It is curious that our health care system has, until recently, had an almost exclusive focus on physical health.
Got the flu, high blood pressure, an ankle sprain? No problem. Though Southwest Colorado is designated as a health professional shortage area with a medically underserved population, primary care is increasingly available to residents in our region.
The Affordable Care Act has helped people gain insurance and, with it, removed a significant barrier to accessing care, as have new practices including two federally designated community health centers in Cortez and Durango. These provide primary and behavioral health care to residents of all income levels via a sliding fee scale, and public and private insurance.
But why has our health care system focused only on the physical body when the mind is as much a part of who we are? Depressed, anxious or suicidal? Thousands of Coloradoans struggle, sometimes daily, with their mental health. Some people struggle more than others and have a hard time accessing the care they need. That was the point of Healthier Colorado’s recent “In our Shoes” walk from Cortez to Durango. Its aim was to highlight that access to mental and behavioral health providers is significantly limited in our state’s rural areas, with only one behavioral health provider per 6,008 residents. But is there a lack of providers? Or a lack of knowledge and barriers to accessing them? What type of care is lacking?
To know, it is important to differentiate the types of care. Mental health care helps people with, or at risk of, mental illness. Behavioral health comprehensively focuses on mental health and substance abuse, co-occurring conditions often prevalent among and contributing to becoming homeless. Crisis care is for people who need crisis stabilization and often a result of people not getting help soon enough.
Healthier Colorado is well-intended in its efforts to call attention to the need for action around rural Coloradoans’ access to mental and behavioral health services. Though gaps certainly do exist, some of the services it indicated were unavailable in Cortez are in fact available there and mobile throughout the region.
Axis Health System provides 85 percent of regional mental and behavioral health care and the majority of crisis health care services in our five-county region that includes Montezuma, Dolores, La Plata, San Juan and Archuleta counties.
As such, it has a responsibility to let people in their service area know about and how to access available services. That includes regionwide outreach to health and human service providers and even its own employees, so staff at each of its eight clinics across the region is informed about the variety of health care services they offer and can share that information with the public. If people do not know about or how to access services, then in their minds, the services do not exist.
Better communication is one way to help connect people with mental and behavioral health care services. Another is to continue to convene regional stakeholders to learn more about the positive efforts, and the work that remains, as did the El Pomar Foundation’s Southwest Regional Council earlier this month.
So doing will help us understand the needs and how to meet them, identify barriers to care and how to reduce them, and together begin to develop a road map to better meet the mental and behavioral health care needs of residents of our rural region.