FORT LUPTON, Colo. -- Suicide rates, overdoses and substance abuse all are on the rise since the onset of the coronavirus pandemic, according to a new Government Accountability Office report.

Colorado's community health centers have seen a dramatic increase in patients in need of care.

Jonathan Muther, vice president of medical services for Salud Family Health Centers, which operates 13 clinics serving both rural and metropolitan residents, said before COVID-19, nearly one in five patients presented symptoms of mental illness or substance-use disorder. Since the pandemic, one in three present symptoms, but most cannot access care.

"Even before the pandemic, more than half of the individuals with an identified need did not receive access to care," Muther recounted. "And that gap has only widened since the pandemic."

Last week, Muther told members of the U.S. Senate Committee on Health, Education, Labor and Pensions his team has responded to the increased need in part by expanding telehealth efforts. But he argued more needs to be done to remove barriers that prevent people from getting care, including lack of adequate health coverage, not knowing where to get help, social stigma, and a lack of non-English-speaking staff.

Changes in how federally qualified health centers are reimbursed would give more providers the flexibility to meet people in need of care where they are.

Muther pointed to Salud's integrated approach to care, where people get mental-health screenings whenever they check in with their primary-care provider, vision specialist or dentist.

"We structurally embed a behavioral-health visit in the context of the medical visit, whether that's in person or via telehealth," Muther explained. "We have behavioral-health providers that just do a proactive outreach to individuals in order to recognize a mental-health concern as early as possible and be able to do something about it."

Adults are most likely to reveal symptoms, which can include increased anxiety or depression, but also physical manifestations such as chronic head or stomach aches, to their doctor.

Muther added getting more mental-health professionals into schools can help reach children. Clinics have also successfully reached patients who don't get regular checkups through targeted outreach.

Experts say the presence of police in full tactical gear and spending hours in school lockdown mode will leave a lasting impression on Maine teens and staff.

Phone calls claiming an active shooter was on school grounds were reported at 10 high schools across the state. Many students hid for hours while staff members prepared for the worst. Others sent text messages to family members, fearing their lives were in danger.

Licensed clinical social worker Greg Marley, senior director of suicide prevention at the National Alliance on Mental Illness in Maine, said the threat was real until it was proved otherwise, and each person affected will have a different reaction.

"And based on their previous trauma, their personality, their mental health condition, it could be incredibly traumatic," he said, "or it could be just really upsetting."

Marley said it's important to not minimize anyone's experience, even if it was based on a hoax. He said maintaining a healthy diet and exercise along with proper sleep are not to be underrated in preventing students from falling into despair.

Teens also can text NAMI-Maine's crisis hotline at 207-515-8398.

While some schools have experienced threats before, this was their experience with "swatting" - the act of calling 911 to report that a shooting already is taking place when it isn't. Experts say swatting is meant to cause chaos and erode students' trust in schools as a safe haven.

Marley said there will be some signs to look for over the coming weeks.

"But if they're showing that they're struggling sleeping, that they're reactive - they're emotionally upset, they're not eating, they don't want to go back to school - those are the signs you need to really respond to," he said.

Marley said parents should reach out to school officials should their students remain fearful, and recommended that parents and students tour the school together to better understand the safety mechanisms in place. Patience and time, Marley said, are key.

First responders experience some of the most horrific events in modern life and often carry huge loads of stress home from their jobs. A new program developed by Wayne State University provides resources and cutting-edge services to Michigan first responders to alleviate post-traumatic stress disorder and other work-related mental health challenges.

The result is Frontline Strong Together, a website and 24/7 call line created by first responders and mental-health experts.

Alireza Amirsadri, associate professor of psychiatry and behavioral neuroscience at Wayne State University, and the project's main developer, said high stress pushes too many first responders to the edge.

"Part of trauma, in fact, is that you dismiss, you deny, you try to rationalize, intellectualize all these. But in reality, it is avoidance of discussing it and the impact of stress on them," Amirsadri said.

Wayne State teamed with the Michigan Crisis and Access Line in consultation with police and fire unions, paramedics and dispatchers to develop the program. The Frontline Together Strong website is at FST5.org, and the helpline is 833-34STRONG (833-347-8764).

Amirsadri said in developing the program, he found that there is a stigma among many police, firefighters and other first responders against admitting to a mental health issue and seeking help.

"We were seeing them in need of mental health issues and many of them were not accepting although they were suffering from symptoms. So, many of them were self-medicating," Amirsadri said.

He said research shows 30% of first responders experience mental-health disorders, including depression and post-traumatic stress disorder, compared with 20% of the general public.

"Did you know that the life of police officers at retirement is about 15 years less than a civilian? 15 to 20 years less? There's a reason for it," Amirsadri said.

The program is funded through a $2-million grant from the Michigan Department of Health and Human Services.

Two months into the new school year, Minnesota social workers in schools say resources still are hard to come by for providing mental-health services. There are additional funds out there, but some constraints as well.

Christy McCoy, a social worker for St. Paul Public Schools, said the increased demand for mental-health care among students isn't slowing down. Her district was among those that received American Rescue Plan funding to add school-based mental-health providers, including social workers. But McCoy said there's been a hiccup in carrying out that approach.

"So, here we've got this money that has come forth all of a sudden, but we're having a difficult time finding people to fill those positions," she said. "So, there's still a few positions open in our district."

She said the workforce shortage is playing out in other districts with extra funding as well. This fall, the U.S. Department of Education announced a new round of separate grants for schools to add mental-health staff. But Minnesota lost out on the first round, and state officials have said they're still deciding whether to reapply.

McCoy pointed out that states didn't have a long time period to gather information for applying, but adds Minnesota is at least pursuing other grant opportunities. She suggested that solutions will have to start playing out soon, because kids' mental-health needs can't wait.

"The needs, they're just coming out of the woodwork," she said, "and I'm hearing that from my colleagues all across the state, all across the nation."

McCoy, who is board president of the School Social Work Association of America, said they're also encountering wait lists in connecting students with providers in the community. Her group pushed in Minnesota for dedicated funding in the last legislative session, but lawmakers failed to agree on supplemental spending. However, Democrats gained full control this election cycle, which may mean less gridlock in deciding how to use the state's budget surplus.