People struggling with mental health issues are your friend, your neighbor, your employee and, in many cases, yourself.
Benjamin-Rus and her husband both suffer from mental health issues. On the exterior, they seem to be ordinary people, just going about their daily lives. But they are quietly facing a struggle within.
Their struggles in Grand County include a small and overworked field of providers to treat them, a monopolized mental health infrastructure to heal them, law enforcement and a legal system that doesn’t quite know how to handle them, and a stigma that often dissuades people from simply accepting them.
The crux of the local problem is a rising need for mental health care that is met with dwindling resources.
In 2017, the county’s largest mental health provider, Mind Springs Health in Granby, saw 653 patients, which was a 22 percent increase from the previous year. The patient count rose again in 2018, to 728.
Currently, the average wait time to see a counselor at Mind Springs is two to three weeks and newly implemented walk-in hours at the Granby office are so popular that people are frequently turned away.
An increased need for treatment is compounded by another statistic, that the number of suicides in the county is two-and-a-half times more than the national average. That figure, while similar in resort areas across the state, serves to illustrate the issue of people not finding the preventative mental health care they might need.
But as demand for help has increased, the number of mental health care providers in the county has dropped, from 28 in 2017 to currently 12, none of which provide services in a language other than English and not all of them accept all health insurances.
Eleven percent of the county’s population stated that they experienced eight or more days of poor mental health in the past 30 days, according to Mental Health Colorado, the state’s leading advocate for prevention and treatment of mental health and substance use disorders. While that’s lower than the state average of 11.8 percent, the issue of mental health is complex in Grand County as the full picture of the local struggle is not entirely quantifiable.
It is hard to know the exact parameters of the issue in Grand County because mental health is consistently unreported, according to Jen Fanning, executive director of the Grand County Rural Health Network, a nonprofit organization that connect citizens with health resources. Many people have not sought help or are undiagnosed because of a variety of barriers to care, including a societal stigma surrounding mental health.
People also move to the county specifically to isolate themselves, which can further hinder the overall understanding of mental health in the community.
“A lot of people come up here specifically to isolate and or feel isolated,” Fanning said. “Not all, certainly not all or even the majority, but it’s possible to do. Or to be transient and move constantly, this is one of those places that happens and it’s not noticeable because we have that seasonal level of work.”
The struggle, nonetheless, is real and ever-present.
What is known is that Grand County has quite a few populations that are disproportionately affected by mental health struggles, including veterans, first responders, people with traumatic brain injuries and the elderly.
For example, the Center for Disease Control estimates that 20 percent of people over 55 experience some kind of mental health concern. This age range accounts for over one-third of the county’s population.
Grand County also has a larger than average population of veterans, which account for about 8 percent of residents, and one study estimates they experience mental health concerns at a rate of almost one in four.
A number of issues the community is facing can also contribute to poor mental health, including the higher cost of living, unstable work, a lack of affordable housing and a lack of services, such as transportation and childcare. Fanning explained these issues exacerbate stress and make it difficult for individuals to take care of themselves, physically and mentally.
“… There’s all this data that that level of stress makes you unhealthy overall because it just elevates everything,” she said. “In my opinion, (stress) is the very basis of our issues in our community, so if we could provide that support and reduce that stigma for the people who truly need it then people would be healthier.”
“In my opinion, (stress) is the very basis of our issues in our community...”
For groups that often face discrimination, such as people of color, the LGBTQ community and people with low-income, the effect on their mental health is even more acute, Fanning said.
In Grand County, the issues facing the community are particularly salient for the almost 50 percent of residents that live below the self-sufficiency standard, which calculates how much income a family must earn to meet basic needs without public or private assistance.
According to the Substance Abuse and Mental Health Services Administration, the relationship between poverty and mental health is complex because it’s unclear if poverty increases the likelihood of experiencing mental illness or if those experiencing mental illness are more likely to experience poverty.
Regardless of the underlying causes, Grand County officials are seeing an increase in people reporting mental health concerns or seeking help, which is weighing on already overworked providers.
“I think we have some great resources available but it is that capacity piece of how quickly can we get somebody in,” said Makena Line, program coordinator at Mind Springs. “We have wonderful staff, but they’re people, too, and they can’t work all the time.”
While mental health concerns have always been common in the emergency rooms at Middle Park Health, the number of such visits has been steadily ticking up, according to Dr. Michelle Lupica, director of the emergency department and trauma services at Middle Park Health-Granby.
“We have wonderful staff, but they’re people, too, and they can’t work all the time.”
And it’s not just medical providers that have noticed the prevalence. Law enforcement now deals with calls regarding mental health concerns on a daily basis, according to the Grand County Sheriff’s Office.
“That is one of our crises right now: we have a lot of those calls so we have to make sure we have the right tools to help these people without making mental health a criminal issue,” Grand County Sheriff Brett Schroetlin said.
Whether the increasing pervasiveness of mental health concerns is because of more people feeling comfortable seeking help or because more people are experiencing mental health issues than before, Grand County doesn’t have the resources to address the growing need.
It could also be because of the county’s growing population in the last few years, going from 12,455 in 2000 to now more than 15,000, according to U.S. Census data.
Fanning explained it’s important to have enough resources to respond to people in a timely manner when they finally do take the first step to seek care.
“When people are ready to see (a provider), you’ve got to maximize that energy,” she said. “You have to have that level of readiness.”