain injuries can be the most severe when compared to other age groups. According to the National Library of Medicine, an estimated 80,000 people in this age group visit an emergency department each year with concerns of brain injury. 

One doesn’t need to be in the NFL or participate in extreme sports to endure the harmful affects a brain injury can have on the body. A simple fall, for some, can change the rest of their lives in the a blink of an eye.

Falls are the leading cause of TBI-associated death in the United States for women over 75 years old and men over 85 years old.

“Falls are one of the most common reasons why older adults get brain injuries,” said Krista Fox, occupational therapist at Aspen Valley Hospital. “And, it’s usually falls from just a standing height.”

The National Institute of the Aging estimates that one in four people ages 65 or older will experience a fall every year.

While no one can predict a fall, there are plenty of preventative measures one can take to better protect themselves.

According to Fox, there are three main areas to focus on when preventing accidents that could lead to TBI:

1.) Biologic

This population may experience muscle weakness, changes in their vision, changes in sensation of their feet, or alterations in equilibrium. With this, it’s recommended to see a physician if you notice any changes in your balance. In addition, physical exercise is highly recommended in order to build muscle and improve joint, tendon, and ligament flexibility, according to the National Institute of the Aging.

2.) Behavioral

Inactivity in this age group is a cause for concern when thinking about how to prevent falls. When someone is inactive, they may have slower reaction times, making falls more likely when active. By cultivating an active lifestyle, one can improve their overall health and balance.

3.) Environmental

Decluttering one’s home can significantly prevent falls. In addition to maintaining an organized space, it’s highly recommended that this age group make alterations to fall-proof their home. This can include having hand rails on both sides of a stair case, getting rid of rugs, and keeping electrical chords out of walkways. These small alterations may seem like insignificant improvements, but they can help save one’s life.

For more tips on how to fall-proof your home, read The National Institute of Age’s tip guide.

What to do if you’re a caregiver of an elder

While experiencing a traumatic brain injury is a significant injury, those who may have a TBI may not even know an injury has happened. One can experience brain fogginess as a symptom of their brain injury or not remember that a fall had occurred, making it challenging to recognize the severity their accident.

According to Fox, if you’re a caregiver of someone who may be significantly impacted by TBI’s, it’s important to ask questions like: “Have you fallen in the last year?” and “Do you have concerns with your balance?”

If you’re concerned that someone you know in this age group may have fallen, she recommends to bring them to a doctor.

“We always recommend that if you have concerns about falling as an older adult, or have concerns for a family member, to see your physician get physical therapy because it is clinically shown to help people,” she said.

Activities for seniors in Aspen

In addition to keeping in mind the three areas to prevent falls, seeing a doctor if you have concerns with your balance and coordination, there’s also groups for those 65 years or older can participate in here in Aspen to improve their overall health.

Pitkin County Senior Services Center offers balance, yoga, tai chi classes and more to seniors. Aspen Recreation Center offers a fitness program designed for seniors called Silver Sneakers.

Editor’s note: This is the third of a weekly series The Longevity Project, a collaboration between The Aspen Times and the Glenwood Springs Post Independent.

In 2016, Aspen resident Nadine Adamson, 66, spent the Fourth of July in Aspen enjoying the parade in front of Jerome Hotel. The following day, however, changed her life.

On July 5, 2016, she was riding her bicycle on her way to pick up groceries from City Market. She was going to attend a potluck later that evening. She can recall her grocery list: organic spinach, berries, and nuts. What followed was a blur.

She learned years later that she biked her way across the river. She imagines she was taking in the beautiful mountainous terrain and perhaps lost sight of what was in front of her. On her way back from the store, she catapulted over the handle bars of her bicycle.

Her head hit the street first; the front of her skull fractured.

“My whole body flew over the handlebars,” said Nadine, who was 59 at the time.

“I was riding a bike without a helmet, which is something I can’t emphasize enough: Always wear a helmet when you’re riding a bike,” she said. “No matter how old you are, wear a helmet.”

Her friend, David, was bicycling home from work and found her lying on the ground. There was blood coming from her head and mouth. Her eyes were rolling back in her head.

She was rushed to Aspen Valley Hospital. Then, she flew in the Flight For Life helicopter to St. Anthony’s Hospital in Lakewood.

She was later told the doctors didn’t think she would live.

“I’m sure maybe with all the different vital signs that the doctors took, that’s why they really didn’t know if I’d survive the flight or not,” said Nadine. “Thank goodness I did. God had better plans for me.”

She has three daughters, one of whom took a photo of her while she was in the hospital.

“All I could think of was right away is how I must have scared my three daughters horribly,” said Nadine, after seeing the photo.

However, after the feeling of horror set in, she let out a chuckle. The metal rod coming out of her head reminded her of a television show she used to watch as a child called “My Favorite Martian.”

She spent two weeks at St. Anthony’s Hospital. Then, she was transferred to Craig Hospital in Denver.

In recovery, she had to go back to relearning the basics. She spent over a month relearning to walk. She relearned how to use the left side of her body, as she couldn’t quite open her left hand.

Learning to drive was one of the most lengthy recovery-processes, taking over a year. Her driving therapist, Lizzy Ransbottom, later told her that her treatment process inspired a new program at Aspen Valley Hospital.

“She said, and because of that, we’ve helped hundreds of people that have had TBI, accidents, or strokes,” said Nadine. “They’ve been able to incorporate that program to help several people. So, I think that’s a huge blessing.

“I’m so thankful and grateful for that.”

Despite the long recovery process, the devastating injuries, she knows her recovery is a miracle.

Bicycling and Traumatic Brain Injuries

While many may think of brain injuries in connection to football, bicycling is actually the type of recreation in which traumatic brain injuries most commonly occur, according to The American Association of Neurological Surgeons.

Nadine is one of an estimated 596,972 U.S. residents who went to the emergency department during the time 2009 through 2018 for bicycle-related TBIs.

While we cannot predict when an accident may occur, wearing a helmet while riding your bicycle has been proven time and time again as a way to mitigate the impacts of bicycle-related injuries.

According to a meta-analysis of 55 studies, “The use of bicycle helmets was found to reduce head injury by 48%, serious head injury by 60%, traumatic brain injury by 53%, face injury by 23%, and the total number of killed or seriously injured cyclists by 34%.”

Despite the benefits of wearing helmets, many still do not wear helmets while riding their bicycles. The Centers for Disease Control and Prevention surveyed 4,170 U.S. residents in the summer of 2012 and found that only “29% of adults and 42% of children always wore a helmet.” 

Colorado ranked No. 6 in the country in The League of American Bicyclists’ 2022 “report card” of the most bicycle-friendly states. Despite the popularity of bicycling here, Colorado state law does not require the use of helmets while riding a bicycle.

Exercise as Medicine

While Nadine was in recovery, her doctor told her that she would likely not be able to return to her long career as a real-estate agent in the Denver area. 

“I have to agree with him on it when I think about it now,” said Nadine. “I think there was a lot more healing needed to happen over the next couple of years.”

While Nadine was in recovery, her doctor told her that she would likely not be able to return to her long career as a real-estate agent in the Denver area.

Fortunately, she had another part-time career that she was told she encouraged to continue, teaching Zumba.

During her last week as an inpatient at Craig Hospital, her therapist scheduled her to instruct a Zumba class. Some of her friends from the Denver area, patients, and therapists came to the class, which was scheduled to be only 30 minutes long.

After instructing the class, Nadine learned she had led the class for 45 minutes, 15 minutes more than she anticipated.

“I handled it, and I think that they were pleasantly surprised that I did that so good,” she said. “I said, you know, that’s amazing.”

Now, six years following the accident, she instructs Zumba once a week in Aspen.

“It’s a happy thing,” said Nadine. “It just makes you feel really good.”

In addition to the emotional health benefits of Zumba, her doctor told her by teaching and participating in Zumba classes, she was creating new pathways in her brain.

“A neurologist at Craig Hospital showed me a scan they had of my brain, and there were two different dark areas there, and he said, ‘That will never come back,'” said Nadine. “So, to regain everything, to learn to adapt, learning to walk, and all that, plus the dancing and Zumba, it’s all really good because it’s building new pathways in my brain.”

Nadine’s hopeful recovery

Nadine said her name translates to “hope” in French, in line with the kind of person she is and her preservation through her accident.

During the challenges of her recovery, she was frequently asked about her emotional state and whether she experienced depression or feelings of hopelessness. But, she always tried to look on the positive side of things.

“I’m a happy person,” she said. “I’m mainly just so grateful and thankful.”

She credits God, the neurologists, and doctors, as well as the treatments available to her recovery.

Editor’s note: This is the second in a weekly series called The Longevity Project, a collaboration between The Aspen Times and the Glenwood Springs Post Independent. Read part 1, “Traumatic Brain Injuries in the High Country” in the Oct. 17 Post Independent.

Every high school sports sideline, courtside or team box in Colorado has an extra-special set of eyes and ears on the action.

While the coaches and players focus on trying to call or make the best play, athletic trainers are close by intently focused on the heads themselves.

If a player stays on the turf, floor or ice for an extended time after a play, or gets up a little wobbly, certain concussion protocols must be followed, per state law which is now written into the rules of the Colorado High School Activities Association.

“Sometimes you see a hit or a fall, or something that might cause a concussion, and it’s our job to assess the kid from there,” said Ryan Erickson, Certified Athletic Trainer (CAT) for Roaring Fork High School in Carbondale.

“Other times you don’t see what happened, but a kid will self-report or come over and say they’re not feeling right,” he said.

Then there are times when it’s not immediately obvious to the player or the sideline staff that an injury may have occurred, or, in the heat of game battle, the player won’t speak up right away.

That’s when those eyes and ears have to be especially astute in order to keep health and safety at the forefront of youth sports.

Erickson is part of a team of CAT’s sponsored by Valley View Hospital/Valley Ortho in partnership with the Roaring Fork School District to provide preventative services, emergency care, therapeutic intervention and rehabilitation for student-athletes at Glenwood Springs, Roaring Fork and Basalt high schools.

Erickson’s work, along with Marni Barton at Glenwood Springs and Mike McCann at Basalt, covers the gamut of sports-related injuries and medical conditions. But concussions and protection against traumatic brain injuries (TBIs) through very careful “return-to-play” policies and procedures are a major focus.

At National Athletic Trainers’ Association conferences he’s attended over his 18 years as a trainer, Erickson said that about a third of the overall attention is given to concussive head injuries. That includes prevention, treatment and rehabilitation.

“It’s a major topic, and there is lots of new research coming out constantly,” he said.

The texts he used in college in 2005 on the topic might as well be tossed out, but not because the people who were researching and studying it at the time didn’t know what they were doing, he said.

“They were the leaders in research and the care of concussions,” Erickson said. “It’s just that so many new things have come to light, and we need to stay up with that.”

Concussion law

The Colorado Legislature in 2012 passed Senate Bill 40, or the “Jake Snakenberg Youth Concussion Act,” named after an athlete from Grandview High School in Aurora who died after suffering a concussion during a football practice.

The law laid out a series of measures and protocols to protect young athletes from head injury during sports, including:

• Requirements for coaches to take annual training around proper concussion protocol.
• Immediately removing athletes from play who sustain a suspected concussion, and not allowing them to return to a game or practice the same day.
• Notifying parents if their child has been removed from play due to a suspected concussion, and providing them with information about signs and symptoms so that they can monitor their child at home.
• Ensuring that a health care provider evaluates the player and gives written clearance for them to return to play, including practices and games.

Kim Gorgens is a neuropsychologist, board-certified in rehabilitation psychology, and also a professor for 22 years at the University of Denver. She helped write Jake’s Law, and continues to be a brain injury policy advocate.

“At the time, Colorado was really out in front in responding to the risks due to concussions in sports,” she said. “There’s been a real push since then to quantify the risk for players, so that those in charge can make the right decisions.”

Gorgens gives TED Talks on the subject, focusing on preventative measures in youth sports, from pee-wee leagues through middle school and into high school, return-to-play policies and sharing information about DU’s biomarker studies around the long-term impacts from head injuries, including dementia and other conditions that appear with age.

“There is a lot of research on some of the poorer outcomes, so that we can better understand what confers the risk for these really terrible outcomes,” Gorgens said. “We are coming to understand youth sports brain injury from every angle, and we’re working really hard to do better by coaches, trainers and parents who are out there coaching on the sand lots.”

Sideline protocols are critical when it comes to avoiding successive concussions, which can lead to more severe TBIs.

When a suspected concussion occurs, coaches and trainers get involved by checking for any immediate symptoms and questioning the players directly involved or who might have witnessed what transpired in order to know what to look for.

“We gather the history of what happened, look for any symptoms they may have at the moment, test their balance and just generally observe them and their behavior,” Roaring Fork’s Erickson said. 

Symptoms typically include headache, dizziness, nausea, vision problems such as double vision, and sudden sensitivity to light or sounds.

“From that, it’s usually not very hard to determine if they have a concussion,” Erickson said.

But that’s not his call. A medical doctor is often on site at the game or event, or on call so that they can come and give the diagnosis.

Concussions aren’t limited to contact sports, either, he said.

“Football gets all the attention, because of the violent nature of the sport,” Erickson said. “But soccer can have as many or more concussions, and in basketball you have kids taking charges and hitting their head on the hardwood.”

Oftentimes, it’s not the initial blow from contact with another player that causes the concussion, “it’s you falling hard and hitting your head on the ground or the court,” he said.

Prevention key, but no fail-safes

DU’s Gorgens is also involved on the technology side of protective sports equipment — another science that’s ever-evolving, but an area where youth sports programs have a hard time keeping up.

And it’s an area where Colorado has fallen behind other states on the prevention side, due to high equipment replacement costs and a lack of routine equipment replacement plans, Gorgens said.

Following the implementation of Jake’s Law, school districts across Colorado were able to ride a funding push to buy new, more-advanced football helmets and other equipment, such as extra-protective Guardian caps that can be used on helmets during practice. Some soccer teams also began using protective headgear.

But much of that equipment is now at or beyond its lifespan, leaving school and club sports programs to hold fundraisers to buy new equipment, Gorgens said.

“We’re having bake sales for brain health, which is sad but true,” she said.

“It is an expense, and it’s an ongoing expense. And it’s an investment that school districts, especially the smaller ones, really wrestle with,” she said.

Gorgens said there may be opportunities for high school sports programs to obtain equipment through corporate research sponsorships, similar to college and professional programs, to test some of the newer advancements. Helmets can be equipped with what are called accelerometers, which measure the G-force and provide important research data, she said. 

“Manufacturers need that field research,” she said.

Glenwood Springs High School head football coach Tory Jensen said much of the protective equipment in his program is at the end of its life cycle. But even that seven-year-old equipment is far superior to what he used in his playing days, and even in his earlier coaching days at Roaring Fork High School in the early 2000s.

“We had terrible equipment when I played, and we hit 10 times harder than we do now,” Jensen said of the evolution of his sport.

“It’s a conversation that has been going on at the high school level for, what, 20 years now,” he said. “It’s a question of how we help our athletes work through playing a collision sport, and it’s difficult. As a coach, it’s unnerving when a head injury happens. You don’t want to see any athlete, or any parent, go through it.”

It’s the down side of any sport, whether it’s a collision sport like football, or even skateboarding, skiing and snowboarding, or mountain biking.

“We are a very active community, and we put ourselves at risk all the time,” Jensen said. “It’s definitely a part of our culture in this valley, no matter what you do.”

More to prevention than padding

There’s a lot more to prevention than just wearing the proper, up-to-date protective equipment.

As Erickson said, “There’s no perfect helmet.”

For Jensen’s football squad, it starts in the weight room.

“The number one thing we do to prevent those kinds of injuries is getting into the weight room and doing the strength and conditioning training you need to help your body absorb the contact that comes with football,” he said.

That can apply to any sport, really. 

“We work on the preventative piece year-round, just trying to get in the weight room as much as possible and working on our strength and conditioning, so when a collision happens you’re less likely to get injured.”

Gorgens concurs.

“Neck strength in particular is a really important predictor in avoiding head injuries,” she said. “That’s one of the reasons we’re really focusing now on the junior high kids, because they don’t have the neck muscular build yet to be able to take those hits.”

Strength and conditioning is a big part of recovery from a head injury, too. 

“The physical therapy field has really emerged as a leader in successful treatment, which runs upstream to doing more on the prevention side,” Gorgens said.

Proper conditioning is a practice Jensen said he carries into his athletic pursuits as an adult. 

“I play hockey all winter long,” he said. “It’s not really a contact sport but, yeah, there’s contact, whether that’s a collision with another player or contact with the ice.

“Think about it; a bunch of old dudes on skates, sometimes things don’t go the way you want it to.”

Staying properly hydrated during physical activity is also key to avoiding injury, including head injuries, Jensen said.

One of the things he emphasizes with his athletes is avoiding energy drinks and certain supplements, which can have the negative side effect of causing dehydration.

“Part of the concussion prevention piece is dehydration, because your brain works within a liquid base that helps protect itself from bumping into the skull,” he said. “If you’re on a two-hour mountain bike ride and crash in the last hour when you’re dehydrated, it’s going to have more of an impact on your body.”

Recovery to return

“The only healer in a brain injury is time. It just takes time,” Jensen said.

A bad concussion can sideline a player for the rest of the season, if not longer. That’s just one of the risks, he said.

The statistics coming back from the National Football League around prevention and proper recovery when concussions occur is encouraging, and something youth programs can learn from, Jensen said.

During the just-concluded NFL preseason, the league reported 70% fewer concussions than in previous years, after new safety measures were put into place.

“I think it would be silly not to follow down that path and get all of our kids doing the same things,” Jensen said.

Erickson said the brain should be treated like any other muscle that gets injured.

“You have to work that injury out, same as any other muscle,” he said.

It can take some athletes longer to recover than others, which is why the return-to-play procedures are so critical. Initially, there’s a five-day progressive return protocol, but the doctor’s advice is the last word.

“We refer to the doctor to say do or don’t return to play,” Erickson said. Initially, that may even include a doctor’s order to stay home from school for a period of time and to not engage in other activities.

“We start with light activity, then gradually increase that activity, and if the symptoms come back, then they’re not ready to return to play yet,” Erickson said. “If they clear all the steps, they’re usually ready to go.”

It’s also important to understand that no two concussions are the same, and no two people are the same when it comes to sustaining a concussion and recovering from one.

“I played a lot of rugby, and I know there are people who have coconut heads, and who can just take more than another person,” Jensen said.

Still, “Every time you get hit in the head, it’s got to add up,” he said.

jstroud@postindependent.com

You can help prevent traumatic brain injury

Be sure to wear a helmet or appropriate headgear whenever you or your children:

• Ride a bike, motorcycle, snowmobile, scooter or use an all-terrain vehicle;
• Play a contact sport, such as football, ice hockey, or boxing;
• Use in-line skates or ride a skateboard;
• Bat and run bases in baseball or softball;
• Ride a horse; or
• Ski or snowboard.

Helmets should be age-appropriate, fit properly, be well-maintained, be worn consistently and correctly and be appropriately certified for protective use.

While there is no concussion-proof helmet, a helmet can help protect your child or teen, and adults, from serious brain or head injury. Even with a helmet, it is important to avoid hits to the head.

Source: Centers for Disease Control and Prevention

Returning to play after a concussion

A concussion is a type of mild traumatic brain injury caused by a forceful blow or jolt to the head or body that disrupts how the brain normally works. A person does not need to be knocked out or lose consciousness to have a concussion.

Many parents wonder if it is safe for their young athlete to return to playing football, soccer, lacrosse or other sports after a concussion. An appropriately trained health care provider can answer these questions and provide guidance on when it is safe and sensible for an athlete to return to sports.

Athletes should not be allowed to continue playing sports, including practices and conditioning, while recovering from a concussion for a variety of reasons:

Recovery time: In one study among high school athletes, athletes who were immediately removed from play after a concussion recovered twice as fast as athletes who continued to participate.

Worsening symptoms: Strenuous activity soon after a concussion has been associated with worsening symptoms.

Increased risk: Parents and young athletes should be aware that a second head injury while an athlete is recovering from a concussion can increase the risk of complications, including the potential for worsening symptoms and longer recovery.

Catastrophic brain injuries, such as those that result in death or permanent neurologic injury, are extremely rare in youth sports. Nevertheless, it’s important to understand that they can happen so that they can be identified immediately and appropriately managed.

Source: Children’s Hospital Colorado

jstroud@postindependent.com

Editor’s note: This is the first of a weekly series The Longevity Project, a collaboration between The Aspen Times and Post Independent.

Many individuals who experience traumatic brain injuries (TBI) undergo what is called perseveration, where they often repeat words or phrases. For Carbondale resident Darryl Fuller, 52, the word he clings to is “nature.”

“Sometimes he calls me nature,” Darryl’s wife, Susan Jordan, said. “Sometimes he calls other people nature. Sometimes he just uses it to fill in.”  

In the early stages following Fuller’s TBI, the word clung to was “determination.” These words choices seem to be in line with the kind of person Darryl Fuller is.

He and Susan have been living in Carbondale for over 20 years. They moved here in 2000, when Darryl took a job at Colorado Rocky Mountain School as the outdoor programming director, a title he’s held since he moved here. 

Before the accident that led to Darryl’s TBI, on a typical weekend, Darryl and Susan would spend it biking or skiing, enjoying all the things living in the mountains has to offer.

A love of nature seems to have carved out a career and lifestyle for Darryl. 

Darryl Fuller’s traumatic brain injury

On May 21, 2022, Darryl was in a backcountry skiing accident on Cathedral Peak. He was with a friend, trying to enjoy one of the last snow storms of the season.

While walking up the peak, Darryl slid on a patch of rocks and lost a ski. He was not injured at this point. After he fell the first time, he and his friend decided to descend the peak, making their way back down the way they had come up. 

They were both being cautious and wearing protective gear, including helmets. Darryl is an experienced skier and outdoorsman, given his long career as an outdoor program director. Still, accidents can happen to the most experienced outdoor adventurers, even those who make safety a priority.

It was on their way back down the peak that Darryl fell again, sliding an estimated 1,000 feet. His friend found him lying unconscious.

Before Darryl’s friend was able to make it to him safely, others who witnessed his fall were able to reach him.

“The miracle was that there were two people, a father and a son hiking at the Cathedral Lakes Trail on May 21. Like, who does that?” said Susan. “Even locals don’t really do that.”

Darryl was airlifted to Aspen Valley Hospital, then transferred to St. Mary’s Medical Center in Grand Junction. According to Susan, he almost didn’t make it.

“He was covered with blood, his eyes were slow and he was intubated. He couldn’t talk. He was not conscious,” Susan said about her first time seeing her husband.

Darryl had broken his leg, tore the upper side of his left eye, and endured a traumatic brain injury.

He moved from St. Mary’s Medical Center in Grand Junction to Craig Hospital in Denver, where he and Susan have been since July 6.

Traumatic Brain Injuries in the High Country

Darryl is one of 1.5 million people diagnosed with a TBI this year, according to estimates from the Centers for Disease Control and Prevention.

The number of people living with TBIs in the United States nearly equals the entire population of Colorado. According to Aspen Valley Hospital, an estimated 5.3 million adults and children living in the United States are suffering from permanent brain injuries. The U.S. Census from 2021 estimates the population of Colorado at 5.8 million.

Each year, Aspen Valley Hospital sees an estimated 2,000 people who come in with concerns of brain injuries. Concussion is the most frequent diagnosis for those patients, but even a mild concussion can lead to lasting impacts.

Austin Colbert, the sports editor and lead photographer for The Aspen Times, endured a mild concussion a handful of years ago and still has lingering symptoms. 

“I had a very light, insignificant knock on the head, and I’m still dealing with symptoms five years later.” Colbert said. “It impacts your life.”

Dr. John Hughes, who owns Aspen Integrative Medicine, described a TBI as “a bomb that explodes in the brain.” This “bomb” often goes undetected on CT or MRI scans, which makes the treatment for TBI all the more challenging.

The most common events that lead to TBIs are falls, car collisions, combative injuries or sports-related injuries. People living in rural or mountainous regions are more likely to experience a TBI than those who live in urban or eastern regions.

With this, Colorado ranks ninth in the country for TBI-related fatalities and 13th for TBI-related hospitalizations, according to Brain Injury Alliance of Colorado.

A study from Craig Hospital estimates that Region 12 of Colorado, which consists of Pitkin, Eagle, Summit, Jackson and Grand counties, ranks No. 1 for TBIs when adjusted for the population.

Like the severity of TBIs, treatment and recovery for TBI patients varies.

“I tell my patients, it’s still going to be a six- to nine-month process, even a year before they might get back to some resemblance of normal and can say, ‘Hey, I have my identity back,'” said Dr. Hughes.

“I think everybody has to have those kinds of kind of long-term expectations.”

Golden nuggets of hope

For Darryl Fuller and Susan Jordan, every day seems to get a little better.

“Every little thing is just like this little golden nugget of hope,” said Susan.

He can read, write, do math problems and more — signs that Darryl is recovering. Conversing and walking are still challenging. 

He and Susan pass the time between his treatments playing games or rolling around the hospital. 

Both of them are currently not able to work. This, along with the cost of medical treatment, is why Darryl’s sister started a GoFundMe page that is still taking donations.

Susan also started a blog on Caringbridge in which she writes journal updates on his progress. She considers the blog a good way to keep people informed and hopes that it is something they can look back on in the future, when Darryl gets better.

For now, they are still in Craig Hospital. The release date always seems to change, depending on the fluctuating recovery process.

Susan hopes Darryl will be treated in more of a residential-style treatment facility soon. 

 “As much as we’d like to get home, he’s not ready to go home,” said Susan. “So, I am super hopeful that we’re going to get Darryl back to a very high level.

“Whatever’s left, we’ll just continue to work on whatever that is.”

Traumatic brain injuries (TBI) are called a “silent epidemic” because the injury impacts millions but can go undetected. Over the years, concerns for TBIs has grown, in part due to the attention paid to long-term health complications experienced by professional football players.

“For a long time, people would say to somebody, ‘You had a concussion, brushed it off. Get back out on the field, no big deal,”‘ said Krista Fox, occupational therapist at Aspen Valley Hospital.

We’ve come a long way since then. Research shows that even a mild concussion can have lasting impacts that may go away over time.

So, what should you do if you or someone you know have experienced a head injury?

The first thing you should do is call 911. The sooner an injured person receives professional medical treatment, the better.

While you wait for emergency responders, you can administer the following steps, according to Mayo Clinic:

1.) Keep the injured person still.

The injured person should be laying down, with their head and shoulders slightly elevated. If they are wearing a helmet, it is advised to not remove it.

2.) Stop any bleeding.

Apply pressure to a wound with a sterile gauze or clean cloth. If there is a skull fracture, do not apply direct pressure.

3.) Watch for changes in breathing and alertness.

Pay close attentions to changes in breath. If necessary, administer CPR.

Applying a cold compress to a head wound is also advised to mitigate swelling.

According to Mount Sinai, it is not advised to wash a head wound that is deep, move an injured person unless absolutely necessary or shake an injured person if they seem dazed.

However, according to Fox, for some it can take a bit of time before an injured person starts to recognize that a brain injury could has occurred.

“Sometimes, it can even be that someone has had an accident or an injury, and they don’t recognize anything happened to their head,” she said. “Then, it may be a couple of days later, and they’ve got headaches, or they’re nauseated and have dizziness.”

If you’ve hit your head, it is important to watch for symptoms.

If you notice any unusual changes after an injury, or if you suspect you may have a traumatic brain injury, contact your doctor immediately.

Three questions could be the difference between life and death for someone experiencing a mental health crisis.

“Are you OK? Is something wrong? Can I help you?”

Kevin Hines wishes someone had asked him those words before he jumped from the Golden Gate Bridge in 2000, he said in a keynote speech for a virtual Longevity Project event on Sept. 21.

He encourages others to “be bold” and reach out when they see signs of distress in others, asking those questions that he himself “desperately needed to hear” nearly two decades ago in San Francisco.

“You could be the catalyst for saving a life,” he said.

Hines was suffering from “lethal emotional pain,” a “common denominator” among those who attempt suicide, he said.

But in a course of events Hines considers nothing short of a miracle — he did not die upon impact with the water, nor did he drown; after surfacing, Hines was kept afloat by a sea lion until the Coast Guard rescued him from the bay — he survived that suicide attempt and now dedicates his life to suicide prevention and mental health advocacy.

That pain didn’t go away with time, Hines said. But living with it is far better than not living at all. Hines felt “instantaneous regret” in the moment after he jumped from the bridge; he now feels gratitude for his second chance and for the change in perspective that the opportunity to keep living provided.

“I knew in that moment that no matter the pain I would be in, I would never again attempt to take my life so long as I would live,” Hines said. “I knew in that moment I’d been given a second chance, I knew in that moment that I get to be here, and getting to be here is a privilege and a gift, no matter the pain you’re in.”

Hines still experiences suicidal ideations, but he realized “our thoughts don’t have to own, rule or define what happens next; they can simply be our thoughts.”

“They plague me, but they’ll never take me,” Hines said, in part because of that notion that thoughts do not have to equal actions and because he knows to ask for help when that lethal emotional pain comes bearing down.

After so much time silencing and burying pain, Hines said he learned that sharing it lessened its weight.

“You must now recognize today that your pain is valid, your pain is worthy of my time and others’, and our pain matters simply because all of you do,” Hines said. “When we silence our pain and we bury it, the feeling bubbles and festers and grows until it bursts. … When you share your pain, a pain shared becomes a pain halved.”

Aspen Strong executive director Angilina Taylor agrees, and it’s especially important with the rising mental health concerns that come with the stressors of the COVID-19 pandemic, she said during a post-keynote panel.

“Mental health really kind of got catapulted into the front of people’s minds through the pandemic, which was an unfortunate way for it to happen but I think that so many more of us are sharing our stories and and sharing what’s actually going on with us, which I think in the long run will help us all,” Taylor said.

Keeping the conversation open — and practicing check-ins with oneself and one another — is part of the crucial and ongoing effort to prevent suicide attempts before they happen, said panelist Kate Moyer, the behavioral health coordinator at Aspen Valley Hospital.

“I think really focusing on on tiny little moments that we have in terms of talking with each other can be hugely helpful in just trying to create some of those ripple effects that are really key to spreading awareness and knowledge about what it looks like maybe to not be okay, … the goal being that we can prevent a crisis from happening,” Moyer said.

The pain itself may be “inevitable,” Hines said in his keynote. “It’s coming for all of us if it hasn’t already.”

But “suffering is optional, a choice. … If you instead decide to live with, fight, battle and thrive in spite of your condition or issue, that makes you the hero of your own story, never to suffer again,” he said.

kwilliams@aspentimes.com

Change in the field of law enforcement is happening. Garfield County Sheriff Lou Vallario has seen it.

For most of his 34-year career in law enforcement, mental health just wasn’t part of the equation in Vallario’s training experience. A violation of the law led to handcuffs; a crime was a crime. A hard-line approach to law enforcement didn’t leave much flexibility — or support — for those experiencing mental distress or a behavioral health crisis.

That isn’t the case anymore, which is a a point of pride for Vallario and other law enforcement officials in the valley.

“So many law enforcement agencies have opened their eyes and shifted to realizing, this isn’t the good old days where all we do is chase criminals,” Vallario said. There is also recognition now that for those experiencing a behavioral issue, “these people might be acting out criminally, but they’re not necessarily criminal.”

“We deal with a lot of people with a lot of issues that aren’t necessarily criminally related,” he added, “but again, we’re the ones out there at three in the morning, and we’re the ones that people call. … We’re part of the community, too.”

Officers, lawmakers and community members are now more aware of the role mental health plays in a person’s behavior; they’re also more supportive of equipping first responders with the tools necessary to handle those situations, Vallario said.

One of those avenues is training; another is the emergence of co-responder programs that dispatch mental health clinicians to support law enforcement on calls related to behavioral health.

It’s a relatively recent shift in Vallario’s eyes, with awareness growing in the past five years, he said.

Aspen Police Department’s approach to mental health and community policing is evidence of that: Police Chief Richard Pryor secured funding from the city in 2016 for the department’s first human services officer, a position designed to connect people to behavioral health resources rather than place those people in the criminal justice system.

“It has evolved for sure, now four years in, because of the abundance of resources that we have in our valley — I think the system has become way more robust,” said Braulio Jerez, who has held the position for a couple of years. (Andy Atkinson, who originated the role, was “instrumental” in shaping how it served the community, Jerez said.)

The initiative has worked well enough that the department just brought on a second human services officer this month. Both officers are core members of the Pitkin Area Co-responder Teams (commonly referred to as PACT), a program that provides training and support for officers and includes mental health professionals to respond alongside law enforcement for some calls.

The initiative involves mental health clinicians from the county as well as a peer specialist and a case manager from Mind Springs Health, plus officers and deputies from Aspen, Snowmass Village and Pitkin County law enforcement agencies; it launched in 2019 after securing a $1.5 million grant from the state. Similar co-responder programs exist throughout the Roaring Fork Valley as partnerships between local agencies and the Aspen Hope Center.

It’s not that mental health was an entirely foreign concept a decade ago, Basalt Police Chief Greg Knott said. But now, there are a lot more resources to help first responders address it.

“Mental health issues and concerns have always been there,” Knott said. “We’ve just not had the ability to set up systems and provide resources, as we have in the past few years, to really make that the focus and make it collaborative efforts among mental health providers and law enforcement and (emergency medical services) and the hospital.”

Hiring for compassion, training for success

In Snowmass Village, building a police department equipped to help people experiencing a mental health crisis starts with “you’re hired.”

“We try to choose the right person to become a police officer: someone who exhibits patience, compassion, empathy, just in natural day-to-day life, that makes them a good officer and prepares them for dealing with those mental health challenges that we come across with out on the street,” said Snowmass Police Chief Brian Olson.

Still, it’s no substitute for intensive programs such as mental health first aid and crisis intervention team training, the likes of which are now the norm in departments throughout the valley.

Olson recognizes that need for training and puts it into practice. Every member of the Snowmass Police Department, including patrol officers, community response officers and the front office manager, has completed crisis intervention training.

Jenny Lyons, a county mental health program administrator who focuses on PACT, considers the crisis intervention program to be the “gold standard” in law enforcement training; the 40-hour intensive weeklong program gives officers the tools to help those experiencing mental health crises.

Other departments in the valley like the Aspen Police Department also have trained all of their officers in the program; PACT is even hosting two single-day “CIT 2.0” refresher courses this week, according to Lyons.

And many of those who haven’t yet cleared that all-trained mark are actively working toward a goal of 100% participation in the crisis intervention program, including the Basalt Police Department and Garfield County Sheriff’s Office. An eight-hour mental health first aid program offers a primer for officers in some departments, too.

The crisis intervention training goes well beyond lectures in a classroom setting, Olson said. Actors stage possible scenarios in real time and behave just as someone in a crisis might.

“The training is long, it rattles your nerves, it makes your eyes well up with tears — it’s just super powerful, and it was amazing,” Olson said. “I haven’t heard anybody go through it who hasn’t been moved, and who didn’t learn an awful lot.”

The controlled environment gives instructors the opportunity to hit pause and check in with participants; a scenario going south might be followed by a prompt to take the situation in a new direction, teaching participants how to adapt and learn from their missteps while they’re still in a space where the stakes are much lower than they are out in the field.

“Sometimes we learn the most when we fail,” Olson said. “It hurts, but when we fail, we understand most specifically what it is we need to do better. Sometimes, when we get it right, that doesn’t leave a long, lasting impression.”

Collaborating on co-response

Still, training is only one side of the coin. A 40-hour program may be the “gold standard” in ensuring officers are better equipped to handle crisis calls, but it’s hardly an all-encompassing program, nor one that can provide an equivalent to the years professional clinicians and counselors spend earning their qualifications.

“You have to understand that law enforcement officers signed up to be cops, not to be crisis workers,” Vallario said, “and that’s why we rely so heavily on the people that signed up to be crisis workers.”

Hence those co-responder initiatives, which are implemented at agencies throughout the valley to offer mental health resources on the scene and after the call in an effort to better serve people struggling with their mental health.

Funding comes from a variety of sources, including state grants, backing from local municipalities and support for nonprofits that work in tandem with law enforcement.

There is also a community benefit in the outcomes of co-responder programs that can’t be qualified by a dollar amount, officials say.

“If we provide the proper health care for them, and the resources to get them on a different path, … I think that we’re going to have a better community than that old way of the revolving door, arrest, jail, arrest, jail, and never getting anything resolved,” said Kirk Wheatley, the newly hired Aspen Police Department human services officer.

He’s been in law enforcement for nearly two decades and just transitioned to the human services role; he said his own training was an “eye opener” to a way of policing that focused less on arrests and more on understanding.

“I think it’s just continual education,” Wheatley said. “I believe the more that we educate ourselves on the people that we’re really dealing with out there, probably the less calls we will have as a department and the less people will be thrown in jail that … shouldn’t be in jail to begin with.”

These co-response programs are “community policing at its finest,” said Jenny Wood, the director of criminal justice services in Colorado’s Office of Behavioral Health.

She sees three positive outcomes from the growing popularity of such initiatives: “It’s going to increase officer satisfaction, community satisfaction. … and divert people from getting involved with the criminal justice system when they really just need health care.”

“It really brings people back to why they became police officers,” Wood said.

Programs vary from community to community. But at the core are two components: on-scene support and after-the-fact follow-ups to ensure individuals get help and support beyond the moment of an immediate crisis.

The resources from PACT have been “tremendous,” said Aspen Police Department’s Jerez, who frequently works with the mental health professionals supported by the program.

“Honestly, it would make this job so much more difficult if I didn’t have (mental health professionals) alongside me, because the reality is, we’re not mental health clinicians, we’re not mental health providers,” Jerez said. “We get a pretty good understanding (of mental health) just with time within the department, with our training, but to make those calls and pinpoint a diagnosis, let’s say, on an individual — it’s not something I’m qualified to do.”

Between Basalt and Parachute, many agencies contract with Aspen Hope Center for support from the local nonprofit’s crisis clinicians. The nonprofit crisis center also supports survivors and first responders throughout the valley in the aftermath of critical incidents that involve serious injuries or fatalities and offers confidential counseling for first responders struggling with their own mental health.

Aspen Hope has been operating mobile crisis and co-response programs since 2010, years before other similar initiatives cropped up throughout the state, according to executive director Michelle Muething. (Whereas co-responder programs happen in tandem with law enforcement, the mobile crisis program offers standalone services under the Aspen Hope umbrella.)

Some early co-responder programs emerged in Colorado around 2013 and 2014, but it wasn’t until 2017 that the concept “went gangbusters” and began growing exponentially aided by state legislation, said the state’s co-responder program manager Emily Richardson.

Even so, “you can’t just put a policy on paper and say ‘bam, it’s implemented,’” Muething said. “It takes time and a whole lot of effort.”

Mental health professionals and first responders come from “two very different cultures,” Muething said. But once the cogs click into place, a strong connection between the groups helps ensure the success of the co-responder collaborations.

“Our partnerships and relationships are vital. … We know how to do this dance on-scene where they know when to let us step forward, we know when to step back and they step forward,” Muething said.

A “culture shift” in law enforcement

Richardson also sees another benefit to the co-responder collaboration: It just might be contributing to a positive “culture shift” in the way first responders view resilience and well-being by putting them in frequent, close contact with mental health professionals.

“Having a colleague close who is a therapist, who they can see is a fine person, isn’t psychoanalyzing them every second of the day and is knowledgeable about this stuff, I think that it just builds into the culture,” Richardson said.

Many of those who have been in the field for any extended period of time can attest to the challenges of the job and challenges — personal or professional — that come with seeking help.

Confidential peer support systems have been fundamental in the effort to shift the way first responders cope with the stressors of a job that can and does involve facing traumatic situations head-on. The programs allow first responders to get support without fear that they’ll be misunderstood or that disclosing their mental health struggles could jeopardize their job; some agencies contract with Aspen Hope Center for those programs.

Aspen Hope has a couple of staffers, Muething included, who can bring their understanding of first responders to debriefs and counseling sessions with local agencies. Several departments also contract with Code-4 Counseling, an organization that specializes in mental health support for first responders.

Support for — and participation in — these programs comes from those in the highest ranks. Vallario said he believes “you have to have support from the top;” Knott said that when the officer check-in program began at Basalt Police Department, he was “the first one through the door.”

“In my career, 25 years prior to that I had never walked through that door to speak with a trained person, and it was incredibly beneficial, and it was incredibly helpful, and I continue to go today,” Knott said.

The tides are changing now, flowing toward a law enforcement culture that is now more open to the idea of seeking mental health support, Knott said.

“We don’t do what has been historically done in law enforcement in my career of, you know, just go to the call and go home,” Knott said. “We really worry about the mental health, we really take that seriously of our officers and our deputies.”

And at the Garfield County Sheriff’s Office, the agency has hosted a multi-day “mental body armor” seminar twice in the past five years to highlight the importance of seeking help, Vallario said.

When Vallario started his law enforcement career more than three decades ago, there was no support system for first responders coping with trauma; the mentality was that “you’re bulletproof and you can’t be affected by this,” he said.

“What happens is, we deal with these traumatic events that, being human, affect us too,” Vallario said. “There’s nothing in our training that makes us numb to these things.”

He has seen firsthand the consequences that come from that mentality and from the barriers — time, resistance, embarrassment, fear, a lack of resources — that accompany it.

“We say we put it on the shelf,” he said. “OK, then something else happens, we put it on the shelf, and whether that’s a three-year, five-year, 20-year thing, eventually your shelf breaks, and that’s when we start losing law enforcement officers to substance abuse, gambling, divorce, suicide, because we weren’t able to intervene at the time we should have intervened.”

The way Vallario sees it, a culture shift that embraces mental health is indicative not only of the attitudes within law enforcement agencies but also of a willingness from lawmakers to create the financial backing and legislation for something that “wouldn’t have even been a topic 10 or 15 years ago.”

“It’s snowballing,” Vallario said.

And it’s happening outside the world of law enforcement just as much as it is within the field, according to Aspen Police Department Assistant Police Chief Linda Consuegra.

“We all want to think that we’re strong, we don’t need any help,” Consuegra said. “And I think hopefully with our support program, the check-ins, we start to normalize that. And it’s just having conversations, right? … This is the struggle that everyone has.”

kwilliams@aspentimes.com

kwilliams@aspentimes.com

“I jumped.”

“It was the single worst action of my entire life,” Kevin Hines said. “The millisecond my hands left the rail, I had an instantaneous regret for my actions. It’s 100% recognition that I had just made the greatest mistake of my life, and it was too late.”

Hines is one of fewer than 40 people who have survived a jump from the Golden Gate Bridge and one of fewer than 10 who have regained full mobility. Since his suicide attempt in 2000, Hines has built a career on sharing his story in the hope that others struggling with mental health issues find solace in the fact that they aren’t alone and that help awaits them.

But it’s a lifetime of seeking help that has gotten Hines to where he is today.

Born and raised in San Francisco, Hines said his mental health issues stem from a traumatic infancy, in which he had a difficult home life and his brother died. Hines said he developed abandonment issues and a severe detachment disorder.

At 9 months old, he was fostered by the Hines family, which later adopted him when he was 4 years old. Hines credits them with saving his life.

“They gave me a future and stability and opportunity,” he said. “Growing up in the Hines household was a beautiful thing. We wanted nor needed for anything, all because of how hard (they) worked.”

In his new home, life was much more stable than with his birth parents, who he said sold drugs just to put a roof over their heads. But the lingering effects of his previous environment coupled with genetics continued to impact Hines as he grew up.

Throughout the years, Hines had ups and downs and said mental health issues were always present. At 17, he was diagnosed with bipolar disorder — the same diagnosis he said his birth parents received — with psychotic features. Hines said he had manic highs and dark depressions, paranoid delusions, hallucinations and panic attacks.

Before his diagnosis, Hines called himself an eclectic teenager who had many interests. He was a skilled wrestler, played on the football team and participated in his school’s theater department.

“I really enjoyed life, and I was thoroughly excited for what was to come,” he said. “And then at 17 1/2, it all kind of came crashing down, and I developed a mental illness.”

Hines said his family started to pick up on signs that he might have a mental illness, but they didn’t know what to do about it.

“I was not telling anybody how severe my symptoms were, so I would see things and hear things that no one else could see or hear,” Hines said. “I kept it to myself. I would have paranoid delusions, and I wouldn’t tell anybody.”

Shortly after an outburst at school, Hines said his mother took him to see his first psychiatrist. Hines said the next two years were a “rocky road” as he tried to find medicine and a dosage that could help.

Leading up to the moment on the bridge, Hines said he felt self-loathing and heard voices telling him he had to die. On Sept. 25, 2000, at 19 years old, Hines jumped from the Golden Gate Bridge.

After the U.S. Coast Guard pulled him from the water with a broken back and other serious injuries, Hines began a long, intensive road to recovery, both physically and mentally.

In the 21 years since his attempt, he has continued to seek out care with a new psychiatrist. He’s also been admitted into a psychiatric hospital nine times, with the latest stay in 2019.

About six months after his attempt, Hines began publicly speaking to others about his experience. The first time was at his former school, where he spoke to more than 100 seventh and eighth grade kids.

“I still had my back brace and my cane,” Hines said about injuries he suffered in the fall. “I read a speech from the page, dropping page by page to the floor, crying and shaking the whole time. It was very raw.”

When he was finished, the students asked him questions, and he felt like he made an impact. That impact was evident when he got a call shortly thereafter from the school asking him to visit again. Awaiting him were 120 letters from students thanking him for presenting. Some students even wrote that they were having thoughts of suicide, and those kids were screened and given the help they needed.

It is a moment that sticks with Hines years later.

“It feels amazing,” he said. “It was the first time I spoke, and it had that kind of an impact. My dad looked at me when he read the letters, and he said, ‘Kevin, we have to do this however, wherever possible.’ And we never stopped.”

By 2008, Hines turned his speaking engagements into a full-time job. He stays busy by traveling the country speaking about mental health and his personal experience. He continues to hear from audience members about how sharing his story has kept them from attempting suicide and encouraged them to seek help. By 2017, he was speaking more than 300 times per year.

In addition to coordinating speaking engagements, he has written a memoir titled “Cracked, Not Broken: Surviving and Thriving After a Suicide Attempt” and produced a documentary called “Suicide: The Ripple Effect.” He’s currently working on a new graphic novel called “Hope Dealers” as well as producing a docuseries called “The Journey.”

Hines is speaking at an event capping The Longevity Project at 6 p.m. Tuesday, Sept. 21, at the Riverwalk Center, 150 W. Adams Ave. in Breckenridge. Tickets are $25 and include a glass of wine, beer or soda, and food. For tickets and more information, visit SummitDaily.com/longevity.

Pitkin and Garfield counties share some bleak trends.

More than 120 deaths by suicide occurred between 2015 and into 2021 within these Western Slope neighbors, according to data compiled by the Colorado Department of Public Health and Environment and the Garfield and Pitkin county coroners.

“It doesn’t matter how pretty it is where you live or how much money you have,” Pitkin County Chief Deputy Coroner and Investigator Audra Keith said. “I think that people have problems everywhere and struggle with mental health, and stuff that goes on in the world definitely affects people’s mental well being.”

Throughout Colorado, 7,295 people have died by suicide between 2015 and 2020 (2021 numbers are not yet available).

The Centennial State saw 1,294 deaths by suicide in 2020, or roughly 22.47 deaths by suicide per 100,000 people.

In the same year, Garfield County saw 31.64 deaths by suicide per 100,000 people. Pitkin County saw 22.51 deaths by suicide per 100,000 people.

Yet one inspiration drives everyone toward wellness: hope.

The tenacity of hope is proven through the stories from those who’ve lived it.

They come from all over the Roaring Fork and Colorado river valleys. Personal stories of overcoming depression, isolation, anxiety and instrumenting the dark experience as octane to help as many people as they can.

Helping to create such outcomes are the professionals, specialists and volunteers of Garfield and Pitkin counties. They’re on the front lines combating what seems to be an endless, oftentimes invisible war destroying many people’s lives.

Their underlying message?

Reach out, talk to someone, understand that it’s OK to seek help. The fight is well worth it.

‘TELLTALE SIGN’

Glenn Lee started giving away all his possessions. Anything that meant something to him was gifted to someone else.

“That was a huge telltale sign that something was not right,” said his daughter, Vanessa Lane.

Then, two days before the birth of his first granddaughter, the 45-year-old Lee took his own life, and then Lane found herself fatherless at the age of 21.

“There is an incredible sadness that takes over,” said Lane, who grew up in Denver and moved to the Roaring Fork Valley when she was 28. “There is self-blame. Could we have done more, and what did we not do right?”

Now a peer recovery coach with Mind Springs Health in Glenwood Springs and a sitting member of the Zero Suicide Committee, Lane uses her own harrowing experiences with suicide to prevent it from happening to someone else.

Though the tragic event in Lane’s life birthed self-isolation as she spent the next 10 years battling anxiety and depression, the power of conversation prevailed.

It started with her mother.

“My mother was always someone I talked to about this,” Lane said. “When people die with the idea of this as their only solution, it hurts my heart. I was thinking that I was gonna take what I was suffering from when I was a kid, and I just want to talk about it and talk about it.”

Lane said face to face conversations with other people who are suffering makes a difference.

“You’re worth talking about,” she said. “Let’s talk about why you feel this way.”

When it comes to exhibiting signs in relation to suicide, no one fits into the same category and nobody suffers from the same thing, Lane said.

People do, however, commonly share one action when they’re in the midst of suffering: prolonged, uninterrupted isolation.

Oftentimes, Lane said it’s especially men who struggle in seeking help. They either fear the stigma or simply do not trust the counselor with the information.

But there are other signs to look for.

In Lane’s experience, when someone casually brings up suicide in conversation, that’s a red flag worthy of intervention.

“I think just somebody even talking about it or threatening, whether it’s to get attention, it doesn’t matter what it is,” she said. “That is enough of a red flag to have that conversation.”

In addition to talking about suicide, exhibiting risky, out-of-character behavior or vocalizing self-negativity also deserve a helping hand, Lane said.

Because the grief never ends, Lane said. It’s always there.

“But I feel like if you can get out and help someone else that is suffering, it makes it better… it makes it better,” she said. “The sense of missing them never goes away, but getting out there and doing something makes a world of difference.”

PRACTICING THE DISCIPLINE

Allison Daily is well acquainted with loss.

Daily’s brother, Rod Snyder, died by suicide in 1990. At 24, she was the one to receive the phone call, and she was the one who relayed the news to her parents.

Daily said this tragedy is a big reason why she’s director of Pathfinders, a nonprofit focused on helping people during times of grief and loss.

She’s facing that prospect of loss again now. Her father isn’t doing well. His heart is starting to go out. Doctors recently put him on a pacemaker and defibrillator. Meanwhile, Daily’s husband, Art, died in December 2020.

And Daily’s mother has macular degeneration. She can’t see, making it difficult for her to care for her ailing husband.

Daily said she was the one to initiate an end-of-life conversion with him. They discussed funeral services and various loose ends.

“It’s a discipline in what I do,” she said. “I’ve had to really practice what I talked to others about and really go deep. Actually, what’s beautiful about it is that it’s enabled me to be able to help and support so many people on a deeper level than I ever have been able to.”

Daily puts these heartfelt skills to work with the bereaved after a suicide occurs.

Her motivation is for people to not run from their feelings but to process what’s taken place, she said. Because when Snyder took his own life, Daily said she ran away from her feelings for a while.

“There’s usually guilt involved. There’s people who saw the person last, or they had the last conversation or they had a fight beforehand, so they feel that responsibility,” Daily said. “I don’t try to take those feelings away, because people’s feelings are real. But what I try to do is help them process into where they can get to a place where they’re more comfortable.”

Processing involves talking about the relationship the bereaved had with that person, Daily said.

It can give them an avenue for forgiveness, Daily said, and for “trying to help them to take steps forward to live from a place of loving themselves and honoring that person, instead of staying in the anger.”

Suicide elicits strong feelings, Daily said — ones that can come to a head when they’re bottled up.

“We have such judgment around mental illness or mental conditions,” she said. “But for myself and my brother, I started to really understand where he was at. Did that make it OK that he did that? No. But at least now I understand more of where he was coming from and why he made that decision.”

“It’s a really lonely existence when we do that,” she said. “When we bottle things up and we don’t talk with someone or we don’t get the help that we need, then it just leaves room for really disastrous or explosive decisions.”

CURBING THE TRENDS

Mason Hohstadt is preparing for something big: The Out of the Darkness Western Slope Walk.

The fundraiser, done in correlation with the American Foundation for Suicide Prevention, is slated for Sept. 25 in Glenwood Springs. Registration is 9 a.m. and groups will begin walking at 10 a.m. People can also register online.

Anyone is invited to come to the Glenwood Springs Community Center and walk for something that has affected many people throughout the Western Slope. The route comprises Midland Avenue and walking over the pedestrian bridge.

“We utilize those dollars to get more people trained to give those types of training and education out into the community,” said Hohstadt, chair of the Garfield County Suicide Prevention Coalition. “Most of the time, most of the people who walk are survivors of loss.”

Sept. 25 will also see Aspen host a similar fundraising event: Hike, Hope, Heal. Late registration starts at 10 a.m. at Mollie Gibson Park. The walk begins at 11 a.m.

Additional race information can be found at aspenstrong.org/hike-hope-heal.

Garfield County Suicide Prevention Coalition started in 2006 to “meet the ever-increasing number of suicides that happened in Garfield County,” Hohstadt said.

The effort was something Hohstadt felt compelled to join based on personal experience.

“I’ve been thinking about this the past couple days,” he said. “I have mental health struggles on my own. I have been feeling isolated, feeling left behind — all of those things.”

Hohstadt, a former public health worker in Denver who devoted academic and grad school work to researching HIV, AIDS and Hepatitis C, is driven by a passion to help others.

This is especially true when it comes to suicide.

Hohstadt said the coalition is working on an individual level to help people understand the resources available — and access them.

“One in five people are going to have a mental health challenge in their life,” he said. “That’s a very conservative number; 70 million people in this country will have a mental health challenge or issue in their lifetime.”

“So,” Hohstadt added, “how do we as public health (organizations), which does have a focus and a framework for helping population level, get to a place where we can really move the needle to help people understand?”

The work, however, never ends, Hohstadt said. The mission is to make the shift from the idea of being an outcome organization to a more holistic approach.

“All of these things are interconnected,” he said. “The work will never end it, but it probably will not always look like it does right now.”

Reporter Ray K. Erku can be reached at 612-423-5273 or rerku@postindependent.com