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Teenaged girl making phone call

Community partners team up to assess suicide risk in our schools

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ON AND BEYOND: Community partners team up to assess suicide risk in our schools

So many of us have had feelings of sadness and despair, but even with that experience it is still difficult for most of us to truly understand the deep and pervasive thoughts that can lead a person to consider ending their life. Suicide is a complex, multifaceted issue which is rarely the result of a single source of trauma or stress. Suicidal ideation is a serious issue and occurs in people of all ages. The youth in our region is one group that needs a range of help and support when it comes to suicidal thinking or ideation.

In Colorado, suicide was the leading cause of death among youth ages 10-18 between 2013 and 2017. The 2017 Healthy Kids Colorado Survey indicated that 31.4% of Colorado high school students reported feeling sad or hopeless almost every day for two weeks or more in a row during the previous 12 months. Furthermore, 17.0% reported considering suicide, and 7.0% reported making one or more suicide attempts in the previous twelve months.

The data are startling, but the encouraging news is that there are many effective suicide prevention programs that can bring hope, connectedness, and recovery to young people struggling with thoughts of suicide.

Suicide Risk Assessment Team Research demonstrates that assessing for risk is an effective way to recognize and prevent harm. This informs the foundational belief of the West Central Colorado Suicide Risk Assessment Team (SRAT) that suicide deaths are preventable for youth who are assessed for risk and provided support and treatment from a community care coordination team.

The SRAT is led by The Center for Mental Health and the Montrose County School District (MCSD). Some additional partner agencies include: Hilltop Family Resource Center, Montrose County Department of Human Services, Northside Health Clinic, 7th Judicial District, The Montrose Police Department, and The Montrose County Sherriff’s Office.

In the fall of 2019, members of the Montrose community implemented the Salem-Keiser Suicide Risk Assessment Model for the assessment of suicide risk in our youth. The program has a two-tiered response to any concerns of suicidal ideation. The risk assessment remains simple for the student but provides valuable information needed to determine what level of support will be best to address the risk. If it is identified after the assessment that further evaluation is needed, the school will contact The Center for Mental Health through The Crisis and Support Line.

“MCSD is proud to be a part of a community effort aimed at identifying students who are dealing with suicidal ideation,” James Pavlich, director of Safety and Security for the Montrose County School District, states. He also notes that community collaboration is key to overall success: “This program works because it approaches risk mitigation as a community team.”

“The loss of any youth is a tragedy we want to prevent,” says Laura Byard, LPC, regional director for The Center for Mental Health. “Our community prioritizes the safety and welfare of our youth. We work to ensure they can recover and regain the hope they need to overcome the challenges and pain they are experiencing.”

Since being implemented in Montrose, the SRAT has expanded to provide support in Ridgway, Telluride, West End, Norwood, and Ouray School Districts for the 2020-2021 school year.

Susan Lacy, superintendent of the Ridgway School District, supports the program and the community connection it provides. “One of the benefits of this collaboration is it has established a chain of communication — a bridge between the district, The Center for Mental Health and our school-based counselors. That allows us to keep consistent in our protocol when it comes to assessing suicide risk and communicating about what treatments are being provided.”

Pavlich agrees and notes positive outcomes are becoming more apparent as time goes on: “This program has made our students, staff and community safer already and is reducing the stigma around suicide.”

The Center for Mental Health is proud to be part of this important community team. As the region’s community behavioral health center, our vision is to be the help you need when you need it.

If someone you care about needs help, call our free, 24/7 Crisis and Support Line at 970-252-6220 or walk in anytime to the Crisis Walk-in Center at 300 N. Cascade Avenue, Montrose.

How can I help? Suicide prevention really is a community effort. We can all help.

5 Actions Steps to Help Someone in Emotional Pain

  1. ASK: “Are you having thoughts of suicide?” It’s not an easy question, but studies show that asking an at-risk
    individual if they are suicidal does NOT increase suicide or suicidal thoughts.
  2. KEEP THEM SAFE: Reducing access to highly lethal items or places is an important part of suicide prevention. You can
    ask the at-risk individual if they have a plan. Removing or disabling lethal means can make a big difference.
  3. BE THERE: Create a safe space with your presence and listen carefully to what the person is thinking and feeling.
    Acknowledge feelings without judgement and try to understand underlying emotional struggles. Research tells us that
    acknowledging suicide can decrease suicidal thoughts.
  4. HELP THEM CONNECT: You can help make a connection to a suicide lifeline or with a trusted individual (family member,
    spiritual advisor, or mental health professional).

    1. The Center for Mental Health Crisis Walk-in Center: 970-252-6220 | 300 N. Cascade Avenue, Montrose
    2. Colorado Crisis Services: 1-844-493-8255 | Text “TALK” to 38255
    3. If there is imminent risk for suicidal death, call 911.
    4. Safe2Tell app or call 1-877-542-7233
  5. STAY CONNECTED: Make space and time for ongoing conversations after an emotional crisis. It can make a
    difference.
Montrose Daily Press
Contributed by Nya Greenstone, MSW, LSW, The Center for Mental Health
Montrose Daily Press | March 27, 2021
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The purchase of a designated vehicle for the mental health clinician will allow the clinician to respond autonomously, stay on scene to deliver patient services, and complete follow-up visits while freeing up officers for additional calls for service. Courtesy photo by William Woody (City of Montrose)

Co-response model is helping the community at-large

By News

A look at how Montrose’s co-response model is helping the community at-large

In Montrose, the co-response model involving local law enforcement and mental health professionals is having an impact.

“Throughout our country, communities have been seeing an increase in emergency situations involving persons with addiction or other mental health issues,” said Carol Howe during a webinar that included law enforcement and mental health professionals in Montrose County. “Questions surrounding who should respond and how they should respond are being asked.”

The co-response model — where local law enforcement and mental health professionals respond together — launched in 2018. It’s a partnership with the Center for Mental Health, which provides behavioral health professionals to respond with officers to police calls that involve a person experiencing a mental health crisis, and the Montrose County Sheriff’s Office.

Essentially, officers will arrive on scene, make sure it’s safe, and once secured, Katharyn Burke, a licensed professional counselor and co-responder for Montrose who’s also with the Center for Mental Health, will assess the individual and find the most appropriate action to help the person. It’s on a case-by-base basis, but Burke can help the individual secure a safety plan or, if not available, can offer a referral after the call and inform the person about what resources the Center for Mental Health can provide.

If the person isn’t cooperative, de-escalation tactics are used, but most calls, due to the cooperative nature and partnership, are safe. It’s an individualized response, with the goal of providing the least amount of intervention to meet their needs. For example: sometimes a person will be transported to Montrose Memorial Hospital if there’s a medical requirement.

People are also offered an opportunity to stay at the crisis walk-in center or stabilization unit at the Center for Mental Health, an option that’s often accepted and consistently available. If Burke isn’t available, the mobile response unit from the crisis walk-in center provides support. (The mobile response vehicle was purchased after a successful 2019 grant application for a Peace Officer Mental Health award from the Colorado Department of Local Affairs.)

Burke’s training is extensive. She has a master’s in counseling and is a licensed professional counselor in Colorado, and has several years of experience in crisis work.

The goals of the program are to decrease police involvement when it’s a mental or behavioral health issue, involving best practices for resources and support for people in the community.

“The end goal is to make sure that our community is getting the services they need, and also lessen the time law enforcement is on scene dealing with the individual,” said Tim Cox, patrol commander with the Montrose Police Department and program supervisor.

That collaboration has helped local law enforcement respond to other calls for service when needed, and with Burke following up with the individuals, there’s been a “huge” reduction in crimes committed from people dealing with behavioral or mental issues, all while keeping them out of the judicial system, Cox said.

“It’s done wonders, it really has,” Ty Cox, lieutenant with the Montrose County Sheriff’s Office, said of the program. “We don’t deal with the same people as much and they’re getting the help they need. It’s been such a great program and we’re glad to be a part of it.”

Though centralized in Montrose, there’s also a team in Delta, offering support to people in Paonia, Hotchkiss and Cederadge. It’s all made possible by grant funding from the Office of Behavioral Health. For example, Montrose County Sheriff’s Office paid, through a grant, to send Burke to crisis intervention training, emphasizing the partnership between the entities. (The sheriff’s office also sends deputies to de-escalation training annually for the past five years, as well as crisis intervention training.)

The training is real-life like, offering a formidable sense of what it’s like to respond to a call that requires what’s learned in the training. It’s vital, Tim Cox said, as it reduces the use of force and pivots the focus to what the individuals need.

The amount of calls for service was impacted by the pandemic. At first, there was a reduction of calls. It picked up during the summer, and lately, there’s been a rise. It’s been similar for mental health professionals at the Center for Mental Health.

There’s also been less cross training due to the pandemic — Burke training the officers and vice-versa — but more funding in the future could help that training become more frequent.

At the moment, there’s enough funding for one position in Montrose, and though the budget is limited, there’s benefit to Burke going on call with different officers, said Laura Byard, licensed professional counselor and regional director from the Center for Mental Health, creating connections and partnerships.

It’s true, though, that additional funding could help Montrose County’s co-response model have structured teams (officers working with the same mental health professional), similar to what’s utilized on the Front Range, as well as grow the program.

It makes for a better response overall, Tim Cox said, and Montrose has been on that trend, seeing program growth since its inception.

“We would add more staff, so we have more availability throughout the week for co- response,” Byard said. “That would be our dream big goal.”

A challenge for co-responder programs across the state, Byard said, is determining how many calls require the co-response model. Calls involving alcohol, substance abuse can vary between the police department and sheriff’s office, which often see similar trends. It’s complicated, too, since a criminal charge can be charged to someone dealing with substance abuse and behavioral health, making it tough to track.

(Byard later added that Montrose County has not seen a similar trend to suicide rates experienced nationally during the pandemic.)

But, panelists agreed that the program has helped reduce the number of inmates struggling with mental health, given a big boost by Burke’s follow-up procedures. And, the partnerships are a big part of that, Tim Cox said.

“Although we have great resources, they’re limited, so we’ve learned to adopt and overcome and work together as a team, and it’s been excellent,” he said. “Our community and our partnerships are very valued in Montrose.”

The community can join the effort by offering support to local agencies that provide services to certain sectors of the community, including people experiencing homelessness.

“It doesn’t matter what anybody’s status is,” Tim Cox said. “If somebody needs help, this team here is going to get them the help they need.”

The Center for Mental Health support line is 970-252-6220. The community is encouraged to call with questions or concerns.

To view the webinar, visit youtube.com/watch?v=RGk2wg2rY1Q.

Montrose Daily Press
Josue Perez is a staff writer for the Montrose Daily Press
Montrose Daily Press | March 25, 2020
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Our Future Courtyard (rendering)

Donation puts CMH over the top for courtyard improvement

By News

Donation puts Center for Mental Health over the top for courtyard improvement

The Center for Mental Health is a step closer to being able to complete an outdoor courtyard at its crisis walk-in center, with a $10,000 donation from QHR Health.

The donation, coupled with $5,000 from staff and community members on Colorado Gives Day; $1,000 from Rocky Mountain Health Foundation and $2,500 from the Montrose Community Foundation, puts the Center well above its fundraising goal for the project.

“As a nonprofit behavioral health provider, we depend upon the generosity of community partners, like QHR Health, to fund enhancements to our facilities. This donation will enable us to complete planned enhancements to our crisis walk-in center which provides urgent treatment for individuals who are in crisis due to overwhelming behavioral health challenges,” said Shelly Spalding, CEO for The Center for Mental Health. “The addition of the outdoor courtyard will provide much needed respite for those who are in our care.”

The new courtyard will provide safe, secure, outdoor access to CMH clients where they can benefit from fresh air, sun and the healing power of the outdoors. Currently, CMH clients who may stay for up to five days are unable to safely access an outdoor location.

“Our mission is to strengthen healthcare in rural communities by collaborating with partners to improve access to these services,” said Dwayne Gunter, CEO of QHR Health.

“Together with James Kiser, former CEO of Montrose Memorial Hospital, we are happy to help people in this region. CMH has proven that the need for mental health care was evident and they created a mental health-care resource that meets the needs of those who live on the Western Slope.”

The walk-in center is a life-saving, urgent behavioral healthcare resource serving the Western Slope’s six-county region. Those needing care may come in any time day or night without an appointment and regardless of their ability to pay. Since opening in the fall of 2019, this location has treated more than 1,000 clients, ages 12 to 90.

One element missing from facility is an area where those who are recovering can safely experience the healing power of the outdoors.

“Independent community hospitals and healthcare systems have challenges that are quite different from large, corporate healthcare facilities,” Gunter said.

“At QHR Health, most of us have worked in community hospitals, so we understand the issues communities face. We know the challenges and know that each hospital has its own unique set of demands. That is why the courtyard piqued our interest, it will be a unique but critical part of the healing process.”

This donation comes full circle for QHR Health, which was instrumental in a community needs assessment implemented a few years ago identifying the need for a facility like the crisis walk-in center Montrose. Previously, individuals in crisis needed to travel to Grand Junction or Denver to receive care.

Our Future Courtyard (rendering)

CMH Receives Generous Donation to Complete Outdoor Courtyard

By News, Press Release

FOR IMMEDIATE RELEASE

Contact
Jackie Brown-Griggs
303-300-2255

The Center for Mental Health Receives Generous Donation from QHR Health to Complete Planned Crisis Walk-In Center Outdoor Courtyard

January 20, 2021 — Montrose, CO — The Center for Mental Health (CMH) recently received a generous donation from QHR Health earmarked to complete the planned outdoor courtyard at CMH’s Crisis Walk-in Center.

“As a nonprofit behavioral health provider, we depend upon the generosity of community partners, like QHR Health, to fund enhancements to our facilities. This donation will enable us to complete planned enhancements to our Crisis Walk-In Center which provides urgent treatment for individuals who are in crisis due to overwhelming behavioral health challenges,” said Shelly Spalding, CEO for The Center for Mental Health. “The addition of the outdoor courtyard will provide much needed respite for those who are in our care.”

The new courtyard will provide safe, secure, outdoor access to CMH clients where they can benefit from fresh air, sun and the healing power of the outdoors. Currently, CMH clients who may stay for up to five days are unable to safely access an outdoor location.

“Our mission is to strengthen healthcare in rural communities by collaborating with partners to improve access to these services,” said Dwayne Gunter, CEO of QHR Health. “Together with James Kiser, former CEO of Montrose Memorial Hospital, we are happy to help people in this region. CMH has proven that the need for mental health care was evident and they created a mental health-care resource that meets the needs of those who live on the Western Slope.”

The Crisis Walk-in Center is a life-saving, urgent behavioral healthcare resource serving the Western Slope’s six-county region. Those needing care may come in any time day or night without an appointment and regardless of their ability to pay. Since opening in the fall of 2019, this location has treated more than 1,000 clients, ages 12 to 90. One element missing from the Walk-In Center is an area where those who are recovering can safely experience the healing power of the outdoors.

With a goal of raising $10,000 dollars for the project, CMH was successful in generating nearly $5,000 from staff and community donors on Colorado Gives Day, $1,000 from Rocky Mountain Health Foundation, $2,500 from Montrose Community Foundation and a significant $10,000 donation from QHR Health more than helped CMH exceed its goal.

“Independent community hospitals and healthcare systems have challenges that are quite different from large, corporate healthcare facilities,” adds Gunter. “At QHR Health, most of us have worked in community hospitals, so we understand the issues communities face. We know the challenges and know that each hospital has its own unique set of demands. That is why the courtyard piqued our interest, it will be a unique but critical part of the healing process.”

This donation comes full-circle for QHR Health, as they were instrumental in the Community Needs Assessment implemented a few years ago identifying the need for a facility like the Crisis Walk-in Center in Montrose. Previously, individuals in crisis needed to travel to Grand Junction or Denver to receive care.

About QHR Health
QHR Health is the industry’s leading health solutions provider serving independent, critical access and rural hospitals and health systems across the U.S. For more than 40 years, QHR Health has collaborated with clients to ensure that people in communities ranging from small rural towns, to larger population centers, have local access to quality healthcare services. A wholly-owned subsidiary of Quorum Health, QHR Health maintains a distinct business model with separate operations and a dedicated management team.

About The Center for Mental Health
The Center for Mental Health is a nonprofit organization seeking to promote mental health and well-being. It provides behavioral health services across 10,000 square miles including Delta, Gunnison, Hinsdale, Montrose, Ouray, and San Miguel Counties. Visit www.centermh.org to learn more.

# # #

The Center for Mental Health courtyard
(before project begins)

The Center for Mental Health courtyard
(completed project rendering)

Pink frost-covered flowers

Mental Health Needs Surge

By News

Mental Health Needs Surge

Depression, substance abuse on the rise

If there’s any indicator as to the emotional toll the pandemic has taken, it’s the increased demand for mental health care.

The uncertainty, sadness and struggle to survive COVID-19 have led to an increase in mental health concerns including depression, substance abuse and suicidal ideation both nationwide and in the Gunnison Valley.

Gunnison County leaders last week during a virtual town hall took a closer look at how the community has fared since the start of the pandemic nine months ago.

They found that people of all ages are dealing with the difficulties of navigating the pandemic. For adults, unemployment, food insecurity and child care have been reported as top stressors. Teenagers are taking on uncertainty with class schedules and canceled events such as prom. And the elderly, who face the highest risk of severe COVID-19, are facing isolation and vulnerability like never before.

A Gunnison County business and community survey sent out this November found more than 58% of business owners report their mental health has declined since this time last year.

Nearly a quarter of the 560 respondents said they feel anxious and stressed “most of the time,” and another 26% reported an increase in alcohol consumption.

“Unfortunately we are seeing the same people here over and over again,” said Gunnison Valley Health Foundation Director Jenny Birnie of recent admissions to the hospital.

Birnie said GVH has seen a staggering 500% increase in admissions to its emergency rooms for behavioral issues among adults in 2020. Th e primary diagnoses include anxiety, suicide attempts or ideation, alcohol and opioid non-fatal overdose, depression and hallucinations.

Since January 2020, there has been an 18% increase in visits for suicidal ideation as well as a 10% increase in alcohol non-fatal overdoses for adults in Gunnison County.

Alcohol abuse has long been a problem for both adults and youth in the Gunnison Valley, said Director of Gunnison County Juvenile Services Kari Commerford.

A Healthy Kids Colorado survey from fall 2019 found that 27% of high school students in Gunnison County reported binge drinking (five or more drinks) in the past 30 days.

“This is significantly higher than regional, state and national figures,” Commerford said.

High school students who reported binge drinking expressed increased feelings of hopelessness and suicidal thoughts.

Th ose figures have only continued to climb amid the pandemic, Commerford said.

Regional Director for The Center for Mental Health Kimberly Behounek said increased stress during an event such as a pandemic can result in diffi culty sleeping, concentrating and increased substance abuse.

Knowing where to get assistance for services ranging from testing to therapy and other resources is a good start to addressing mental health issues.

It’s important to know personal priorities and what works for the individual, said Behounek. Whether it’s going for a short walk or reading a book, it’s beneficial to know how to cope with continued stress.

“Your priorities may not be the norm, and that’s OK,” Behounek said.

Birnie acknowledged the hardships Gunnison County residents have faced in recent months but said she was grateful for the county’s current status.

“We’re actually in good shape compared to other communities,” Birnie said.

Gunnison Country Times
Kate Gienapp can be contacted at 970.641.1414 or kate@gunnisontimes.com
Gunnison Country Times | December 17, 2020
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What has been causing stress? (chart)

A recent survey in Gunnison County found financial insecurity to be the biggest stressor as the community continues to navigate the COVID-19 pandemic. (Courtesy photo)

HEALTHY WAYS TO COPE WITH STRESS

Taking care of your emotional health will help you think clearly and react to the urgent needs to protect yourself and your family.

  • Take breaks from watching, reading, or listening to news stories, including those on social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or try a meditation exercise.
  • Try to eat healthy, well-balanced meals.
  • Exercise regularly.
  • Get plenty of sleep.
  • Avoid excessive alcohol and drug use.
  • Make time to unwind.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.
  • Connect with your community- or faith-based organizations. While social distancing measures are in place, consider connecting online, through social media, or by phone or mail.

LOCAL RESOURCES

GVH partnered with The Center for Mental Health (CMH) to gather certified peer support specialists that have overcome a mental health condition and mentor individuals who struggle with mental health, psychological trauma or substance abuse.

SCHEDULE AN APPOINTMENT

GVH Peer Specialist
Gunnison
970.642.4762

CMH Peer Specialist
Gunnison/Crested Butte
970.252.3200

The purchase of a designated vehicle for the mental health clinician will allow the clinician to respond autonomously, stay on scene to deliver patient services, and complete follow-up visits while freeing up officers for additional calls for service. Courtesy photo by William Woody (City of Montrose)

CMH launches mobile crisis service

By News

Center for Mental Health launches mobile crisis service

The Center for Mental Health Crisis Walk-in Center

The Center for Mental Health’s walk-in crisis clinic at 300 N. Cascade Ave. The center recently launched a mobile response program for those in crisis, who cannot access the clinic, and whose situation does not require a law enforcement response. (Montrose Daily Press file photo)

People in need of immediate mental health care can’t always access the Center for Mental Health’s resources, particularly in rural areas. Enter the center’s new mobile crisis response team.

“Our local crisis response program is a 24-hour a day program that works to help support someone who is in a crisis in the community — in their home, their school, or other community-based location — that, due to where they live or availability, that they are unable to come to our crisis walk-in center in Montrose,” chief clinical officer Amanda Jones said Wednesday, in introducing the new service to area law enforcement agencies.

The center operates a crisis stabilization clinic on North Cascade Avenue, in addition to its offices on Miami Road. Therapists have also stepped up to work as co-responders who travel with police agencies on calls where their services are needed.

The mobile crisis program is one more tool to help meet urgent mental health needs.

Trained professionals are sent out to de-escalate situations and stabilize the involved individual. The team conducts a crisis evaluation and then connects the patient to a clinician for an in-person or telehealth assessment. The team can then transport the patient to the crisis center, hospital or other facility, plus make a followup care plan.

People in crisis can call for help themselves; others can also call on behalf of someone else. The crisis team that receives the calls will evaluate the requests and then dispatch someone to help.

Calls can be made to the local crisis line at 970-252-6220 or to the state crisis line, 844-493-8255.

“That phone call is answered live,” said Heather Thompson, the center’s director of Nursing and Emergency Services.

“They basically triage the phone call and determine what needs to happen next. They can either talk to the person on the phone, try to get them to come to the (crisis walk-in) unit. If they’re not able tot come to the unit, a mobile crisis response is necessary.”

The Center for Mental Health’s walk-in crisis clinic at 300 N. Cascade Ave. The center recently launched a mobile response program for those in crisis, who cannot access the clinic, and whose situation does not require a law enforcement response. (Montrose Daily Press file photo)The service launched early this week; already, there have been a few crisis responses, Thompson said.

“It really is a community-based response,” Jones said.

The service is available 24/7 in Montrose, Delta, Gunnison, Montrose, Ouray and Hinsdale counties. It is available to people of all ages and regardless of insurance or ability to pay, thanks to state investment.

“We should not be needing to work out someone’s ability to pay for a service when they are needing that level of an immediate response,” Jones said.

The program comes with support from the Colorado Office of Behavioral Health, which allows a response time of up to two hours in “frontier” communities such as Montrose and the other counties; Jones said that for areas in Montrose and Delta, the response time is likely to be much quicker.

Although the function is similar to the co-responder model, the new mobile crisis team is different — professionals still deploy to a person in need, but the idea is to avoid having to use law enforcement.

“Part of the goal of mobile response is that we are able to screen and, hopefully, deploy our team to a situation without the need for law enforcement. That is what is a little bit different from a mobile response and a co-response model,” Jones said.

The center uses established guidelines to determine when its professionals can safely respond without law enforcement support.

“The goal is that once there is a mobile response, that we are also able, if the individual is safe for transport, that we can transport them to our crisis stabilization unit, a psychiatric hospital location, again, with an intention of taking primary pressures from law enforcement around the need of response or requests for transportation,” Jones said.

The mobile crisis response can be used when the location of the individual in crisis is clear; he or she is willing to speak with a clinician; there is no risk of harm to self or others; no medical concerns and the individual cannot access the walk-in clinic.

A law enforcement response will be needed when unsecured weapons are at the scene; there are unsecured aggressive animals; a domestic dispute is in progress or the person is aggressive or violent toward others.

When a person is actively harming himself or herself, other others; attempting suicide; having a medical emergency; in unresponsive, or is significantly impaired by drugs, medication or alcohol, 911 should be called.

Montrose Daily Press
Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.
Montrose Daily Press | November 21, 2020
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Beer glasses (photo)

Be alert for risks of ‘gray area’ drinking

By News

Expert: Be alert for risks of ‘gray area’ drinking

Isolation and stress exacerbated by the COVID-19 pandemic are also fueling a sneaky risk — “gray area drinking.”

Gray area drinking falls between abstinence and alcohol abuse and the term is used to describe situations in which people drink more than they intended, or of which they are aware, in response to stressors. It can prime the pump for substance abuse issues: Where before, it was a glass of wine with dinner, then an extra one, suddenly, the person is drinking much more for the same effect.

“It’s often a problem for individuals. It’s an easy thing to overlook — just having a second glass of wine or another beer, and maybe you didn’t have that intent in the first place,” said Kathleen Burnell, director of Substance Use Services at The Center for Mental Health.

“Oftentimes, it is paired with other stressors. We have a lot of stress right now. There’s financial stress; there’s health stress; separation and worry about family members. There is a political division going on, which can lead to stress as well, because of the tension. People find themselves looking for a way to relax.”

When dealing with stressors, people don’t always pay as much attention as they should to how much of a substance they are consuming, Burnell said: “And that’s where gray drinking starts to sneak in.”

Signs of gray area drinking may include worry and regret about drinking; being able to stop drinking but finding it hard to stay stopped; drinking that doesn’t appear to be problematic to others and rationalization that swings between a self-admonition to stop drinking and the idea to “live a little,” according to an op-ed Burnell published in August.

One of the first signs drinking is becoming a problem might be an impact on daily routine, Burnell said Monday — such as sleeping later in the morning because of how much one has had to drink; socializing only with friends who also drink or getting less enjoyment out of family time.

“If you find yourself worrying about drinking or how much you drank, generally, worry is our mind’s way of warning us something is going on,” Burnell said.

That extends beyond alcohol, to other substances such as tobacco.

Another warning sign is using more alcohol to achieve the same effect as before — gray area drinking can ratchet up due to the way substances work in the human body.

Burnell also says to be alert to such behavior as self-rationalization, or putting off a task that needs to be done just to accommodate drinking or other substance use.

Legal involvement — being pulled over for being under the influence — is a red flag.

“Something that we’re seeing nationwide is an increase, overall, in substance use,” Burnell said. Isolation has been shown as a major factor.

“We’ve seen that all year long. By feeling disconnected, we tend to get a little less joy out of life and find ourselves looking for a few more coping mechanisms.”

Having more than one outlet for stress is important.

“When we do something like drinking, if it becomes our only tool to relax, then it is not helping us. Often, we get more satisfaction from a relaxing activity if we have more than one choice,” Burnell said.

The Center for Mental Health offers group and individual help to those struggling with substance use and gray area drinking. Help is available by phone, telemedicine or in person, with COVID-19 safety protocols. Call 970-252-3200 to learn more about these options.

Those who are feeling stressed or worried can access a 24-hour hotline at 970-252-6220.

The center also offers free online assessments at www.centermh.org/help. Access the free online tool “myStrength” at www.centermh.org/mystrength for wellness tools and strategies for self-care.

“We’re trying to connect with people wherever they’re at,” Burnell said.

She also acknowledged people are worried for their friends or loved ones who may have fallen into gray area drinking or outright substance abuse.

“We very much care about the people in our lives. It’s hard to sit there and see something where you want to say something,” she said.

Again, people can access support and strategies through the Center for Mental Health.

“We know we can’t make other people change, but by being there alongside them while they are evaluating what they want to do with their lives can be really valuable,” Burnell said.

Montrose Daily Press
Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.
Montrose Daily Press | November 18, 2020
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The Center for Mental Health's walk-in clinic, with crisis stabilization services, began serving patients a year ago. (Justin Tubbs/Montrose Daily Press)

Advocates work to combat suicide

By Media Coverage, News

Advocates work to combat suicide as Center for Mental Health’s walk-in clinic hits first-year mark

Rana Shaner shares her story of survival in hopes of saving others — her way, she said, of giving back after she sought and received help for suicidal thoughts and attempts.

“I’m not ashamed of any of this.… We don’t really choose to have mental illness. We don’t ask for it. These are the challenges we’re faced with. There’s no reason to be ashamed of who you are as a person,” Shaner said Tuesday, midway through Suicide Prevention Month.

Shaner struggled with suicidal ideation from an early age and took the first step to recovery at age 13, when she was able to tell her mother of her dangerous thoughts and was placed into therapy. The journey toward stability continued through young adulthood, when an instructor at her college took her to the campus clinic for help with her panic attacks.

“I had no clue how to start off. I was thankful there were people who did know,” Shaner said.

Today, Shaner is an advocate against suicide who works to reduce the stigma associated with seeking help. She is a member of the Colorado Behavioral Health Task Force and was also appointed to the Mental Health Service Standards and Regulations Advisory Board.

Shaner further sits on the Zero Suicide Task Force through The Center for Mental Health.

The Rocky Mountain region has the highest suicide rates in the nation and in Colorado, the Western Slope’s suicide rate is higher than the overall rate in the state — an ongoing concern for advocates like Shaner and clinicians at The Center for Mental Health. Suicide is the leading cause of death among Coloradans 10-24, although most suicides overall occur in men 45-64.

“There are a lot of signs and symptoms for people to watch out for,” said Center for Mental Health Regional Director Laura Byard.

Falling into the “immediate risk” category are such behaviors as people talking about wanting to die or kill themselves; researching a method; obtaining a weapon, or expressing feelings of hopelessness/no reason to live.

“We would want them to contact the center or the national help line to get help immediately,” Byard said.

The “serious risk” category includes troubling behavior that is new, has increased, or is related to a painful event; expressions of feeling trapped, being in unbearable pain, or of being a burden; increased drug or alcohol use; reckless behavior; agitation; sleeping too much or too little; withdrawing; rage; isolation; revenge-seeking behavior or extreme mood swings.

Byard said people exhibiting these signs should get an immediate evaluation.

The national help line is 800-273-8255 and the clinic’s crisis line is 970-252-6220. Byard also encouraged people to come to the center’s crisis walk-in center at 300 N. Cascade Ave. for immediate help and/or an evaluation. The Center for Mental Health works with insurance, offers a sliding fee scale, and may be able to find other payment assistance options for patients.

The walk-in center was completed last March and opened to patients a year ago today. It provided crisis stabilization and other behavioral health services to almost 600 people in its first year, who before had little to no access to such care without having to travel to Denver or Salt Lake City.

Center stats showed 354 clients who would have otherwise wound up in the hospital emergency room, instead received crisis treatment at the walk-in unit. Many patients also avoided jail by receiving mental health services instead. More than 200 clients received withdrawal management (detox) treatment.

“These crises services will help someone connect and access support quickly during a time when the individual could be experiencing suicidal thoughts,” Center for Mental Health Chief Clinical Officer Amanda Jones said, in a provided statement.

“Rapid connection with services and support can decrease the potential of someone taking action on their thoughts and direct them to services for ongoing care.”

Byard said the crisis center has been an “incredible success” when it comes to serving the entire region. Although the crisis unit is small and cannot, by itself, fill the large gap in behavioral health services on the Western Slope, the feedback has shown Byard it is helpful.

“It’s been amazing for all of us to be able to serve our community this way,” she said.

Patients ages 12 and into their 90s have reached out for help with all kinds of difficulties, she said.

“We are able to connect them with our clinical staff and recommend treatment that is very specific to their individualized needs,” said Byard.

Not everyone in crisis is necessarily suicidal, and people with suicidal ideation might not necessarily be in crisis mode. “Suicidal ideation” refers to thoughts of suicide, whether brief and fleeting, or frequent and persistent.

“Anytime they (suicidal thoughts) creep in, even if it’s brief… we would recommend they get an evaluation. That’s their brain letting them know they need some support for whatever it is they’re dealing with,” Byard said.

Shaner battled suicidal thoughts throughout her life.

“My goal is to do things to promote hope, to educate and to normalize having the conversation to help take the stigma away and just be willing to initiate that discussion,” she said.

“It was challenging for me. I just want people to know there is hope. You can recover. You can create a life worth living. Recovery is possible. I think of it as, recovery is investing in your greatest asset, which is yourself.”

This is not a challenge that can be met overnight, but a long journey — and a worthwhile one, Shaner also said.

“I was so glad I did put in the time and effort,” she said.

“I decided I wanted to make meaning and purpose of my experiences. I could do that by telling my story.”

Before reaching out and fighting for her health, Shaner internalized the stigma that often comes with seeking help for behavioral health issues, believing she was somehow “defective” and unworthy. But that’s not true, she said, and therapy forced her to challenge those destructive thoughts, as well as helped her realize everyone’s existence matters.

“It doesn’t always have to be this big, grand gesture on a big scale,” Shaner said.

“Even if you offer a word of support for someone and it helps them, maybe they pass on the same words to someone else who needs it. We do all matter in this world.”

Stigma remains, Byard said.

“Unfortunately, I do think people are reticent to ask for help. It is not unusual … there’s reticence to seeking treatment. That’s the part we would definitely like to see improved,” she said. That reluctance is among the reasons why it is important to recognize the risks for suicide in oneself or in others, she added.

Suicide isn’t necessarily a symptom of mental illness, Shaner said: people with mental health conditions may not have any suicidal ideations and people without mental health conditions might indeed be suicidal.

Getting help in addressing what underlies suicidal thoughts is critical. Shaner found dialectical behavioral therapy, or DBT, particularly beneficial, and said she is grateful for the Center for Mental Health’s support.

The Center for Mental Health individualizes treatment specific to patient needs, through a thorough assessment and recommends treatment accordingly, including DBT, which focuses on emotions that are difficult to manage (not exclusively suicidal tendencies), Byard said.

When someone comes in to be evaluated for suicidal ideation, trained clinicians talk to them about their situation; psychological paint; stress; level of hopelessness; agitation and overall risk. The clinician works with the patient and his or her support system to create a safety plan and steps for treatment.

“We treat suicidality as a separate clinical issue, working with an individual toward their goals for their best life,” Byard said.

Shaner reiterated the need for people to reach out — ideally, before they are in crisis. Others may think someone who seeks help is a weak person, she said, but: “I beg to differ. I think it takes a person of great strength.”

Montrose Daily Press
Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.
Montrose Daily Press | September 16, 2020
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The purchase of a designated vehicle for the mental health clinician will allow the clinician to respond autonomously, stay on scene to deliver patient services, and complete follow-up visits while freeing up officers for additional calls for service. Courtesy photo by William Woody (City of Montrose)

Co-responder partnership between police and mental health professionals

By Media Coverage, News

Co-responder partnership between police and mental health professionals proves a boon to community; grant buys specially equipped vehicle

In August, her first month as the mental health co-responder assisting law enforcement, clinician Katharyn Burke performed seven evaluations.

That speaks to the necessity of the behavioral health co-responder program, Montrose Police Department Cmdr. Tim Cox said. Cox supervises the program for the police department, which first launched a behavioral health co-responder program in late spring, 2018.

The program is a partnership with the Center for Mental Health, which provides behavioral health professionals to respond with officers to police calls that involve a person experiencing a mental health crisis, and to help de-escalate the situation. The center uses state grants to pay the salary of the co-responder.

“The whole goal of the program is to reduce individuals in behavioral crisis who are going  to the emergency room or crisis walk-in center — ultimately, the No. 1 thing is to keep them out of jail and get them the help they need,” Cox said.

A trained clinician like Burke, who is a licensed professional counselor, can use his or her skills to defuse potentially volatile situations, transport the individual in crisis to immediate care and can also conduct followup with the person. In turn, a police presence helps ensure the clinician’s safety.

Prior to the program, police officers could transport a person in crisis to the ER — and, after it opened, the Center for Mental Health’s crisis walk-in center — but they would not necessarily know whether the person received services and care, plus transporting the person took officers away from law enforcement duties.

“This is an amazing program. To be able to support our community through the co-responder model is a great benefit to our community members,” said Laura Byard, regional director for for the Center for Mental Health and the clinic’s co-responder program supervisor.

The co-responder model gets people support immediately and, ideally, helps them avoid future law enforcement contacts, or at least, decreases the level of such encounters, she said.

“It’s a quicker response. People naturally call 911 when there is an emergency, whether it’s mental health or not. It (program) allows us to get to them really quickly and address their needs,” Byard said.

Enhancing the program is the recent purchase of a specially equipped vehicle for the co- responder, which was possible because of the City of Montrose’s successful 2019 grant application for a Peace Officer Mental Health award from the Colorado Department of Local Affairs.

The city received $42,745 to purchase the vehicle and radio equipment for it; a portion of the grant will also be used to train and certify five officers in peer support counseling.

The purchase of a designated vehicle for the mental health clinician will allow the clinician to respond autonomously, stay on scene to deliver patient services, and complete follow-up visits while freeing up officers for additional calls for service. Courtesy photo by William Woody (City of Montrose)

The vehicle enables Burke to arrive and depart from calls separately, which serves to free up officer time, as well as to give the patient a better transport experience, Byard said.

“Hopefully, it’s a better experience for our community,” Byard said.

Because Burke is able to transport individuals in crisis, responding officers can remain on scene, if the situation requires them to do so.

The co-responder program is a necessity, Cox said. “The partnership between the Center for Mental Health, the Montrose Police Department and Montrose County Sheriff’s Office has been beneficial so far. We knew it was needed in our community,” he said.

Although officers receive a degree of training in crisis intervention, their primary job is law enforcement. A skilled clinician on scene helps them recognize a person in mental health crisis, versus someone who is just out to break the law, Cox also said.

“The ultimate goal is to keep those individuals (in crisis) out of jail,” he reiterated, saying the clinician is ultimately the professional best equipped to assist them.

“Our officers are trained in de-escalation and they do a very good job, but having her there (is helpful),” Cox said.

In the past, officers might know someone was in a crisis, and could take that person to the ER or the crisis center, but that didn’t always end the matter.

“We would never know what happened with that individual. We would see them on the street again and wonder whatco happened,” Cox said.

Having a professional who can follow up after the fact benefits everyone, Cox said. He added that the police are not informed of the details concerning a person’s contact with mental health services, because that is private medical information; however, officers now at least know a person has received care.

“It really is just a huge partnership,” he said, referring to the Center for Mental Health and law enforcement agencies.

“The main goal is to get that individual through that crisis and hopefully, they don’t end up committing a crime because of it,” Cox said.

“I’m just incredibly impressed with our law enforcement and their dedication to ensuring the best experience for those experiencing a mental health crisis,” Byard said.

“I think we’re lucky in our community to have such a great partnership.”

Peer support training, also being funded in part through the DOLA grant, is a benefit, Montrose Police Chief Blaine Hall said in written information.

Through the peer support model, officers are able to talk in confidential settings to other law enforcement members when they are having trouble dealing with job stressors.

Hall last year announced his intention of implementing peer support in order to prevent officer suicides and other crises. Nationwide, officer suicides in 2019 exceeded the number of line of duty deaths, although the MPD’s last reported officer suicide was in 2007. The

hope is that having a peer support program will help officers overcome the stigma of seeking help when they are affected by the hard things they see on the job.

“Our officers see and experience things no one should see in a lifetime,” Hall said in a press release Monday, announcing how the DOLA grant is being spent.

“Officers need access to trained law enforcement peer support specialists who understand the profession and can assist officers and their families when the job takes a toll on their mental health wellbeing.”

Montrose Daily Press
Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.
Montrose Daily Press | September 02, 2020
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Wrapping up Mental Health Awareness Month

By News

Wrapping Up Mental Health Awareness Month

This May we have been celebrating Mental Health Awareness Month in some new ways – most of them virtual. As we close out this month, I wanted to share why it is so important to us at The Center for Mental Health.

Mental Health Awareness Month began in 1949. It was started by Mental Health America to raise awareness, educate the public, and advocate for policies that support mental health. Every year in May we take time to promote mental health issues and try to break down the stigma that is often associated with seeking help.

In an effort to break down the stigma, the industry has turned to the term “behavioral health.” This term seeks to include both mental health issues and substance use disorders. One in 12 American adults has experienced a substance use disorder and 1 in 5 has experienced a mental illness during the past year. That equates to 467,000 Colorado adults who experienced a substance use disorder and over one million who experienced a mental illness. Approximately one quarter of these individuals received treatment at one of Colorado’s 17 Community Mental Health Centers.

On October 31, 1963, President John F. Kennedy signed the Community Mental Health Act into law. This led to the establishment of Community Mental Health Centers throughout the country so that anyone who needed care could receive it. This helped people with mental illnesses who were “warehoused” in hospitals and institutions move back into their communities. A growing body of evidence at that time demonstrated that mental illnesses could be treated more effectively and in a more cost-effective manner in community settings than in traditional psychiatric hospitals.

The Center for Mental Health is one such Community Mental Health Center and currently serves clients in Delta, Gunnison, Hinsdale, Montrose, Ouray, and San Miguel counties.

Our goal is to provide behavioral healthcare to anyone in our communities who may need it. We know that good mental health is essential to overall health and personal well-being. Emotional problems can impair a person’s thinking, feelings, and behavior and, over time, can become increasingly serious and disabling.

As a local Community Mental Health Center, we try to make sure everyone has access to affordable, high-quality care. Offering 24/7 crisis and support services, individual and group therapy, and maintaining offices in rural areas are just some of the ways we support our residents.

During this time of COVID-19, we have watched our communities pull together in countless ways to support one another. It is critical that our neighbors feel connected and supported during this time. As we close out this year’s Mental Health Awareness Month, we encourage you to continue caring for each other. If you see someone who needs extra support, please reach out and use The Center for Mental Health as your community resource.

Sincerely,
Shelly J. Spalding, CEO
The Center for Mental Health
www.centermh.org
970.252.3200