Improving care and treatment for mental health and substance abuse problems is an easy goal to get behind until faced with the question that most goals face: how to pay for it. Colorado’s major mental health hospital is in Pueblo, and the facility is in need of improvements as demand for services continues to rise in the state. Strengthened mental health services are important to help those struggling with mental illness and substance abuse, but cost is what often stands in the way. Therefore, Colorado must consider ways to both increase funding but also spend those funds as effectively as possible. Three new state Senate bills aimed at more efficient pretrial detainees are examples of how to look at more specific ways the state can spend on mental health services.
An editorial in The Denver Post was published last week urging lawmakers to pass Senate bills 250, 251 and 252, and while these bills would increase spending and address the shortage of inpatient beds, they are mostly aimed at making sure the state can meet rules for how detainees are evaluated before trials. The number of mental health evaluations ordered by Colorado courts has increased, and the state often does not follow through on these evaluations in the requested time limit—there is now concern that the state could face high fines for this in the future. One of the primary goals of the Senate bills would be to make the location of these evaluations more appropriate—outpatient evaluations rather than stays in (expensive) state hospitals are appropriate in many cases, for example.
This is an interesting lesson in how to both provide more resources for mental health but also focus on how to spend those resources in the most efficient way possible. Currently, there is also a proposed November ballot measure that would increase Denver sales tax to raise money for mental health and substance abuse treatment. While this tax increase is an additional expense, it is worth taking into account the ways taxpayers are already paying for these treatments: information from Mathematica Policy Research shows that about one in eight emergency room visits in the U.S. are for mental health or substance abuse reasons, and about one third of these people do not receive follow-up care within 30 days. Not only are these emergency room visits expensive for everyone, they are not the most beneficial treatment option for the patients themselves.
Therefore, more funding for mental health and substance abuse services is itself a possible way to spend more efficiently. Yes, this will likely require an increase in sales tax, but taxpayers are already spending for high numbers of emergency room visits. Beyond this, more support for those dealing with mental illness and addiction is important for the well-being of any community. Mental illness affects people of all incomes and circumstances, but it is also of the major causes of homelessness, according to the National Coalition for the Homeless, and there are over 5,000 homeless people in Denver (this comes from 2017’s Point-in-Time survey, which acknowledges it is a low estimate due to undercounting).
Colorado is in need of additional funding for mental health and substance abuse services, not just to avoid fees for not meeting court-required evaluations but because this is an issue that affects the overall health of our population. Funding will hopefully get a boost from the November ballot initiative, but even if this does happen, lawmakers should continue to keep in mind how to most precisely use these funds to ensure that each dollar helps as much as possible.
