Short of staff and beds, mentally ill remain in Colorado's jails and on our streets

Milena Castaneda has moved on. For two years after earning a degree, she worked as a caseworker, assisting people with chronic mental health problems. But now she's working a new job.

"I love it and I miss it to this day. I miss doing direct service because I remember the change I would make on the individual level."

 The pay was low and the work was hard. She made little more than minimum wage. She understands why there are staffing issues.

"You're requiring them to go to get undergrad, graduate even licensure for little pay and they don't see that as really worth it."

It hits home with the mentally ill who live on the streets or reside in Colorado's jails and end up in emergency rooms and in the courts in an inefficient system that leaves gaping holes.

"I think it's one of the most pressing issues of our time. And I think we're squeezed in a way," said Vincent Atchity, CEO and President of Mental Health Colorado.

The state is short of beds at in-patient mental health facilities and people to staff them. People like 23-year-old Olivia Schack wait in jail.

"She's been dealing with Jefferson County Mental Health since she was 17 and they told us that we needed to start pressing charges to get her in the system," said her mother Kendra Anderson.

Schack, who has schizoaffective disorder and other mental health problems has lived on the streets, self-medicated with drugs and has been in and out of the criminal justice system. A judge ordered her to a state mental facility in December, but she remains in jail without conviction.

A lawsuit brought by Disability Law Colorado against the Department of Human Services for holding people with long term mental health needs in jail settings means the state has entered into a consent agreement to either get them to mental health facilities in a month or pay fines.

"We're not in compliance with that. We have about 440 people in jail, many of whom have been waiting for one year for a bed," said Leora Joseph, the Department of Human Services Director Office of Civil and Forensic Mental Health.

 The fine, fortunately is capped at $12 million a year. It could be far higher.

Colorado already had shortfalls before being hit with additional demands that came along with the pandemic.

"We do have approximately 84 beds that we had to close during the pandemic, but we are slowly building back," said Joseph.

Many nurses left. In 2022, the state was only able to hire four. A $14,000 signing bonus this year has meant 11 have been added, but the state is still short. There are 100 beds at the state facility in Pueblo available, but that cannot be used due to staffing shortages. Demand has risen. There has been an 81% increase in the number of mental health referrals requested by judges adding to the backup.

"So our ability to serve patients in the hospital has decreased at the same time that we've seen this increase," said Joseph.

The mental health community as a whole is aware of the problems.

"It's a colossal disaster for the management of the population," said Atchity. In addition to being ineffective, it is wasteful, he said.

"The state is paying out taxpayer dollars for our inability as a state to do what is legally essential and humanely appropriate for folks... If we could get ahead of the game and take care of people properly we'd manage the behavior and we'd be not in this endless loop of waste."

"The system itself has always been broken, it's always been flawed," said Castenada. Health care is far better at treating visible problems like broken limbs, she said.

"I believe our system sees that if you don't see it, it's not an issue, so we ignore it." Meantime, in addition to the 440 waiting in jails for treatment, many more with serious mental health problems remain on the streets, turned over and over in a system of jails, courts, emergency rooms and other costly services.

In 2022, the state legislature approved more beds. In 2023 lawmakers approved a study of potential solution for the problems. But decades of ignoring the problem have created a system of inefficiency and failure.

"There's not going to be any quick fixes and no quick amount of money that will be saved quickly with a very quick fix. That's just not what we're dealing with here," said Joseph.