By Michael Lott-Manier
Colorado’s 69th General Assembly convened in January in the shadow of heartbreaking tragedies in Aurora and in Newtown, Conn. Gov. John Hickenlooper and legislators from both parties expressed the desire to respond to a perceived connection between these atrocious crimes and serious mental illness.
Mental Health America of Colorado (MHAC), as it has done for 60 years, met with legislators and lobbyists to educate them about mental health. We reminded them that the vast majority (96 percent) of violent crimes are not committed by individuals with mental health conditions, that connecting violence and mental health in public policy further stigmatizes an already marginalized group of people, and that the best way to prevent violence in all its forms is to focus on the fundamentals of health and education.
The political expediency of taking action in response to tragic violence could have resulted in policies that would have worsened the stigma around mental health, negatively affecting many of the 1.5 million Coloradans who have a behavioral health condition. Motivated as always by the knowledge that mental illnesses and addictions are diagnosable and treatable health conditions, and that recovery is possible, MHAC and our partners chose to seize the opportunity created by renewed public attention to the issue of mental health. Together we moved the conversation toward policy changes that could help individuals with serious behavioral health problems and their families get the help they need, when they need it.
After 120 days of intense debates, emotional advocacy, and legal fine-tuning, we are proud to say that 2013 truly was the Year of Mental Health at the Colorado state capitol.
In addition to other health care reforms (Medicaid expansion, improved parity for behavioral health coverage) two historic pieces of behavioral health legislation moved forward this year. One deals with Colorado’s civil commitment laws — statutes long overdue for a 21st century update. The other is a bill that includes over $20 million in funding to create a statewide behavioral health crisis response system. The governor signed both bills into law at the Jefferson Center for Mental Health on May 16.
Updating commitment laws
Colorado’s current laws governing how law enforcement and medical professionals can commit someone against his or her will for mental health or addiction treatment were passed in the 1970s. Back then a diagnosis-driven mindset led to three separate commitment statutes for alcohol, drug and mental health treatment. We advocate for a person-centered approach that recognizes the widespread issue of co-occurring mental health and substance use disorders. Colorado House Bill 13-1296 establishes a task force comprised of experts from the worlds of medicine, law enforcement, behavioral health advocacy and individuals who have lived experience with involuntary commitment to integrate these statutes into one new and improved law.
The group created by HB 13-1296 will also need to approve a legal definition of “danger” as it is used in statutes as meaning “substantial risk” of harm to self or others. There is currently no statutory definition of dangerousness due to mental illness in Colorado. Many people have expressed concerns about defining a term that has been variously interpreted by medical professionals and lawyers for decades. This task force is charged with creating a system that respects and balances individual civil rights, the concerns of family members, and the needs of law enforcement and medical professionals. Part of that system will be a just and standardized definition of danger to self or others.
Historic funding for crisis response
One of MHAC’s founding goals is to reduce the need for involuntary treatment. That is why we fought hard for funds to create a statewide behavioral health crisis response system that will offer evidence-based alternatives to hospitalization. We are very grateful for the support of Gov. Hickenlooper and members of the legislature’s Joint Budget Committee in securing over $20 million for this historic effort. Senate Bill 13-266 lays out guiding principles, crafted by MHAC and our partners at Metro Crisis Services and the Colorado Behavioral Healthcare Council, for a crisis system that will improve overall public services in our state.
Calling 911 and/or going to the emergency room has become the de facto behavioral health crisis system for most Coloradans. This situation drains costly public resources while failing to improve public health and safety. SB 13-266 sets up a competitive bidding process for funding to establish regional crisis treatment centers across the state, form mobile crisis response teams and create a 24-hour statewide behavioral health crisis hotline. MHAC and our partners made sure that innovative, state of the art ideas — expanded peer-to-peer services, trauma informed care, public stigma reduction efforts — were also included in this historic bill.
It goes without saying that our work is just beginning. This legislative session has empowered Colorado’s behavioral health community to take bold steps to transform how we deal with this vital and long-ignored area of health care. With profound gratitude to the governor and the legislature, we are thrilled to be a part of the historic changes set in motion this year.
Michael Lott-Manier is the public policy and advocacy coordinator at Mental Health America of Colorado.