Time to address mental health
When politicians and commentators talk about Colorado’s unmet budgetary needs, they usually highlight spending on education and transportation. Occasionally, they’ll notice the $32 billion unfunded liability in the public pension system that glowers over the state’s future like an angry cloud. But mention mental health care, and their eyes often go blank. What’s the backlog there?
A big one, actually. The state’s major mental health hospital in Pueblo and the smaller Fort Logan facility are aging and have struggled to keep up with soaring demand for services and beds. And yet the combined price tag for a new Denver area hospital and upgrading the Pueblo facility checks in at more than $650 million.
We mention this by way of providing context to the state’s mental health challenge, not because we expect major construction anytime soon. But lawmakers are hardly off the hook. They need to take action to alleviate a crisis involving a shortage of inpatient mental health beds by approving three Senate bills ( 250, 251 and 252) that were filed last week.
Without reforms in those bills, including $4 million in additional funding, the state is facing potentially ruinous fines for violating a legal settlement governing how pretrial detainees are evaluated for mental competence to stand trial and how those ruled incompetent receive treatment.
As recently as the turn of the century, according to the state Department of Human Services, Colorado courts ordered 332 annual competency evaluations for pretrial detainees. In the most recent fiscal year, by contrast, they ordered 2,072 — a staggering increase.
During the same period, the number of court-ordered “restorations” — treatment that restores individuals to a condition that allows them to face charges — spiked from 87 a year to nearly 900.
Experts can debate why courts are directing so many more peo- ple into the mental health system, but the fact is the state has no choice but to deal with them in a timely fashion. But it is failing at the task, by its own admission.
Under a legal settlement reached with Disability Law Colorado, the state must offer inpatient competency and restoration services to everyone who needs them within 28 days. At the end of last year, however, more than half of 179 defendants in line for such services had been waiting longer than that. It’s only a matter of time before a court decides to impose penalties on the state, as a federal judge did when the state of Washington violated a similar agreement.
Although SB 250 would strengthen jail-based behavioral health services, especially in rural facilities, the legislative package isn’t mainly about boosting resources. Indeed, no one believes the state can spend its way out of the problem given the trajectory of court-ordered evaluations and restorations.
Instead, the bills seek to ensure defendants get evaluations and treatment at the most appropriate setting. Most detainees do not need to be sent to state hospital for a competency evaluation, for example, and many individuals deemed incompetent can be treated on outpatient basis rather than occupy scarce, expensive hospital beds.
To that end, SB 251 assigns behavioral health professionals as court liaisons who can assist judges in identifying treatment options in their communities. SB 252 institutes numerous reforms, including capping the time individuals involved in less serious offenses can be confined while being restored to competency.
All three bills are scheduled for a hearing Monday in the Senate Finance Committee, and they’ll need smooth sailing to get through both chambers by the May 9 adjournment. But there’s really no alternative if the state is going to treat mentally ill defendants in the manner they deserve while avoiding a costly judicial reaction to the unacceptable status quo.
The members of The Denver Post’s editorial board are William Dean Singleton, chairman; Chuck Plunkett, editor of the editorial pages; and Megan Schrader, editorial writer.