Officials: Pitkin County’s mental health effort working

A nearly $500,000 collaborative effort to offer better and more accessible mental-health care in Pitkin County last year appears to be paying off in a big way.

From lower response times for people in crisis to better attention paid to students in Aspen and Basalt public schools to more residents gaining overall better mental health, the effort garnered gushing praise at Tuesday’s Pitkin County commissioners meeting.

“From our position at the hospital — we have been very happy,” said Lori Maloy, Aspen Valley Hospital’s chief clinical officer. “In fact, it has exceeded our hopes.”

Maloy’s words were echoed by county public health officials, as well as their counterparts in local law enforcement, the Aspen School District, a key low-income health care clinic and a local mental-health care agency.

“For the last year, I’ve got to tell you, it’s been absolutely phenomenal,” said Aspen Police Chief Richard Pryor. “I feel like I have a team I can go to.”

Pryor, in fact, was given credit Tuesday for getting the ball rolling on collaborative mental-health care in the Upper Roaring Fork Valley. That’s because he convinced Aspen City Council in 2016 to provide money for a “human services officer” to deal with the mental health issues exhibited by some members of the community his officers repeatedly had to police.

The system at the time was not consistent, not communicative and not working, Pryor said.

That officer, who out of necessity had to begin communicating with the various entities that make up the city and county’s mental-health care system, got other people talking about collaboration, said Nan Sundeen, Pitkin County Human Services director.

At about the time Aspen’s human services officer started, Pitkin County commissioners appointed a committee to look at the county’s mental-health care system, which it found to be fragmented and full of gaps. In December 2017, commissioners approved a $488,000 contract between Mountain Family Health Centers and Mind Springs Health to provide better, more complete, more accessible mental-health and substance-abuse care in the county.

The contract — which included $40,000 from the school district, $70,000 from the city of Aspen, $73,000 from AVH and $304,500 from a county property tax called the Health Community Fund — required Mountain Family and Mind Springs to work together to plug those mental-health care gaps.

Mountain Family operates a large clinic in Basalt that offers medical, dental and mental-health care, mainly to low-income residents. Mind Springs offers mental-health services in the Roaring Fork Valley and beyond. Both entities were able to hire more therapists and other staff to meet the Pitkin County mandate.

Mind Springs’ therapists now go to clients who need help, while Mountain Family screens every patient for mental health and offers therapists who can deal with short-term mental-health issues, officials said Tuesday. No one who needs mental-health services is turned away, said Lindsay Maisch, Mind Springs director in Pitkin County.

Together, the two agencies were able to help 1,436 new clients with mental-health issues in 2018, she said.

“I kind of want to celebrate that a little bit,” Maisch said Tuesday. “It’s a pretty big number considering.”

Pitkin County’s estimated population in 2017 was 17,875 residents, according to the Colorado State Demography Office.

A good example of how the relationship between the agencies works occurred last summer after midvalley residents were able to return to their homes after the Lake Christine Fire, said Jacqueline Skramstad, Mind Springs regional director.

A bilingual Mind Springs team including Skramstad canvassed the El Jebel Mobile Home Park at that time, and knocked on 300 doors to check on residents’ mental health, she said. Those with acute reactions to the fire were referred to Mountain Family Health for a session or a few sessions with a therapist, Skramstad said.

Those with a history of mental-health issues or those with reactions that went a bit deeper were wrapped into Mind Springs’ system for longer-term care, she said.

Many residents, however, simply appreciated the effort the team took to come to people’s homes, she said.

“I was surprised,” Skramstad said. “A lot of the people we were able to talk to just needed to tell their story.”

A key metric that suggests the collaboration is working is the time it takes a therapist to respond to a person in a mental-health crisis, Maisch said. In 2016, it took 76 minutes. In 2018, it took 42 minutes, she said.

“It’s a good illustration of how quickly we’re getting there,” Maisch said.

Pitkin County Sheriff Joe DiSalvo said that response time cannot be understated. Sheriff’s deputies and police officers — like teachers and nurses — are not specially trained to deal with people in mental-health crisis, and waiting for someone who is tends to be like waiting for an ambulance, he said.

“Seventy-six minutes might as well have been three days,” DiSalvo said.

The sheriff also praised the collaboration because it allowed him to provide a part-time therapist for Pitkin County Jail inmates.

Another key component of the collaboration is a full-time therapist at the Aspen School District. The therapist provides “far more effective services for students than I’ve ever seen,” according to a testimonial from an Aspen High School teacher read at Tuesday’s meeting by Maisch.

Studies are showing that by sixth grade, 1 in 4 students suffer from depression or anxiety issues, said Tom Heald, Aspen assistant superintendent. The therapist is able to “support kids in a really timely manner,” he said.

“She’s an invaluable asset to the students and staff,” according to the testimonial from the high school teacher.

Basalt-area schools also have access to a therapist three days a week as part of the collaboration.

Aspen Valley Hospital has seen major benefits from the collaboration, Maloy said.

Response time to the hospital for therapists is down to 32 minutes from more than 60 minutes previously, she said. In fact, 20 percent of patients with mental-health issues arrived with a crisis response therapist, she said.

In addition, average stay for behavioral health patients at the hospital has dropped from three days to one day.

“And that’s huge,” Maloy said, adding that such patients tend to dominate staff time. “It’s just an amazing impact.”

Michelle Miscione, an AVH social worker, told the story of a recent patient who might not be alive today without the behavioral health collaboration. The man had her card from a previous meeting and recently emailed her with suicidal ideations, but he wouldn’t give her his address, she said.

Miscione knew he lived in Snowmass Village and had his cellphone number, so she called APD’s human services officer for help. That officer called Snowmass Village police, who tracked down the man using his cell number in 30 minutes, she said.

He was hospitalized and recently stopped by the hospital to thank medical providers who helped him, Miscione said.

“I’m not so sure he would have survived without (the new collaboration),” she said. “On the front lines, it’s really, really satisfying.”

Pitkin County Public Health Director Karen Koenemann and Human Services Director Nan Sundeen want commissioners to approve the same 2018 contract for 2019. The effort wasn’t fully staffed until April, so officials want to see what a full year of funding brings, Koenemann said.

Commissioners are set to address the contract at their regular meeting Feb. 27.