A host of barriers that make it harder for people suffering from poor mental health to access preventive care has led to an increase in care delivered through emergency departments, according to a new report.

Rick Doucet is the CEO of Community Reach Center, which provides mental-health care in Adams County. He said lack of adequate insurance coverage can cause people to put off getting help, which can lead to deteriorating conditions.

"It's hard for people that don't have insurance or Medicaid to make that decision to be seen," said Doucet. "That's why a lot of people end up in the ERs, or they end up being picked up by law enforcement."

Numerous efforts are underway in Colorado to improve diagnosis and treatment of mental-health conditions, reduce stigma, and expand coverage and access to services.

But according to new analysis by the Center for Improving Value in Health Care, the number of patients seen by Emergency Departments across Colorado continues to rise.

Emergency rooms have become the most accessible option for many suffering from potentially preventable mental-health crises.

From 2016 to 2021, the number of children seeking mental-health or potential self-harm care at emergency departments increased by 158%. In 2021, youths accounted for one in five of these visits.

Doucet noted that emergency rooms are not set up to provide mental-health services, and the services they can provide come at significantly higher costs.

"I mean, you walk into the ER, the dollars start adding up," said Doucet. "So it is going to increase the costs to the community, to the insurance companies, to the individual if they don't have insurance."

Anxiety, panic and major depressive disorders account for 44% of all mental health-related diagnoses in Colorado.

Doucet said the state is currently looking at the possibility of funding community mental-health centers at a higher rate to help cover the potentially crippling costs of uncompensated care.

"Because if you don't cover the costs for people that don't have insurance," said Doucet, "or their insurance companies don't pay enough for the services, you can't keep your doors open, you can't serve them."




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School is back and one way parents can set their kids up for success is ensuring screen time is not getting in the way of sleep.

Dr. Maida Chen, professor of pediatrics at the University of Washington School of Medicine, said there is a strong connection between sleep and mental health, and they affect each other in a circular way, which Chen pointed out screens can exacerbate.

"The screens sort of work in both directions so that if you have underlying mental health issues, screens will worsen sleep," Chen explained. "If you have sleep issues, it'll worsen sleep issues to the point of, perhaps, further triggering the development of mental health issues."

Chen noted it's not just the screens themselves affecting sleep. The content, especially on social media, can be activating. It can trigger anxiety, for instance, which makes it hard to sleep. Mental health is a major issue for youth. A study from the Centers for Disease Control and Prevention found 42% of high school students felt persistently sad or hopeless in 2021.

Chen believes social media heightened social isolation during the pandemic, leading to greater mental health and sleep challenges for young people. But she also emphasized adults have to model the behavior they want to see in their children.

"It makes no sense for us to be chastising our teens for being on their phones and on social media when they turn around and that is all they see the adults in their world doing," Chen contended.

To help with the issue, Chen added families do not have to change their habits all at once. She suggested having screen-free time about 30 minutes before bed, when families can instead spend time together. If media is involved, Chen advised families should watch something together.


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This is National Suicide Prevention Week, part of National Suicide Prevention Month, a time to raise awareness of the problem, and ways to prevent it. The California Parent and Youth Helpline reports a dramatic increase in calls about suicide - making up about 60% of the calls, texts and live chats received since May of last year.

Dr. Lisa Pion-Berlin, president and CEO of Parents Anonymous Inc., runs the helpline.

"In 2022, we had the highest rate of suicide ever, 49,449 deaths," she said. "So, that doesn't include the fact that 12 million adults in 2021 thought about suicide. And 3.5 million people made a plan, and 1.7 million attempted it."

She added that suicide deaths increased in 2021 and 2022, whereas they had been going down in prior years. Statistics show that 20% of children and adults in America suffer from some kind of serious mental health condition. Trained counselors are online at 'CAParentYouthHelpline.org'.

Pion-Berlin added it is crucial to take people seriously if they mention suicidal thoughts.

"It is very important if anybody mentions any thoughts they have - or a plan, or any concerns they have about suicide - that you take them seriously," she implored. "Don't brush them off."

Data show that youth of color living in rural areas are the fastest-growing category of people attempting suicide, and completing those attempts.

Recently approved legislation provides funding for barriers on the Penobscot Narrows Bridge - a scenic but unfortunate hot spot for suicide attempts. The bridge currently has posted signs and phones, which connect those in distress with a crisis clinician, but mental health advocates say it's not enough.

Greg Marley, senior clinical director of suicide prevention for the Maine chapter of the National Alliance on Mental Health, said the barriers are needed to help buy time.

"Time for that crisis to pass. Time for them to reconnect to help, to hope," he said. "Time to resolve that issue."

Marley said the barriers save lives. The Memorial Bridge in Augusta was the site of 14 suicides before a fence was erected to prevent people from jumping, and there have been no suicides on the bridge since.

The Maine Department of Transportation is currently building the new barriers on its own as there are no engineering standards for bridge design that consider suicide prevention. That's something Marley said he'd like to see change so it doesn't take legislative action to ensure the bridges are safe for people considering suicide.

"It doesn't mean that the suicides by other means in that region go up," he said, "but it does stop people from focusing on that one site about how they might end their pain."

Marley said anyone who needs to connect with a crisis clinician should dial 988. He recommended that people share their concerns with their primary-care provider, a trusted friend or pastor - anyone, he said, to break the isolation of suicidal thoughts.