Calls to the Colorado Crisis Line, a state-funded service operated by the nonprofit Rocky Mountain Crisis Partners, have hit an all-time high during the coronavirus pandemic.
The same goes for mental health services provided via telehealth, according to the Colorado Department of Human Services and the Colorado Department of Public Health and Environment.
And it's coming at a time when the Joint Budget Committee is in the process of cutting what's paid to providers of those services.
Last Saturday, the JBC slashed $17 million from behavioral health services and more could be likely as the committee looks for $2.5 billion in cuts to balance the 2020-21 budget.
Robert Werthwein, director of the CDHS department of behavioral health, said that in March the crisis line had its highest volume of calls ever, more than 21,000, a 57% increase over the previous March. February and April also had record calls, and the same looks to continue in May.
In addition to the volume, calls are lasting longer, averaging 11 to 13 minutes each.
Werthwein attributed the increases to the stresses of COVID-19, and "exacerbated emotions" coming out of the pandemic. Those calls touch on financial or relationship issues, anxiety, depression, thoughts of suicide and substance use.
But the budget woes will have an impact on the availability of behavioral health services, not just the crisis line.
The one glimmer of hope: federal funds, including from the CARES Act, may be able to play a role in keeping those services funded.
While the federal guidance on CARES has been that the money — Colorado got $1.673 billion about two weeks ago — can't be used to backfill cuts, it can be used to cover costs related to the pandemic.
Werthwein said they're looking at federal money as well as what can be provided at the local level. But he added that they won't know the full extent of the cuts until lawmakers finish their work on the 2020-21 budget.
Another concern among state officials is suicide prevention, especially among youth and young adults.
The majority of suicide deaths in Colorado, some 70%, are adults ages 25 to 64, according to Lena Heilmann of the office of suicide prevention at CDPHE.
Most of those who contemplate suicide don't go through with it, Heilmann said. Because suicide is a public health issue, it's important to acknowledge why people consider it. Cultural reasons, food insecurity, isolation, discrimination and lack of housing can all contribute to feelings of suicide, she said. The isolation tied to COVID-19 is another factor, she said.
With kids out of school, isolated from their normal peer connections, that's leading to an increased volume of kids needing mental health services, such as those provided by Children's Hospital. Jason Williams, director of operations for the Pediatric Mental Health Institute at Children's, said it's especially acute for those ages 12 to 15.
While the rest of the hospital's beds are readied for those suffering from the virus, and not always occupied, the hospital's psychiatric in-patient units have been full for some time, Williams said. The requirements for social distancing have also resulted in changes in how mental health services are delivered, Williams explained, such as relying more on telehealth.
Williams said that prior to the pandemic, they'd schedule about 100 telehealth appointments per week. It's now 6,000 per week.
He also asked that the budget writers do what they can to protect behavioral health services.
The crisis line can be reached at 1-844-493-8255, or by texting "TALK" to 38255.
CDHS also has started two educational campaigns, one targeting adults and another directed at young people, known as "Below the Surface."