Report reveals fewer beds and more pressure on Colorado's state mental health system

A report by a national nonprofit shows Colorado ranks near the bottom when it comes to available beds for psychiatric care.

 "The number of state psychiatric hospital beds for adults with severe mental illness has continued to decline to a historic low of 36,150, or 10.8 per 100,000 population in 2023," says the Treatment Advocacy Center, a Virginia based nonprofit.

Colorado's numbers are even lower than the national average with 83 beds per 100,000 people. There were 543 beds in 2016 and last year there were 482.

More have been added this year, says Leora Joseph, the director of the Office of Civil and Forensic Mental Health with the Department of Human Services. But the state still has staffing problems, particularly when it comes to nursing.

"And the data is showing us that more beds make a difference. We're asking for more beds," Joseph told a meeting of a Joint Justice Committee of the Colorado Legislature Wednesday afternoon. "In the last 10 years, we have seen a 46% increase in severe mental illness."

 The trend of reducing the number of beds has hit nationwide, says the Treatment Advocacy Center's executive director Lisa Dailey.

"It is a little surprising that it still continues, and we are still losing beds, and we're still losing staffed beds," she said.

The number of beds available for people with severe mental illness is now at 36,150, with the majority being devoted to people committed to facilities by the criminal justice system.

"Despite the increasing use of state hospitals for forensic patients, thousands of inmates with serious mental illness languish in jail for months, or even years, waiting for a state hospital bed to open," Dailey said.

In Colorado increasing demand for those bed spaces has come along with an increase in mental illness as lawyers seek mental health reviews and judges increase their orders committing people to the state facilities to have their ability to stand trial determined.

"From 2018 until now, we have seen 160% increase in court ordered restorations services," Joseph told the committee.

Courts seek to have criminal suspects restored to mental competency to stand trial. They are not at state facilities like the one in Pueblo for long term treatment.

Many families have pushed people into the criminal justice system with hopes that it is the pathway to getting help, with a shortage of options in other places.

"So really the conclusion that it that you almost can't avoid from looking at these numbers is that we're really creating a system that's invested almost entirely in ensuring that... we're only delivering care after a crime has been committed, or after a person has already had their symptoms criminalized and they've ended up being arrested," said Dailey.

Joseph is asking the state to increase funding to open more beds as hundreds wait for a spot. Most wait in jails without conviction. The average is 93 days. Things got worse during the pandemic when there were fewer treatment options says Joseph.

"And if you don't treat the situation, what happens? It gets worse. So it's growing and growing upon itself."

She is hoping for more improvements with recruitment and retention and more available beds. But it won't be immediate, even if more money is approved.

"It's not going to be tomorrow that we fix it, but we now have tools that are going to allow us to move these patients into beds to get the treatment that they need."