When this legislative session ends in a few days, lawmakers will pat themselves on the back and go tell their voters all the good they’ve accomplished and how they wisely invested the $32 billion state budget.
Few will talk about how they nibbled around the edges on substance abuse in Colorado while year after year they make it easier and more profitable to sell marijuana. There's lip service aplenty but little political will around mental health, and we all pay the price for that.
Academic papers online say the return on investment is huge -- as much as 7 to 1 -- for states that invest in mental health programs, not counting he spillover into jails and hospitals, and the savings to families is transformative.
"The individual economic burden of [a serious mental illness] is high, comparable to cancer and diabetes," reports the The Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California reported this month.
Researchers estimated a lifetime cost for the individual -- along with lost education opportunities, a shorter career and a shorter life expectancy -- to be $1.85 million per patient.
The Gazette's Stephanie Earls and Jakob Rodgers reported at ColoradoPolitics.com last week on the depth of the mental health crisis facing Colorado -- and how ineffective the state's response has been.
The boldest solution this session was offered up to allow Denver and other cities to create medically supervised sites for drug addicts to shoot up. Besides saving lives from overdoses, it would have created a doorway to treatment.
The proposal was shelved by Democrats in February, however, when it became a political football for Republicans, who don't have the votes within their party to control anything in the House or Senate. Chalk one up for a successful bluff.
The Senate had another bold plan this year to curb substance abuse deaths, including making drug overdose antidotes more readily available to schools and first-responders. Alas, predictably, the price tag for Senate Bill 227 was whittled down and changed "significantly" before it ever got a hearing on the floor, said Sen. Brittany Pettersen, D-Lakewood, a tireless champion on the issue. Why? Because lawmakers had already spent elsewhere nearly all the state budget for next year.
And with the end of the session in sight, the next day Gov. Jared Polis and House Democrats rolled out a plan to ask Colorado voters to raise the tax on cigarettes and vaping by more than 60 percent to pay for behavioral health programs. It's a long shot. In 2016, Colorado voters were asked to raise the tax for health programs and it failed by more than 6 percent after Big Tobacco burned through millions of dollars to defeat it.
Calling it a concern and making it a priority is a political shell game.
In state and federal money, Colorado spends in excess of $1.2 billion a year on behavioral health. That doesn't include the spillover into jail cells and hospital beds when prevention becomes response.
“It’s very rare you find the cost-effective solution is also the humane solution,” Robert Werthwein, the director of the Colorado Office of Behavioral Health, told me. “Too many people with mental health issues end up in jail, and too many people with mental health issues end up in the ER … where they end up being observed rather than treated.
“Those are really expensive outcomes, and they're not the outcomes we want.”
Mind you, the state of Colorado has been sued repeatedly over the last decade for how it treats the mentally ill who are facing criminal charges, more time and tax dollars flushed away in the court system rather than doing what’s right in the first place.
“I won’t go as far as to say whether that’s enough for not,” Werthwein told me. “I think where we have to start at step one is to see what we’re doing with that 1.2 billion, are we being smart, are we being efficient, are we being effective with the money we are spending.”
That’s why this month Polis created his Behavioral Health Task Force, made up of state government’s top executives. Polis, at a press conference to announce his roadmap to saving people money on health care, announced that Colorado would view mental health the same way it treats physical health.
Stigma for too long has gotten in the way.
“I think most people don’t realize how many people they know who are struggling with behavioral health concerns,” Werthwein said. “And I think there are still a lot of people who aren’t comfortable opening up about their behavioral health as they do with their physical health.
"Relating to something is important, and knowing someone who has struggled with any kind of health, including mental health, draws you closer to wanting to being invested in solutions.”
How pervasive is the desperation? The federal Substance Abuse and Mental Health Services Administration estimated 9.4 million American adults -- more than three times the entire population of Utah -- considered suicide in 2014.
State Sen. Pete Lee, D-Colorado Springs, has been a legislative champion for criminal justice for years. He’s baffled that others can't see mental health as a root cause and dismayed about the mix of politics and stigma, he said over breakfast near the Capitol recently.
“It’s not sexy,” he said of the politics around mental health. “People like to do things that are showy. And most people don’t think that about mental health and equal justice. It’s out of sight, out of mind, but if you really talk to anyone, they have someone in their family who’s been impacted by mental illness or substance abuse, virtually everyone.
He was on a roll as he ate a biscuit. “We don’t talk about it, we don’t deal with it, because it’s not a bright shiny object," Lee said. "People want to do major bills that look like they have huge impact, but the impact of the mental health system is hugely impactful and touches the lives of virtually everyone.”