The COVID public health emergency created a spike in the adoption of a wide range of telehealth services, and Coloradans are continuing to access mental health care remotely, according to new analysis by the Center for Improving Value in Health Care.

Cari Frank, vice president of communications at the center, said telehealth is also helping address the current shortage of mental-health providers practicing in Colorado.

"And so telehealth enables people to get access so that they aren't having to go to a physical location," Frank explained. "They're also able to access mental health providers outside of our state."

Relaxed policies during COVID that helped providers get paid for telehealth visits played a significant role in the increase in the number of patients accessing care remotely. Frank noted data tapped through the Colorado All Payer Claims Database shows the top diagnosis among patients was anxiety disorder, followed by PTSD, major depression and adjustment disorders.

There are advantages to getting care in the privacy of your own home, especially in less populated areas where a neighbor might ask uncomfortable questions if they see your car parked outside the only psychologist's office in town. Frank pointed out telehealth also makes it easier to fit sessions into people's busy lives.

"I think it's a more comfortable setting, to be in the comfort of your own home," Frank acknowledged. "You can be in your pajamas, you can be on the couch. Just turn on your phone or your computer and talk to somebody."

Last year, nearly 29% of Coloradans who reported experiencing symptoms of anxiety and/or depressive disorder were not able to access treatment in the past four weeks. Frank emphasized telehealth can make it easier to keep people connected to care, which also can help keep overall health costs down by reducing emergency room visits when illness goes untreated.

"If you can expand telehealth services for mental health, and get people actually talking to somebody before an event turns into something like an emergency department visit, then we're certainly going to be saving health care dollars," Frank stressed.

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.