The Denver region is seeing an influx of new options for mental health and addiction treatment, but it’s not yet clear how much of a dent those new and expanded programs will put in the sizable unmet demand for such care.
UCHealth and Denver Health both recently opened new inpatient units, while a drug treatment facility in Parker is adding two buildings. Construction recently started on a new behavioral health hospital in Westminster, and HealthOne hospitals in the metro area have opened five units offering intensive outpatient behavioral health care to children and adults since 2020.
The need for care is significant. About 29% of Colorado adults who reported they were experiencing anxiety or depression said they were unable to get counseling as of spring 2022, according to the Kaiser Family Foundation.
The Denver Department of Public Health and Environment’s behavioral health needs assessment, which was completed in January, found about 41% of people who said they sought behavioral health care in the past year didn’t get it. The odds of not getting care were higher for some services than others, with 64% of people saying they couldn’t find inpatient addiction treatment.
While it’s sometimes lumped together in people’s minds, different types of behavioral care aren’t just apples and oranges, but a whole produce section. Some providers treat only people with mental illnesses or addictions; some work with those who have both. The intensity ranges from a weekly therapy session to locked wards where staff attempt to stabilize the sickest populations.
“People need to go up and down the continuum (of care), and if there’s a gap in one level, it jams up the system,” said Dr. Christian Thurstone, director of behavioral health services at Denver Health.
The Denver report estimated about 117,000 people in the city may need behavioral health care but aren’t receiving it at this point. The most commonly reported barriers to getting care were transportation, costs or lack of insurance coverage, inaccessible hours, stigma and racism.
Any new capacity for behavioral health care is welcome, especially from a safety-net provider like Denver Health, said Vincent Atchity, president and CEO of Mental Health Colorado. But there still needs to be more investment, both in opening additional beds and in reaching people who don’t know how to get care, such as those experiencing homelessness, he said.
“That’s all good news. We just need more of that, and in every community,” he said.
UCHealth
The UCHealth Anschutz campus opened a new 40-bed inpatient mental health center last week.
Most people likely will arrive through an emergency room, and the unit is set up to offer electroconvulsive therapy and esketamine treatment, as well as traditional medications, said Anne Felton, senior director of behavioral health at University of Colorado Hospital.
Electroconvulsive therapy essentially triggers a small seizure to reset parts of the brain, and esketamine is a form of the psychedelic ketamine given as a nasal spray. Both are approved for people with depression who haven’t responded to other treatments.
Because it’s a new unit, UCHealth was able to design it not only to avoid fixtures that patients could use to harm themselves, but also to make it feel less threatening, Felton said. For example, the room where they search patients for contraband looks like a doctor’s office, to make it more comfortable to get undressed, she said.
The University of Colorado Hospital had an inpatient mental health unit until 2009, but that closed because there was an overall shortage of beds at the time, Felton said. Now, the hospital has three large inpatient buildings, which made it possible to offer a psychiatric unit again, she said.
“They had to, I think, make really difficult decisions based on the needs in the community,” she said.
The inpatient psychiatric unit will probably lose money, but it’s a necessary part of the overall continuum of care, Felton said. Other investments since 2019 totaled more than $100 million and included adding behavioral health providers to primary care clinics and setting up virtual care options, including an intensive outpatient program with multiple hours of therapy several days a week, she said.
“Inpatient (care) is just a piece,” she said.
Denver Health
Denver Health Medical Center opened the first licensed detoxification facility for people under 18 in Colorado this spring, with plans to gradually take on more patients.
Thurstone said the hospital’s emergency room treats about 900 teenagers for substance use in a typical year. Before they opened the detox facility, there wasn’t much they could do except revive teens who’d overdosed and give them or their parents information about outpatient treatment, he said.
Now, Denver Health has a place to send young patients to be stabilized for a few days and start on medication-assisted treatment, Thurstone said. Medication-assisted treatment typically involves giving patients a milder opioid so they can function without painful withdrawal symptoms, though some people prefer a shot to block the effects of opioids in the brain.
The unit opened May 15. It wasn’t fully staffed at the time, Thurstone said, but a patient had stopped breathing from an overdose, and the medical team feared they’d overdose again if they walked out. While they have a therapist on staff now, they’re still limiting admissions to one person per week so they can slowly build up the program, he said.
“We’re accepting the kids we think will die” without treatment, he said.
While the system still has plenty of holes, it’s improved significantly over the last 20 years, Thurstone said. Insurance is now required to cover behavioral health in the same way that it does physical health, and there’s an increasing recognition that addiction is a brain disease, not a character flaw, he said.
“It’s been a long slog,” he said.
Valley Hope of Parker
Valley Hope, a chain of addiction treatment centers based on the 12-step method, announced its Parker location will expand by about 40% by the end of February, doubling from eight to 16 detoxification beds and adding more space for residential and outpatient treatment. (Residential differs from inpatient treatment because, while patients live where they’re getting care, the experience can be more like staying in a dormitory than a hospital room.)
They’re also looking to add a partial-hospitalization program, where patients spend most of the week receiving treatment, but have a few days off and go home to sleep, said Scott Spielman, executive director for Valley Hope’s Colorado locations.
A separate Valley Hope program in Littleton for pregnant women and new mothers also needs to grow if it’s going to meet the need, but that will depend on raising additional funding, Spielman said. It’s been a bit easier than it was in the past to interest donors in addiction treatment, and the state has some funding available from settlements with companies that contributed to the opioid crisis, he said.
“It’s a shame that it’s crisis-driven, but mental health and substance use is finally getting the funding it’s needed for decades,” he said.
The ability to meet the need is also limited by staffing, Spielman said. Addiction treatment isn’t easy work, and everyone in health care is struggling to hire after the upheaval of the pandemic, he said.
“I need more nurses. I need more techs. I need more — almost everything,” he said.
West Pines Behavioral Hospital
The hospital is moving from its current location on the Lutheran Medical Center campus to a new building in Westminster in the fall of 2024 and growing from 104 beds to 144.
Intermountain Health, which merged with SCL Health last year, is replacing the Lutheran hospital building, though that wasn’t the reason for a new facility, said Jeffrey Woods, operations group president for Acadia Healthcare.
Acadia will operate West Pines and be the majority owner, with Intermountain taking a smaller stake.
The current building has spaces for adults with different mental health conditions, with a separate unit in Lutheran’s facility for geriatric mental health patients. The new hospital will be able to offer two units for older people: one for those who only have behavioral health conditions and one for those also experiencing dementia, Woods said.
They’re also looking to add a unit for children or teenagers, depending on which the community has a greater need for, and new spaces for recreation and art therapies, he said.
“That extra space will allow us to treat a population that’s somewhat different,” he said.
Scott Peek, Front Range market president for Intermountain, said he doesn’t know of any one thing driving hospitals to make behavioral health investments at the same time, but all of them have seen an increase in patients coming to the emergency room in crisis. Having a range of behavioral health care options for different patients’ needs will also lead to better outcomes, he said.
“A lot of times we’re at the pointed end of that stick, taking care of patients that have nowhere else to go,” he said. “This also is a better way to take care of these patients, not just a release valve for the emergency rooms.”
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