Aurora-based UCHealth is launching a sweeping $100 million initiative to combat the state’s mental health crisis, with programs that will embed mental health professionals in primary care offices and ERs, expand virtual care, and ultimately see the opening of an inpatient behavioral health unit at the University of Colorado Hospital in the east Denver suburb.
The move, announced Wednesday, comes amid a yearlong project by The Gazette highlighting Colorado’s lack of access to mental health care. The investigation showed that as many as 382,000 Colorado residents lack access to mental health services, and even those who can get care often aren’t getting what they need.
A matching donation program could mean as much as $150 million will be available for the nonprofit regional health system’s “multi-pronged” approach, which will include the hiring of 60 mental health professionals at UCHealth’s 12 acute-care hospitals and the offices of affiliated physicians in Colorado, southern Wyoming and western Nebraska.
“We’re asking others to join us, in that we’re putting up another $25 million in dollar-to-dollar matches for philanthropic donations,” said UCHealth president and CEO Elizabeth Concordia. “So the other component here, not only are we stepping up, we are looking to partner with anyone else and help them get interested in this as well.”
UCHealth’s plans will be rolled out over the next five years, and the new mental health wing on Aurora’s Anschutz Medical Campus isn’t due to open until 2023. Patients, however, should begin seeing changes at the local level over the next 18 months as moves to integrate behavioral health care into the primary care and emergency room settings are put into play and expanded.
“What the patient should actually start seeing is licensed clinical social workers and psychologists working hand in hand with primary care physicians to have immediate resources in behavioral health, as opposed to going to their primary care physician and then being referred and trying to find a behavioral health resource,” Concordia said.
“We think it will significantly improve access for the residents in Colorado and specifically for Colorado Springs in those primary care practices.”
The expansion of UCHealth’s behavioral health telecare program, which allows patients to consult with mental health providers by video connection, will help bring such services to rural areas that lie in the state’s vast mental health care desert. Thirty-nine Colorado counties don’t have a single practicing psychiatrist.
Telecare in the ER can help patients and busy doctors tasked with treating a chronic psychological issue in a crisis setting, said Chris Gessner, president and CEO of University of Colorado Hospital, where the top five emergency room diagnoses are all behavioral health-related.
“The integration into primary care is sort of a longer-term strategy that’s going to take some time and is the best way to manage this, but we realize that ... there are going to be people in crisis today, and tomorrow, and they will be showing up at our emergency room because there’s no other place else for them to go,” Gessner said.
“We are working in various parts of UCHealth to equip our emergency rooms to better take care of those patients by telesupport with behavioral health professionals, as well as creating certain areas in the emergency department where we have behavioral health triage-type centers that can quickly assess their problem and determine where they need to be seen next. Not all of those patients need to be admitted.”
Gessner said that while some components of the UCHealth plan are “up and running” in other parts of the country, to combine so many approaches with such bold financial backing, and launch everything all at once, is “pretty unique.”
It’s hoped that the initiative can not only change the way people with behavioral health diagnoses access care in Colorado, but how patients, physicians and the general public think about wellness, Gessner said.
“In order for them to have optimal outcome and experience, we need to provide behavioral health in an integrated fashion with their medical care. A lot of times in this country, they think of those as silos. Medical care is on one side; behavioral health is on the other,” Gessner said.
“I think that’s just old-fashioned thinking that needs to go away, and that’s what this effort is all about — sort of integrating those to achieve ultimate outcomes.”
Dr. Neill Epperson, chair of psychiatry at the University of Colorado School of Medicine, said she hopes the multimillion-dollar investment will help patients access the care they need. She also hopes it will serve to lure more students into the mental health fields, including psychiatry, where they are so desperately needed.
“Here at CU, we had 15 people from our medical school class in the past year apply for residencies in psychiatry” out of a class of about 180 students, she said. “That is the most we’ve ever had, and also the most I’ve ever heard of, percentagewise. We are pouring them out — pouring out people who are passionate about psychiatry and mental health — but we can’t pour them out fast enough.”
Epperson said she also believes the UCHealth project could advance mental health treatment efforts on a national scale, in ways that might be hard to imagine.
“There are a number of other states in a similar situation to us. I think we can really be a model for how a health system and an academic department can work together ... to not only promote good patient care but to create new knowledge that will then further promote good patient care,” Epperson said.
“Not only do we have the capacity to train the workforce ... we also have the capacity to add the research mission, which I think will promote new knowledge which can then be put back into the system to improve our outcome. For everyone.”
“We are pouring them out — people who are passionate about psychiatry and mental health — but we can’t pour them out fast enough.” Dr. Neill Epperson, chair of psychiatry, University of Colorado School of Medicine